PDF(Pubmed)
Abstract：
BACKGROUND: Although pleomorphic adenoma (PA) is the most common neoplasm of both minor and major salivary glands, its presence in the buccal surface of upper lip is rare.
METHODS: A 70-year-old male presented with a chief complaint of recent rapid growth of a mass in the buccal aspect of the upper lip. A well-circumscribed mass measuring 3 × 2 cm with intact overlying mucosa without regional lymphadenopathy was evident. Core needle biopsy report was suggestive of PA. Complete excision of the tumor was performed. The defect was large and primary closure was not possible. Reconstruction with FAMM flap was planned. After 4 weeks, the flap was covered with epithelia and created a satisfactory result.
CONCLUSIONS: The definite diagnosis of PA is based on histopathological examination. The following features help to differentiate PA from other tumors; tubuloalveolar and gland-like structures, islands of cuboidal or polygonal cells in a chondroid, hyalinized, fibroadipose or mucinous hypocellular stroma which are stained positively for periodic acid-Schiff and Alcian. Despite these characteristics, differentiation of PA from dermal mixed tumor may be challenging especially when the specimen is from the upper lip. The main advantages of FAMM.F are being thin and pliable flap, having wide arc of rotation; being suitable for reconstruction of mucosal defects; resistance against postoperative radiotherapy and easy harvesting.
CONCLUSIONS: The FAMM flap is a reliable reconstruction technique for medium-sized intraoral defects with limited morbidity to the donor site. It provides functional reconstruction of the oral cavity with a low risk of post-operative complications.
METHODS: A 70-year-old male presented with a chief complaint of recent rapid growth of a mass in the buccal aspect of the upper lip. A well-circumscribed mass measuring 3 × 2 cm with intact overlying mucosa without regional lymphadenopathy was evident. Core needle biopsy report was suggestive of PA. Complete excision of the tumor was performed. The defect was large and primary closure was not possible. Reconstruction with FAMM flap was planned. After 4 weeks, the flap was covered with epithelia and created a satisfactory result.
CONCLUSIONS: The definite diagnosis of PA is based on histopathological examination. The following features help to differentiate PA from other tumors; tubuloalveolar and gland-like structures, islands of cuboidal or polygonal cells in a chondroid, hyalinized, fibroadipose or mucinous hypocellular stroma which are stained positively for periodic acid-Schiff and Alcian. Despite these characteristics, differentiation of PA from dermal mixed tumor may be challenging especially when the specimen is from the upper lip. The main advantages of FAMM.F are being thin and pliable flap, having wide arc of rotation; being suitable for reconstruction of mucosal defects; resistance against postoperative radiotherapy and easy harvesting.
CONCLUSIONS: The FAMM flap is a reliable reconstruction technique for medium-sized intraoral defects with limited morbidity to the donor site. It provides functional reconstruction of the oral cavity with a low risk of post-operative complications.
摘要：
背景：尽管多形性腺瘤（PA）是小唾液腺和大唾液腺中最常见的肿瘤，它在上唇颊表面的存在是罕见的。
方法：一名70岁男性主诉是最近上唇颊部肿块迅速增长。可见明确的肿块，大小为3×2cm，粘膜完整，无局部淋巴结肿大。核心针活检报告提示PA。进行肿瘤的完全切除。缺损较大，无法进行初次闭合。计划使用FAMM皮瓣进行重建。4周后,皮瓣被上皮覆盖，产生了令人满意的效果。
结论：PA的明确诊断取决于组织病理学检查。以下特征有助于将PA与其他肿瘤区分开来；肾小管肺泡和腺样结构，软骨细胞中的立方体或多边形细胞的岛，透明质化，纤维脂肪或粘液性低细胞基质，对高碘酸Schiff和Alcian染色呈阳性。尽管有这些特点,PA与真皮混合瘤的区别可能具有挑战性，尤其是当标本来自上唇时。FAMM的主要优点。F是薄而柔韧的皮瓣，具有较宽的旋转弧度；适用于粘膜缺损的重建；耐术后放疗，易于收获。
结论：FAMM皮瓣是一种可靠的重建技术，适用于中等大小的口内缺损，对供体部位的发病率有限。它提供了口腔的功能重建，术后并发症的风险较低。
方法：一名70岁男性主诉是最近上唇颊部肿块迅速增长。可见明确的肿块，大小为3×2cm，粘膜完整，无局部淋巴结肿大。核心针活检报告提示PA。进行肿瘤的完全切除。缺损较大，无法进行初次闭合。计划使用FAMM皮瓣进行重建。4周后,皮瓣被上皮覆盖，产生了令人满意的效果。
结论：PA的明确诊断取决于组织病理学检查。以下特征有助于将PA与其他肿瘤区分开来；肾小管肺泡和腺样结构，软骨细胞中的立方体或多边形细胞的岛，透明质化，纤维脂肪或粘液性低细胞基质，对高碘酸Schiff和Alcian染色呈阳性。尽管有这些特点,PA与真皮混合瘤的区别可能具有挑战性，尤其是当标本来自上唇时。FAMM的主要优点。F是薄而柔韧的皮瓣，具有较宽的旋转弧度；适用于粘膜缺损的重建；耐术后放疗，易于收获。
结论：FAMM皮瓣是一种可靠的重建技术，适用于中等大小的口内缺损，对供体部位的发病率有限。它提供了口腔的功能重建，术后并发症的风险较低。
