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Case Report
Multimodal treatment of atypical transformation of pleomorphic adenoma (PA) of the lacrimal gland into high-grade ductal carcinoma
1 PhD Student, Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
2 DDS, Master Candidate, Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
3 Resident of Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
4 Resident of Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
5 Resident of Department of Anatomic Pathology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
6 Researcher/PhD Holder, Department of Anatomic Pathology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
7 Head of Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
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Wilber E Bernaola-Paredes
Rua Prof. Antonio Prudente 211 – Liberdade, São Paulo, ZIP Code: 01509001,
Brazil
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Article ID: 101232Z01WP2021
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How to cite this article
Bernaola-Paredes WE, Filho VB, Carvalho HP, Chen FK, Dalcin JF, Costa FD, Pellizzon ACA. Multimodal treatment of atypical transformation of pleomorphic adenoma (PA) of the lacrimal gland into high-grade ductal carcinoma. Int J Case Rep Images 2021;12:101232Z01WP2021.ABSTRACT
Introduction: Pleomorphic adenoma (PA) is a tumor with a mix of components (epithelium-mesenchymal). It occurs more frequently in both the larger and smaller salivary glands, and less frequently in the lacrimal glands. The transformation of PA into high-grade Ductal carcinoma involves a series of histopathological, morphological, and molecular mechanisms, so that its occurrence is rare, nevertheless, the mortality rate is still high. Surgery in conjunction with adjuvant radiotherapy has been shown to be effective in locoregional disease control (LDS); however, the multimodal treatment indicated in the literature remains a controversial issue.
Case Report: The present case report aims to describe our experience with the multimodal treatment of an atypical presentation of transformation of PA of the lacrimal gland into a rapidly evolving high-grade ductal carcinoma, and to describe the proposed adjuvant radiation treatment.
Conclusion: Adjuvant radiotherapy is a feasible alternative for locoregional control of the disease, irrespective of the anatomopathologic characteristics of the tumor. Randomized clinical trial studies are recommended for an accurate assessment of the impact of multimodal treatment with respect to overall survival rates, locoregional survival, and disease-free survival.
Keywords: Adjuvant radiotherapy, Lacrimal gland, Malignant transformation, Mixed, Pleomorphic adenoma, Salivary gland tumor
SUPPORTING INFORMATION
Acknowledgments
The co-author Wilber E Bernaola-Paredes is student fellow and supported with a scholarship provided by the National Council for Scientific and Technological Development of Brazil (CNPq), Sao Paulo, Brazil (140071/2019-9).
Author ContributionsWilber E Bernaola-Paredes - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Valdener Bella Filho - Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Henrique Perez Carvalho - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Felipe Ko Chen - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
José Francisco Dalcin - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Felipe D'Almeida Costa - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Antonio Cassio Assis Pellizzon - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Wilber E Bernaola-Paredes et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
