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Head and Neck
Diagnosis
Parotid Space
Malignant Tumors
Parotid Malignant Mixed Tumor
Parotid Malignant Mixed Tumor
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Malignant mixed tumor (MMT)

          • Synonyms

            • Carcinoma ex pleomorphic adenoma
            • Carcinoma ex benign mixed tumor

          • Definitions

            • Malignant tumor arising within parotid benign mixed tumor (BMT)
            • 2 types of MMT
              • Carcinoma ex pleomorphic adenoma
                • Common MMT type
                • Consists of single malignant cell type
              • Carcinosarcoma (true MMT)
                • Consists of multiple malignant cell types
                • Very rare (< 70 cases in literature)

          IMAGING

          • General Features

            • MR Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    • Staging, Grading, & Classification

                      • Gross Pathologic & Surgical Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Okano K et al: Cytological features of carcinoma ex pleomorphic adenoma of the salivary glands: a diagnostic challenge. Diagn Cytopathol. 48(2):149-53, 2020
                                  2. Gupta A et al: Carcinoma ex pleomorphic adenoma: a review of incidence, demographics, risk factors, and survival. Am J Otolaryngol. 40(6):102279, 2019
                                  3. Rauso R et al: Ossified Carcinoma Ex Pleomorphic Adenoma in accessory lobe of parotid gland: Complexity in clinical, imaging and histologic diagnosis and minimally invasive surgery. Oral Oncol. 92:95-98, 2019
                                  4. Seok J et al: The Difference in the Clinical Features Between Carcinoma ex Pleomorphic Adenoma and Pleomorphic Adenoma. Ear Nose Throat J. 98(8):504-509, 2019
                                  5. Covinsky M et al: Low Grade Carcinoma Ex-Pleomorphic Adenoma: Diagnosis and Diagnostic Challenges Caused by Fine Needle Aspiration: Report of Three Cases and Review of Literature. Head Neck Pathol. 12(1):82-88, 2018
                                  6. Ogawa T et al: Clinical utility of dynamic-enhanced MRI in salivary gland tumors: retrospective study and literature review. Eur Arch Otorhinolaryngol. 275(6):1613-1621, 2018
                                  7. Katayama I et al: Perfusion MR imaging detection of carcinoma arising from preexisting salivary gland pleomorphic adenoma by computer-assisted analysis of time-signal intensity maps. PLoS One. 12(5):e0178002, 2017
                                  8. Kashiwagi N et al: Carcinoma ex pleomorphic adenoma of the parotid gland. Acta Radiol. 53(3):303-6, 2012
                                  9. Katabi N et al: Prognostic factors of recurrence in salivary carcinoma ex pleomorphic adenoma, with emphasis on the carcinoma histologic subtype: a clinicopathologic study of 43 cases. Hum Pathol. Epub ahead of print, 2010
                                  10. Lüers JC et al: Carcinoma ex pleomorphic adenoma of the parotid gland. Study and implications for diagnostics and therapy. Acta Oncol. 48(1):132-6, 2009
                                  11. Kato H et al: Carcinoma ex pleomorphic adenoma of the parotid gland: radiologic-pathologic correlation with MR imaging including diffusion-weighted imaging. AJNR Am J Neuroradiol. 29(5):865-7, 2008
                                  12. Zbären P et al: Carcinoma ex pleomorphic adenoma: diagnostic difficulty and outcome. Otolaryngol Head Neck Surg. 138(5):601-5, 2008
                                  13. Völker HU et al: True malignant mixed tumour (carcinosarcoma) of submandibular gland--a rare neoplasm of monoclonal origin? Histopathology. 50(6):795-8, 2007
                                  14. Fan KF et al: MRI findings of carcinosarcoma in the parotid gland. Oral Oncol. 42(3):323-6, 2006
                                  15. Fowler MH et al: Malignant mixed tumors of the salivary gland: a study of loss of heterozygosity in tumor suppressor genes. Mod Pathol. 19(3):350-5, 2006
                                  16. Sheedy SP et al: CNS metastases of carcinoma ex pleomorphic adenoma of the parotid gland. AJNR Am J Neuroradiol. 27(7):1483-5, 2006
                                  17. Tortoledo ME et al: Carcinomas ex pleomorphic adenoma and malignant mixed tumors. Histomorphologic indexes. Arch Otolaryngol. 110(3):172-6, 1984
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Malignant mixed tumor (MMT)

