Metastatic pleomorphic adenoma to the supraspinatus muscle: a case report and review of a rare aggressive clinical entity

Authors

  • James G McGarry
  • Maeve Redmond
  • John B Tuffy
  • Lorraine Wilson
  • Seamus Looby

DOI:

https://doi.org/10.3941/jrcr.v9i10.2283

Keywords:

Pleomorphic adenoma, metastatic, rotator cuff metastasis, parotid tumours

Abstract

We report a case of a 65-year-old female with a recurrent right parotid pleomorphic adenoma (PA) 24 years after initial surgical excision. Positron-emission tomography (PET) and computed tomography (CT) demonstrated an unusual suspicious FDG-avid erosive rim enhancing mass centered in the right supraspinatus muscle. Cytology from CT-guided aspiration of the mass was consistent with a histologically benign PA, and the patient was diagnosed with metastatic pleomorphic adenoma (MPA). The patient later developed diffuse pulmonary metastases and died within 3 months. MPA, although rare, is recognised as a potentially lethal malignant complication of recurrent or longstanding benign PA. As no biochemical or genetic parameters are predictive of malignant change, patients presenting with recurrent PA should be considered for screening for metastatic disease.

Author Biographies

James G McGarry

Specialist registrar (SpR) in Radiology,

Department of Radiology, Beaumont Hospital,

Beaumont Road, Dublin 9, Ireland.

Maeve Redmond

Dr. Maeve Redmond,

Consultant Histopathologist,

Department of Pathology,

Beaumont Hospital, Beaumont Road,

Dublin 9, Ireland.

John B Tuffy

PACS senior radiographer,

Department of Radiology,

Beaumont Hospital, Beaumont Road

Lorraine Wilson

Consultant Nuclear Medicine Physician, Blackrock Clinic Nuclear Medicine/PET-CT Centre,

 

Seamus Looby

Consultant Neuroradiologist,

Department of Neuroradiology, Beaumont Hospital,

Beaumont Road, Dublin 9, Ireland.

Published

2015-10-27

Issue

Section

Neuroradiology