PLEOMORPHIC ADENOMA OF THE SALIVARY GLAND: FROM DIAGNOSIS TO TREATMENT, A LITERATURE REVIEW

Abstract

Pleomorphic adenoma (PA) is the most common benign tumor of the salivary glands, accounting for approximately 60% of cases, and may rarely evolve into malignancy due to genetic alterations. Although slow-growing and painless, it requires accurate differential diagnosis, especially with other tumors such as mucoepidermoid carcinoma. PA mainly affects adults between 30 and 60 years of age, being more common in women and the parotid gland, but it can also affect other areas such as the palate and upper lip. Its etiology is controversial, and risk factors include smoking, radiation, and genetic predisposition. Diagnosis is confirmed by biopsy, and malignant transformation, although rare, may lead to carcinoma ex-pleomorphic adenoma, with a risk of metastasis. OBJECTIVE: to compile and critically analyze the research already conducted, offering a comprehensive overview of advances in diagnosis, surgical management, prognosis, and possible complications, such as malignant transformation. METHODOLOGY: This is a literature review on pleomorphic adenoma of the salivary gland. The research used the Virtual Health Library (VHL) as a data source and applied specific terms such as "pleomorphic adenoma", "salivary gland", "diagnosis" and "treatment", with language filters (Portuguese, English, and Spanish) and publication period (2019-2024). Thirty-two studies were selected after applying the inclusion and exclusion criteria. Although it does not require ethical approval, the review follows good scientific practices. RESULTS AND DISCUSSION: RESULTS AND DISCUSSION: The analysis of the studies reveals that pleomorphic adenoma (PA) has varied clinical and histopathological characteristics, making effective diagnostic methods and appropriate therapeutic approaches essential. Ultrasonography and computed tomography are useful in the initial evaluation, but fine needle aspiration biopsy (FNAB) remains the standard method for diagnostic confirmation. Surgical treatment, with complete resection and safety margins, is essential to prevent recurrences, which can occur in up to 45% of cases, depending on the technique used. Malignant transformation, although rare, can lead to carcinoma ex pleomorphic adenoma, an aggressive condition that requires extensive surgical interventions and, in some cases, radiotherapy. Recent studies highlight the promising role of molecular markers such as PLAG1 and HMGA2 in diagnosis and prognosis, especially in cases of malignant transformation. CONCLUSION: The management of pleomorphic adenoma of the salivary gland requires an accurate diagnosis, using imaging methods and FNAB, in addition to appropriate surgical treatment to minimize recurrences and avoid malignant transformation. Advances in molecular markers offer new possibilities for early diagnosis and prognosis, reinforcing the importance of rigorous postoperative follow-up to monitor complications.