                                          • Synonyms

                                            • Carcinoma ex pleomorphic adenoma
                                            • Carcinoma ex benign mixed tumor

                                          • Definitions

                                            • Malignant tumor arising within parotid benign mixed tumor (BMT)
                                            • 2 types of MMT
                                              • Carcinoma ex pleomorphic adenoma
                                                • Common MMT type
                                                • Consists of single malignant cell type
                                              • Carcinosarcoma (true MMT)
                                                • Consists of multiple malignant cell types
                                                • Very rare (< 70 cases in literature)

                                          IMAGING

                                          • General Features

                                            • MR Findings

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    • Staging, Grading, & Classification

                                                      • Gross Pathologic & Surgical Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Okano K et al: Cytological features of carcinoma ex pleomorphic adenoma of the salivary glands: a diagnostic challenge. Diagn Cytopathol. 48(2):149-53, 2020
                                                                  2. Gupta A et al: Carcinoma ex pleomorphic adenoma: a review of incidence, demographics, risk factors, and survival. Am J Otolaryngol. 40(6):102279, 2019
                                                                  3. Rauso R et al: Ossified Carcinoma Ex Pleomorphic Adenoma in accessory lobe of parotid gland: Complexity in clinical, imaging and histologic diagnosis and minimally invasive surgery. Oral Oncol. 92:95-98, 2019
                                                                  4. Seok J et al: The Difference in the Clinical Features Between Carcinoma ex Pleomorphic Adenoma and Pleomorphic Adenoma. Ear Nose Throat J. 98(8):504-509, 2019
                                                                  5. Covinsky M et al: Low Grade Carcinoma Ex-Pleomorphic Adenoma: Diagnosis and Diagnostic Challenges Caused by Fine Needle Aspiration: Report of Three Cases and Review of Literature. Head Neck Pathol. 12(1):82-88, 2018
                                                                  6. Ogawa T et al: Clinical utility of dynamic-enhanced MRI in salivary gland tumors: retrospective study and literature review. Eur Arch Otorhinolaryngol. 275(6):1613-1621, 2018
                                                                  7. Katayama I et al: Perfusion MR imaging detection of carcinoma arising from preexisting salivary gland pleomorphic adenoma by computer-assisted analysis of time-signal intensity maps. PLoS One. 12(5):e0178002, 2017
                                                                  8. Kashiwagi N et al: Carcinoma ex pleomorphic adenoma of the parotid gland. Acta Radiol. 53(3):303-6, 2012
                                                                  9. Katabi N et al: Prognostic factors of recurrence in salivary carcinoma ex pleomorphic adenoma, with emphasis on the carcinoma histologic subtype: a clinicopathologic study of 43 cases. Hum Pathol. Epub ahead of print, 2010
                                                                  10. Lüers JC et al: Carcinoma ex pleomorphic adenoma of the parotid gland. Study and implications for diagnostics and therapy. Acta Oncol. 48(1):132-6, 2009
                                                                  11. Kato H et al: Carcinoma ex pleomorphic adenoma of the parotid gland: radiologic-pathologic correlation with MR imaging including diffusion-weighted imaging. AJNR Am J Neuroradiol. 29(5):865-7, 2008
                                                                  12. Zbären P et al: Carcinoma ex pleomorphic adenoma: diagnostic difficulty and outcome. Otolaryngol Head Neck Surg. 138(5):601-5, 2008
                                                                  13. Völker HU et al: True malignant mixed tumour (carcinosarcoma) of submandibular gland--a rare neoplasm of monoclonal origin? Histopathology. 50(6):795-8, 2007
                                                                  14. Fan KF et al: MRI findings of carcinosarcoma in the parotid gland. Oral Oncol. 42(3):323-6, 2006
                                                                  15. Fowler MH et al: Malignant mixed tumors of the salivary gland: a study of loss of heterozygosity in tumor suppressor genes. Mod Pathol. 19(3):350-5, 2006
                                                                  16. Sheedy SP et al: CNS metastases of carcinoma ex pleomorphic adenoma of the parotid gland. AJNR Am J Neuroradiol. 27(7):1483-5, 2006
                                                                  17. Tortoledo ME et al: Carcinomas ex pleomorphic adenoma and malignant mixed tumors. Histomorphologic indexes. Arch Otolaryngol. 110(3):172-6, 1984