Extensive review in the detection of the malignant transformation of pleomorphic adenoma.

BACKGROUND AND OBJECTIVES: There is an increasing likelihood of malignant change in pleomorphic adenoma (PA) with time. This extensive review aims to highlight the current areas of difficulty or controversy in the diagnosis of malignant transformation of pleomorphic adenoma - a subject of most interest and challenge to a pathologist. It is also the objective of this review to compare the clinical and pathological points-of-view on the diagnosis of malignant transformation of pleomorphic adenoma. METHODS: A literature search using MEDLINE, accessed through the National Library of Medicine PubMed interface, for articles relating to malignant transformation of pleomorphic salivary adenoma written in the English language. RESULTS: The updated literature indicates that carcinomas in pleomorphic adenoma may arise in an older age group than benign lesions and are usually larger and longer standing lesions. The use of molecular changes to study malignant transformation of pleomorphic adenoma, unfortunately, have no specific expression on the tumor suppressor genes to detect the malignant transformation of pleomorphic adenoma from pathological point view. CONCLUSION: The use of combined clinical evidence and pathological evidence are very important in the detection of the malignant transformation of pleomorphic adenoma. KEYWORDS: pleomorphic adenoma, malignant transformation of pleomorphic adenoma.