Sebaceous adenoma of the parotid gland in a 16-year-old girl

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• Summary
• 1. Introduction
• 2. Case report
• 3. Discussion
• References
• Copyright

Summary 

Sebaceous adenomas of salivary gland origin are rare tumors, which mainly occurred in elderly adults. We present a case of sebaceous adenoma of the parotid gland in a 16-year-old girl.

Keywords: Sebaceous adenoma, Parotid gland, Neoplasm

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1. Introduction 

Although sebaceous glands are commonly found in the major salivary glands, sebaceous adenomas arising from these structures are rare, and no more than 10 cases of sebaceous adenoma in the parotid gland have been reported in the English literature [1], [2]. A review of these cases indicates most of the patients suffered from sebaceous adenoma were elderly adults, and that this tumor occured in an adolescent patient is exceedingly rare [3]. Here we report an uncommon case of sebaceous adenoma of the parotid gland in a 16-year-old girl.

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2. Case report 

A 16-year-old girl presented with a soft mass in her left parotid gland, and it had been noticed 5 days prior to presentation. The patient's medical history was uneventful and no details were obtained from her family history. Physical examination disclosed a mobile mass in the lower margin of the left parotid gland. The local skin was normal and the regional lymph nodes were not palpable. A magnetic resonance imaging indicated a soft tissue mass with 20mm×22mm in size in the superficial lobe of the left parotid gland. The rest of the examination was normal. Under general anesthesia, the mass was totally excised. Grossly, the excised lesion was yellowish, and under microscopy, the specimen showed a multilobulated entity, which was well circumscribed and separated by dense fibrous connective tissues. The varied sized lobules were composed of mature sebaceous cells and lined with less differentiated generative epithelial cells (Fig. 1), no signs of malignancy were found. The pathological diagnosis was sebaceous adenoma. No recurrence was revealed at a 15 months follow-up.

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• Fig. 1. 

  Photomicrograph showed sebaceous adenoma composed of numerous lobules of well-differentiated sebaceous cells centrally and generative cells formed squamous layer (HE, 10×).

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3. Discussion 

Sebaceous adenomas of the major salivary glands are rarely reported in adult patients, and these tumors occur most often in the parotid gland, less commonly in the submandibular, sublingual and minor salivary glands [4]. The clinical features of sebaceous adenoma are characterized by a painless and slowly growing mass. Histologically, this tumor is well circumscribed and composed of sebaceous lobules with irregular size and shape, and each lobule contained mature sebaceous cells and undifferentiated germinative cells in variable proportion [1].

The etiology of sebaceous adenoma of the salivary glands origin is unknown. The mean age of the patients suffered from sebaceous adenoma is 61.4 years old, and most of the tumors occurred in males [3]. The occurrence of a sebaceous adenoma in the salivary glands of a child before puberty is scarcely reported and only 1 child with sebaceous differentiation was noted out of 604 salivary glands examined [3]. Gnepp and Brannon stated the identical factors that activate sebaceous glands in the skin during puberty possibly activate those in the salivary glands [3]. In this case report, a 16-year-old girl with sebaceous adenoma of the parotid gland is presented. This is much younger than others have previously documented. Accordingly, the factors relative to the pathogenesis of this lesion may have been activated in childhood. Because the patient is in adolescence and these usually have a long term of asymptomatic status usually presented.

Sometimes, cutaneous sebaceous neoplasms could be indicatives of Muir–Torre syndrome, a rare autosomal dominant genodermatosis mainly affecting adults [5]. In this hereditary disease, one or more sebaceous neoplasms of skin occurr in association with multiple visceral malignancies giving them important predictive status of the 21 reported primary salivary gland sebaceous tumors, 2 patients had a history of prostatic carcinoma. The incidental association of sebaceous tumors in salivary glands with other malignancies does not always give rise to a diagnosis of Muir–Torre syndrome [3]. In the current case, the patient did not show any signs of the internal malignancy and did not recur in 15 months follow-up after surgery.

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References 

1. Lipani C, Woytash JJ, Greene GW. Sebaceous adenoma of the oral cavity. J. Oral Maxillofac. Surg. 1983;41:56–60
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2. de Vicente Rodriguez JC, Fresno Forcelledo MF, Gonzalez Garcia M, Aguilar Andrea C. Sebaceous adenoma of the parotid gland. Med. Oral Patol. Oral Circ. Bucal. 2006;11:E446–E448
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3. Gnepp DR, Brannon AR. Sebaceous Neoplasms of salivary gland origin. Report of 21 cases. Cancer. 1984;53:2155–2170
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4. Izutsu T, Kumamoto H, Kimizuka S, et al. Sebaceous adenoma in the retromolar region: report of a case with a review of the English literature. Int. J. Oral Maxillofac. Surg. 2003;32:423–426
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5. Ponti G, Ponz de Leon M. Muir–Torre syndrome. Lancet Oncol. 2005;12:980–987
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