Benign Salivary Tumors (Pleomorphic Adenoma)

Pleomorphic adenoma is the most common benign salivary gland tumor, accounting for the majority of non-malignant salivary neoplasms. It most frequently arises in the parotid gland, followed by minor salivary glands of the palate, lips, and buccal mucosa. Clinically, it presents as a slow-growing, painless, firm, and well-circumscribed swelling, often present for several years before diagnosis. Despite its benign nature, pleomorphic adenoma has a notable potential for recurrence and, rarely, malignant transformation if left untreated.

Histopathologically, pleomorphic adenoma is characterized by its mixed cellular composition, comprising epithelial and myoepithelial cells within a variable stromal background that may appear myxoid, chondroid, or fibrous. This histologic diversity explains the term “pleomorphic.” Imaging studies such as ultrasound, CT, or MRI are useful in defining tumor extent and planning surgical management, especially in major salivary glands.

The treatment of choice is complete surgical excision with adequate margins, as incomplete removal significantly increases the risk of recurrence. Enucleation alone is discouraged due to microscopic pseudopod extensions beyond the capsule. Long-term follow-up is recommended, as recurrences may occur many years after initial treatment. With appropriate surgical management, the prognosis of pleomorphic adenoma is excellent.