International Healthcare Research Journal 2018;2(8):192-194. INTRODUCTION Carcinoma ex pleomorphic adenoma (Ca ex PA, CXPA) is type of rare, aggressive, poorly understood malignancy usually occurring in the salivary glands and accounts for most cases of malignant mixed tumors reported in the literature. 1-3 It is also known as carcinoma ex mixed tumor, carcinoma ex adenoma, and carcinoma ex benign pleomorphic adenoma.4 It was first described by Beahrs et al. in 1957 and accounts for 3. 6% of all salivary gland neoplasms and for 11.7% of salivary malignancies.5 Various authors state that Carcinoma ex pleomorphic adenoma usually occurs in the 6th-8th decades of life. 5,6 As per the histological classification report of the World Health Organization (2005), the so called “malignant mixed tumors,” are divided into 3 different clinical and histologic entities: 1) carcinoma ex pleomorphic adenoma (carcinoma in pre-existing pleomorphic adenoma), 2) carcinosarcoma (true malignant mixed tumor), and 3) metastasizing pleomorphic adenoma. Literature search reveals that most malignant mixed tumors are carcinoma ex pleomorphic adenoma, whereas the latter 2 types are extremely unusual and rarely reported. 7 The gold standard for making an accurate diagnosis is pathological assessment and its treatment often involves an ablative surgical procedure, which may be followed by radiotherapy. It has been stated that patients with CXPA have a poor prognosis. This case report presents a case of Carcinoma ex pleomorphic adenoma affecting a 48 year old male patient. CASE REPORT A 48 year old male patient came to the department of Oral Medicine and Radiology with a chief complaint of a growth on the left side of the face since two years. The growth was initially small and gradually increased to the present size. There was history of associated pain since 1 month. Medical and past dental histories were non-relevant. General physical examination was non-contributory. Extra-oral examination revealed a growth of size 5x6 cms on the left side of the face extending anteroposteriorly 2 cms from corner of mouth to 5 cms posteriorly to the ear lobe. The post auricular area had a 7x8 mm growth [Figure 1(a) and (b)]. Skin over the growth was normal. There was no surface rise in temperature. It was slightly tender on palpation, soft-firm in consistency. It was non- fluctuant, slightly compressible but non reducible. Diascopy test was negative. On intra-oral examination, no abnormality was detected. On the basis of history and clinical examination of the growth, a provisional diagnosis of a malignant tumor of the salivary gland was given. A differential diagnosis of other malignant tumors was considered. The patient was sent for further investigations which included MRI (Figure 2) which confirmed the diagnosis of Carcinoma ex Pleomorphic Adenoma DISCUSSION Pleomorphic adenoma is the most common benign salivary gland neoplasm. 8 The terms pleomorphic adenoma and mixed tumor both represent attempts to describe this tumor's interesting histopathologic K A Case Report of Carcinoma ex Pleomorphic Adenoma CASE REPORT A B S T R A C T ISSN: 2456-8090 (online) International Healthcare Research Journal 2018;2(8):192-194. DOI: 10.26440/ihrj.v2i8.169 HARPREET GREWAL *1 , KESARI SINGH 2 , VASUDHA BHAGAT 3 QR CODE Carcinoma ex-pleomorphic non-malignant tumour (Ca ex PA, CXPA) is a rare, aggressive, poorly understood malignancy of the exocrine gland. The clinical findings typical of this neoplasm embrace history of a slow growing, ulcerated, painless mass that enlarges speedily. The current definition of Ca ex PA became widely accepted in the second half of the twentieth century. It is uncommon, having a prevalence rate of 5.6 cases per 100,000 malignant neoplasms and a yearly incidence rate of 0.17 tumours per 1 million persons in the world. The cancer is found predominantly in the sixth to eighth decades of life and is slight female predilection. KEYWORDS: Ex-pleomorphic, Tumour, Malignant, Carcinoma 192