Penatalaksanaan adenoma pleomorfik di palatum pada pasien dewasa muda dengan biopsi eksisi

https://doi.org/10.22146/mkgk.32012

Syahril Samad(1*), Asri Arumsari(2), Kiki Akhmad Rizki(3)

(1) Program Pendidikan Dokter Gigi Spesialis Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Padjajaran, Bandung, Jawa Barat, Indonesia
(2) Departemen Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Padjajaran, Bandung, Jawa Barat, Indonesia
(3) Departemen Bedah Onkologi, Fakultas Kedokteran Gigi, Universitas Padjajaran, Bandung, Jawa Barat, Indonesia
(*) Corresponding Author

Abstract


Adenoma pleomorfik adalah tumor pada kelenjar saliva minor yang paling sering terjadi di daerah palatum keras (43%). Tumor pada kelenjar saliva minor mayoritas berupa tumor ganas akan tetapi adenoma pleomorfik merupakan tumor jinak. Insidensi terbanyak pada dekade ke – 4 sampai ke – 6. Laporan kasus ini bertujuan untuk menjelaskan penatalaksanaan adenoma pleomorfik dan insidensi kejadiannya pada pasien dewasa muda. Pasien perempuan umur 16 tahun dengan benjolan pada palatum. Secara klinis tampak massa yang sewarna dengan jaringan sekitar, bulat, nodul tunggal, tidak bergerak, berbatas jelas, palpasi agak keras, dan tanpa rasa sakit, diameter 4×3 cm,3×2 cm dengan pertumbuhan yang lambat. Foto rontgen panoramik dan waters menunjukkan adanya massa dan biopsi insisi menunjukkan adanya adenoma pleomorfik. Dilakukan terapi definitif untuk pengangkatan tumor dengan bedah eksisi. Pemeriksaan histopatologi memperlihatkan hasil yang sama dengan biopsi insisi. Kemudian, dilakukan pemasangan obturator. Hasil perawatan pada hari ketiga, minggu keempat dan minggu kedelapan memperlihatkan luka bekas operasi sudah menyembuh dan tidak ada tanda - tanda terjadinya rekurensi.Kasus adenoma pleomorfik harus menjadi pertimbangan dalam diagnosis banding pada pasien dengan benjolan di rongga mulut (di palatum, bibir, lidah dan mukosa bukal). Tingkat kekambuhan kasus adenoma pleomorfik dilaporkan sangat rendah setelah dilakukannya eksisi bedah.

ABSTRACT: Palatum pleomorphic adenoma management in adult patient by excisional biopsy. Pleomorphic adenoma is a minor salivary gland tumour and most cases occurs in hard palatum (43%). Most cases in minor salivary gland tumour are malignant but pleomorphic adenoma is benign. The most incidence rate is at fourth to sixth decade.This case report is aimed to explain about the management of pleomorphic adenoma and the incidence in young adult. A 16 years old female with a mass in palatum. Clinically a mass is identically in color with surrounding tissue, round, single nodul, immobile, bounded clear, hard in palpation and without pain, with size is 4×3 cm, 3×2 cm in diameter with slow in progression. Panoramic and waters radiografi and also incisional biopsy shows the result is pleomorphic adenoma. Definitive therapy is done by excisional surgery. Histopatologically shows the same result with incisional biopsy. Then, insertion obturator was done. Patient came to control at third day, fourth week and eight week. Wound post operation was heal and no sign of recurrency. Pleomorphic adenoma should be considered in differential diagnose in patient with a mass in oral cavity (palatum, lip, tongue, and buccal mucosa). Reccurency rate of pleomorphic adenoma case is very low after excisional surgery.


Keywords


adenoma pleomorfik, biopsi eksisi, tumor kelenjar ludah minor, pleomorphic adenoma, excisional biopsy, minor salivary gland tumor

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References

Sharma N, Singh V, Malhotra D. Pleomorphic adenoma of the hard palate. A Case Report. Indian Journal of Dental Sciences 2010; 2(1): 18-20.

Gothwal AK, Kamath A, Pavaskar RS, et al. Pleomorphic adenoma of the palate. A Case Report. Journal of Clinical and Diagnostic Research. 2012; 6(6): 1109-11.

Rahnama M, Urzula O, Czupkallo L, et al. Pleomorphic adenoma of the palate. A Case Report and Review of The Literature Wspolczesna Onkol. 2013; 17(1): 103-6.

Jorge J, Pires FR, Alves FA, Perez D, Kowalski P, Lopes A, Almeida OP. Juvenile intraoral pleomorphic adenoma: report of five cases and review of the literature. Int J. Oral Maxillofac. Surg. 2002; 31: 273-75.

Singh RB, Baliarsingh RR, Satpathy AK, Naik CB, Nayak A, Lohar TP et al. Pleomorphic adenoma of both hard and soft palate. a case report. annals and essences of dentistry. 2012; 4(3): 30-3.

Al-Ani LS, Al Azzawi LM. Evaluation of immunohistochemical expression of P53 and PCNA in pleomorphic adenoma, mucoepidermopid and adenoid cystic carsinomas of salivary glands. Tikrit Journal of Dental Sciences. 2013; 1: 1-8.

Fonseca I, Martin AG, Soares AJ. Epithelial salivary glands tumor of children and adolescents in southern portugal: aclinicopathologic study of 24 cases. Oral Surg Med Oral Pathol. 1991: 72: 696 – 701.

Lazarro B, Cleveland D. P53 and ki 67 antigen expression in small oral biopsy specimens of salivary gland tumours. Oral Surg Oral Med Oral Pathol Oral Endod. 2000; 89: 613-17.

Jorge J, Pires FR, Alves FA, Peres DE, Kowalski LP, Lopes MA, Almeida OP. Juvenile intra-oral pleomorphic adenoma: report of five cases and review of the literature. Int J Oral Maxillofa Surg. 2002; 31: 273-75.

Al Rawi NH, Ahmed JN, Mohammed HO. Immunohistochemical Expression of p53 and bcl-2 Benign and Malignant Salivary Gland Tumours. 2007; 4: 1-4.

De courten A, Lombardi T, Samson J. Pleomorphic adenoma of the palate in achild: 9-years follow up. Int J Oral Maxillofac Surg. 1996: 25: 293-5.

Chen YK, Lin LM, Lin CC, Yan YH. Palatal pleomorphic adenoma in a child with osteoid formation: report of a case. ASDC J Dent Child. 1998: 65: 209-11.

Bayles SW, Todd NW, Muller S, Rabkin D. Pleomorphic adenoma of the pediatric tongue. Otolaryngol Head Neck Surg. 1999; 120: 934-6.



DOI: https://doi.org/10.22146/mkgk.32012

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