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Type:
Educational Exhibit
Keywords:
Education and training, eLearning, MR, CT, Ultrasound, Head and neck
Authors:
M. E. Perez Montilla1, I. Bravo Rey1, E. Roldán Romero1, F. Bravo-Rodríguez2; 1Cordoba/ES, 2Cordoba /ES
DOI:
10.1594/ecr2015/C-1042
Findings and procedure details
We reviewed cases of pleomorphic adenoma of the head and neck from our hospital.
The most common locations were the major salivary glands (parotid and submandibular gland).
Less frequent locations were the soft palate,
parapharyngeal space and lacrimal gland (figure 1,
diapo 7).
The algorithm of imaging proposed included ultrasound,
contrast-enhanced computed tomography and/or nonenhanced and contrast-enhanced magnetic resonance (MR) imaging,
applied in a different order depending on clinical data.
Generally it was presented as solid,
lobulated,
well-defined and homogeneous mass and normally a solitary lesion.
The larger lesions may have a heterogeneous appearance due to necrotic-cystic changes,
hemorrhage or calcifications (figure 2,
diapo 8).
The feature of lobulated shape is being emphasized in differential diagnosis.
In ultrasound are usually hypoechoic solid lesions,
with posterior acoustic enhancement and that may contain calcifications.
Vascularization in pleomorphic adenomas is often poor or absent (even when the sensitive power Doppler mode is used),
but may be abundant.
In CT normally have a similar density to muscle with mild to moderate enhancement after contrast administration.
Because of its slow growth,
pleomorphic adenoma may demonstrate bone remodeling.
Lesions are typically hypointense on T1-weighted images and hyperintense with a complete and hypointense capsule on T2-weighted images.
Small lesions show an intense and homogeneous enhancement and larger lesions a heterogeneous enhancement (figure 3,
diapo 9).