The Journal of Laryngology and Otology December 1997, Vol. Ill, pp. 1177-1178 Pleomorphic adenoma presenting as a base of tongue mass A. K. GUPTA, S. K. SINGHAL, S. B. S. MANN, J. R. BAPURAJ*, R. K. SARANI Abstract A rare case of pleomorphic adenoma of the base of the tongue with a relevant review of literature is reported. Key words: Salivary gland neoplasms; Tongue Introduction Benign and malignant tumours of minor salivary glands are commonly seen in the palate, upper lip, gums, cheek, floor of the mouth, pharynx, larynx and trachea (Burbank et al., 1959). The literature indicates an overall ratio of approximately 1:6 for the benign/malignant lingual salivary gland tumours (Main et al., 1976; Clark and Yarington, 1980; Everson and Cawson, 1985). The most common benign tumour in this region is a pleomorphic adenoma whereas adenoid cystic carcinoma is the most common malignant tumour reported, accounting for 46.3 per cent of cases (Chaudhary et al., 1961; Pogrel, 1979). Only three cases of pleomorphic adenoma of the base of the tongue have been reported so far in the English literature (Goldblatt and Ellis, 1987). Case report A 50-year-old female presented to the ENT Outpatients department of Nehru Hospital of the Postgraduate Institute of Medical Education and Research, Chandigarh, with complaints of odynophagia, a feeling of a lump in the throat and exertional dyspnoea of six months duration. At a peripheral institution, an attempt had been made to FIG. 1 11U ± Pre-operative CT scan showing a mass of homogeneous density at the base of the tongue. examine the larynx and take a biopsy under general anaesthetic but the endotracheal tube could not be negotiated because of a large mass at the base of the tongue and an emergency tracheostomy was done. After about one month the patient was referred to us for further management. Indirect laryngoscopy revealed a firm mucosa-covered mass at the base of the tongue measuring 2.5 X 1.75 cm. There was neither a history of bleeding nor could any visible pulsations be seen over the mass. Computed tomography (CT) scan revealed a non- contrast enhancing mass of homogeneous density over the base of tongue (Figure 1). A biopsy was taken from the mass using the apnoeic technique with a punch forceps. The biopsy specimen was reported as 'pleomorphic adenoma' (Figures 2 and 3). Subsequently, excision of the mass was performed under general anaesthetic by a lateral pharyngotomy approach and the total mass was excised. The histopathological examination of the mass reconfirmed the diagnosis. The post-operative period was uneventful and the patient was successfully decannulated on the 10th post-operative day. The patient was regularly followed up for a period of 14 months without any evidence of recurrence. FIG. 2 Histology showing clusters of tumour separated by fibrous tissue and skeletal muscle (H & E; X 550). From the Departments of Otorhinolaryngology and Head and Neck Surgery, Radio-Diagnosis and Imaging* and Histopathologyt, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. Accepted for publication: 2 October 1997. 1177