DEEP LOBE PLEOMORPHIC ADENOMA OF THE PAROTID GLAND - A CLINICOPATHOLOGICAL STUDY WITH A REVIEW OF MOLECULAR GENETICS

Abstract

Background: Pleomorphic adenoma is the most common benign tumour of the salivary glands. It usually occurs in the superficial part of the parotid gland, while tumours arising from the deep lobe are uncommon. Deep lobe tumours can be difficult to diagnose and treat because of their location and close relation to important structures like the facial nerve and parapharyngeal space. This study includes patients diagnosed with deep lobe pleomorphic adenoma at a tertiary care centre over a period of 2 years. Information was collected regarding patient history, symptoms, imaging (CT/MRI), surgical approach, and postoperative results. All cases were confirmed by histopathological examination. Aims and Objectives: 1. To study the incidence of Deep Lobe Pleomorphic Adenoma of parotid gland lesions in patients attending ENT OPD/admitted in ENT ward in our region. 2. To evaluate the distribution in age, sex, modes of presentation of the parotid gland swellings. 3. To study histomorphology of parotid salivary gland lesions and correlate with FNAC findings. Subjects and Methods: Patients admitted in ENT WARD/attending ENT OPD with FNAC proven Pleomorphic Adenoma parotid swellings are selected for the present study from 1st Jan 2024 to 1st January 2026. A prospective clinical study is conducted over the selected group for their age, sex, modes of presentation and their investigations. Study on various treatment modalities and their operative approach has been done. Observation and Results: The parotid gland lesions were more common in females and in most of the cases belonged to lower socioeconomic status. The most common investigation done was Fine needle aspiration cytology. In maximum cases Superficial Parotidectomy was done. Total Conservative Morbidity was done in few cases. Morbidity with facial nerve paralysis was seen in 1 case. Facial nerve paresis was seen in 2 cases. Conclusion: This study is a single institutional experience of 10 cases. Deep lobe pleomorphic adenoma is a rare condition that requires careful evaluation. Imaging plays an important role in diagnosis and surgical planning. Complete surgical removal with preservation of the facial nerve provides good outcomes and low chances of recurrence. Most of the patients were in fourth decade of life. Imaging, especially MRI, helped in identifying the exact size and extent of the tumour. Fine needle aspiration cytology and histopathological examination plays a crucial role in diagnosis and treatment of these cases. Management was mainly operative. No major complications or recurrence were noted during follow-up.