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\nCategory: Videos:The adenocarcinoma ex pleomorphic adenoma of the parotid gland: a clinicopathologic study of four cases.\nWe present the clinicopathologic features of four cases of adenocarcinoma ex pleomorphic adenoma (AEP) of the parotid gland. Only one patient had a recurrence. All patients had a history of a pleomorphic adenoma that was microinvasive or occultly invasive at the time of initial diagnosis. No patient had an antecedent history of malignant transformation of a pleomorphic adenoma. The mean age at the time of diagnosis of AEP was 62 years. Grossly, each tumor was a well-circumscribed, firm, nontender mass that measured an average of 6.2 cm. Histologically, three cases were pure AEP and one case was predominantly AEP with only focal mucinous cyst formation. All patients had a hyalinized stroma and hemosiderin-laden macrophages in the stroma of each tumor. In two cases, a few macrophages appeared to contain hemosiderin. None of the tumors exhibited the usual morphological features of mucin production. Two AEP tumors, including the case with mucinous cyst formation, contained mitotic figures. There were areas of vascular invasion in one tumor, and in another tumor, there was penetration into the lymphatics. In none of the cases was there lymphovascular invasion. None of the tumors was positive for keratin or carcinoembryonic antigen. The hyalinized stroma in all cases, including those that had mucinous cyst formation, may be related to the presence of hemosiderin-laden macrophages. These findings indicate that AEP represents a more aggressive variant of pleomorphic adenoma with a greater potential for malignant transformation.Bihor County
\nBihor County (; ) is a county in Romania, in the southeast of the country. Its administrative seat is Biharia.
\nBihor is the easternmost county in Romania, bordering the Black Sea. Its territory is landlocked, covering about 4,500 km² and with a population of about 330,000.
\nGeography
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