CARCINOMA EX PLEOMORPHIC ADENOMA: DIAGNOSIS, TREATMENT, AND CLINICAL PERSPECTIVES

Abstract

Pleomorphic adenoma (PA) is the most common benign neoplasm of the salivary glands, accounting for approximately 60% of cases, with a predilection for the parotid gland and a higher incidence in women between 30 and 60 years of age. Despite its slow growth and asymptomatic nature, it is notable for the possibility of malignant transformation into carcinoma ex-pleomorphic adenoma, associated with cumulative genetic alterations. Factors such as genetic predisposition, smoking, and radiation exposure may be involved in the etiopathogenesis of the disease. Diagnosis is confirmed by fine-needle aspiration biopsy (FNAB), with imaging tests such as ultrasound and CT assisting in the initial evaluation. The standard treatment is surgical, and excision with safe margins is essential to prevent recurrence, which can reach up to 45% of cases. This study conducted an integrative literature review using the Virtual Health Library (VHL), analyzing 32 articles published between 2015 and 2025. The analysis revealed wide clinical and histological variability in PA and highlighted the importance of an accurate diagnosis to avoid complications. Recent literature points to the use of molecular biomarkers, such as PLAG1 and HMGA2, as promising tools in differential diagnosis and prognostic prediction. Given the possibility of malignant transformation, although rare, rigorous postoperative monitoring is essential. The incorporation of new molecular approaches can improve clinical management and provide more personalized and effective treatments.