Membranous Multifocal Basal Cell Adenoma: Case Report

Objectives: A rare case presentation of Basal cell adenoma with regard to its site of origin, clinical behavior, surgical management and approach.

Methods (Case presentation): A case of a 72 year old female patient who had presented painless swelling on the left side of palate accompanied by dysphagia. Neck CT Scan after contrast injection showed round, solid and inhomogeneous enhanced large mass in left prestyloid parapharyngeal space. A small similar mass is seen in the left superficial lobe of parotid gland.

The clinical, radiological findings and the clinical course had led to a suspicion of salivary gland pathology such as Pleomorphic adenoma ,Warthin`s tumor and Basal cell adenoma.

Results: The histological examination of the lesion through the soft palate revealed Basal cell adenoma of minor salivary glands, membranous type. With regard to the diagnosis plus the location of the tumor a decision were made to remove both tumors through a preauricular approach without the need to mandibular split which preferred to Trans-palatal approach.

The additional biopsy from the Parapharngeal space and from the superficial lobe of left parotid was also consistent with basal cell adenoma.

Conclusion: BCA is a rare benign tumor of the salivary gland, represents only 1-2% of all salivary tumors. This tumor usually arises in the major salivary glands, followed by the upper lip; while it is very rare in the minor salivary glands. Membranous variant is a rare subtype of this tumor warrants separate consideration because of its recurrence and rate of malignant transformation. Because of BCA’s low prevalence, previous reports on CT findings of parotid gland BCA contain only sporadic cases or small case series.

To the best of our knowledge, only six cases involving the palatal minor salivary glands and eight cases of bilateral lesions of the parotid salivary glands have been reported in the English literature till date.