Pleomorphic adenoma: the great mimicker of malignancy

Juan C. Hernandez-Prera, Alena Skálová, Alessandro Franchi, Alessandra Rinaldo, Vincent Vander Poorten, Peter Zbären, Alfio Ferlito, Bruce M. Wenig

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Pleomorphic adenoma (PA) is the most common salivary gland neoplasm, and its diagnosis is straightforward in the majority of cases. However, not infrequently, PA shows unusual and uncommon histological features that can be confused with those of malignancy. The difficulties in diagnosing PA arise from its ability to mimic invasion, show atypical or metaplastic cytomorphology, and show morphological features that overlap with those of established salivary gland carcinomas. In addition, recognising early malignant transformation to carcinoma ex-pleomorphic adenoma continues to be a frequent challenge. This review describes the diagnostic pitfalls of PA, and offers a systematic approach to avoid them by combining classic histopathology with novel immunohistochemical and molecular tests.

Original languageEnglish
Pages (from-to)279-290
Number of pages12
Issue number3
StatePublished - Sep 2021
Externally publishedYes


  • MAML2
  • MYB
  • PLAG1
  • early carcinoma ex pleomorphic adenoma
  • invasion
  • oncocytic metaplasia
  • pleomorphic adenoma
  • squamous metaplasia


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