Diagnosis: Pleomorphic adenoma of the submandibular gland
Pleomorphic adenoma (benign mixed tumor) is the most common benign tumor of the major salivary glands. Over 80% arise from within the parotids while 8% are in the submandibular gland. They are slow growing lesions which tend to occur in middle aged women. This one was present for over 10 years. They are usually solitary and may demonstrate patchy enhancement,hemorrhage, necrosis and calcification. Malignant transformation is possible. The differential of submandibular space masses includes adenopathy, benign submandibular gland neoplasm, malignancy such as adenoid cystic & mucoepidermoid carcinoma, branchial cleft cyst, cystic hygroma, lipoma, abscess, diving ranula and a pedunculated parotid tail lesion simulating a posterior submandibular space mass. The attenuation and enhancement pattern isn't compatible with cyst or lipoma. Diving ranula is possible if there is simultaneous involvement of the sublingual space which is not the case here. Abscesses are usually clinically apparent and more inflammatory change of the adjacent fat planes would be expected. This mass was removed from the submandibular space at surgery. Related Cases