Lobna Ayadi
Salma Chaâbouni
Houria Dhouib
Karima Abbès
Morched Dhouib
Saloua Makni
Mohamed Abdelmoula
Abdelmonem Ghorbel
Abdelmajid Khabir
Tahya Boudawara


Background : Polymorphous low-grade adenocarcinoma (APBG) is a variant of malignant tumour of minor salivary glands usually arising in the palate.
Aim : Our aim is to discuss morphology, evolution and differential diagnosis of this rare tumour.
Case reports: The first case interested a 65-year-old-woman admitted for a two- months-history of a right submaxillary swelling. Examination found a tumour of the right side of the palate. A biopsy concluded to a pleomorphic adenoma. Giving that the mass enlarged, a surgical resection carrying off the thyroid with a bilateral neck dissection was performed. Diagnosis was an APBG partially resected with lymph node metastasis. The patient received adjuvant radiotherapy. Local recurrence appeared 28 months after treatment. The second case interested a 57-year-old-woman who consulted for a 12-year-history of a swelling of the  lower lip. Clinical examination showed a painless nodule measuring 2 cm located in the mucosal side of the lower lip. An excisional biopsy was performed. Pathologic examination  concluded to an APBG completely resected. The patient had no evidence of disease with a follow-up of 54 months.
Conclusion: APBG is characterised by a morphologic diversity and a cytologic uniformity that may cause a diagnostic dilemma especially with adenoid cystic carcinoma and pleomorphic adenoma. Its aggressiveness is assessed by its local infiltrative growth pattern requiring a wide surgical excision.


Polymorphous low-grade adenocarcinoma, minor salivary glands, prognosis, surgery



  1. Evans Hl, Batsakis JG. Polmorphous low-grade adenocarcinoma of minor salivary glands: a study of 14 cases of a distinctive neoplasm. Cancer 1984; 53: 935-42.
  2. Chadli-Debbiche A, Ben Brahim E, Dougaz A et al. Adénocarcinome polymorphe de faible malignité des glandes salivaires accessoires - une observation. Tun Med 2000; 78: 607- 12.
  3. Lopes Ma, Kowalski Lp, Santos Gc, De Almeida OP. A clinical pathologic study of 196 intraoral minor salivary gland tumors. J Oral Pathol Med 1999; 28: 264-7.
  4. Simpson Rhw, Clarke Tj, Sarsfield Ptl, Gluckman Pgc, Babajews AV. Polymorphous low-grade adenocarcinoma of the salivary glands: a clinicopathological comparison with adenoid cystic carcinoma. Histopathology 19991; 19: 121-9.
  5. Buchner A, Merell Pw, Carpenter WM. Relative frequency of intra-oral minor salivary gland tumors: a study of 380 cases from northern California and comparison to reports from other parts of the world. J Oral Pathol Med 2007; 36: 207-14.
  6. Freedman Pd, Lumerman H. Lobular carcinoma of intraoral minor salivary gland origin: report of 12 cases. Oral Surg 1983; 56:157-65.
  7. Batsakis Jg, Pinkston Gr, Luna Ma, Byers Rm, Sciubba Jj, Tillery GW. Adenocarcinoma of the oral cavity: a clinicopathologic study of terminal duct carcinomas. J Laryngol Otol 1983; 97: 825-35.
  8. Luna Ma, Wenig Bm. Polymorphous low-grade adenocarcinoma. In ; Barnes L, Eveson Jw, Reichart P, Sidransky D, eds, World Health Organization Classification of Tumours - Pathology and genetics of head and neck tumours, Lyon: IARC Press, 2005 : 223-4.
  9. Castle Jt, Thompson Ldr, Frommelt Ra, Wenig Bm, Kessler Hp. Polymorphous low-grade adenocarcinoma A clinicopathologic study of 164 cases. Cancer 1999; 86: 207-19.
  10. Evans Hl, Luna Ma. Polymorphous low-grade adenocarcinoma A study of 40 cases with long-term follow up and an evaluation of the importance of papillary areas. Am J Surg Pathol 2000; 24: 1319-28.
  11. Brocheriou C. Adénocarcinome polymorphe de faible malignité des glandes salivaires accessoires. Sept observations. Arch Anat Cytol Path 1992; 40: 66-72.
  12. Perez-Ordonez B, Linkov I, Huvos AG. Polymorphous low-grade adenocarcinoma of minor salivary glands: a study of 17 cases with emphasis on cell differenciation. Histopathology 1998; 12: 521-9.
  13. Curran Ae, White Dk, Damm Dd, Murrah VA. Polymorphous low-grade adenocarcinoma versus pleomorphic adenoma of minor salivary glands: Resolution of a diagnostic dilemma by immunohistochemical analysis with glial fibrillary acidic protein. Oral Surg Oral Med Oral Pathol 2001; 91: 194-9.
  14. Epivatianos A, Lordanides S, Zaraboukas T, Antoniades D. Adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma of minor salivary glands: a comparative immunohistochemical study using the epithelial membrane and carcinoembryonic antibodies. Oral Diseases 2005; 11: 175-80.
  15. Gonzalez-Garcia R, Rodriguez-Campo Fj, Munoz-Guerra Mf, Nam-Cha Sh, Sastre-Perez J, Naval-Gias L. Polymorphous lowgrade adenocarcinoma of the palate Report of cases. Auris Nasus Larynx 2005; 32: 275-80.
  16. Crean Sj, Bryant C, Bennet J, Harris M; Four cases of Polymorphous low-grade adenocarcinoma. Int J Oral Maxillofac Surg 1996; 25: 40-4.