LGPA - Mass noticed in mouth and sore appeared on the outside in the cheek area

	Asked by cresseyd (Male ) on Sat 05, Apr 2008 08:06am :
	My mum has an LGPA, originally found around 30 years ago, but not identified as anything serious and therefore not treated. Some years later purely by chance, her GP who specialised in ENT, noticed the lump, which was across her soft and hard pallette, and sent her for investigations. A number of ops followed, the site didn't heal and eventually mum was referred to Oncology in Leeds, where she had further but more radical surgery followed by 4 weeks of radium treatment. This was around 10 years ago. Mum was left with a hole in the roof of her mouth, most of the right cheeck bone, and som eof the right lower eye socket removed. She was fitted for a pallette, which has been refitted a number of times as her jaw is shrinking. Mum has regular specialist apts but has had no investigations since a PET scan around 5 years ago, when she was told that the cancer was now attached to her sinus at the back of her head, close to the brain. Late last year, mum noticed a mass in her mouth which has been growing at some rate. Specialist said they couldn't do anything. Around Xmas a small sore appeared on the outside, in the cheeck crease, which is now a mass of what looks like abcesses, but coul dbe ulceration, yet still she is told nothing can be done. My question? Surely there must be more that can be done to help? Sorry - a bit long winded
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	Answer by Dr Bobby V, MD (oncologist) on Thu 10, Apr 2008 01:42pm: Hi, Lacrimal gland pleomorphic adenoma (LGPA) are usually benign tumors, although a small proportion of them may turn malignant with the passage of time (Doctors call this phenomenon as "carcinoma ex pleomorphic adenoma" and this may be seen in about 5% of patients of pleomorphic adenoma). LGPAs are very slow growing, and often take several years to grow to clinically detectable levels. Although the salivary glands are the commonest site of these tumors, they can also occur in the sweat glands and lacrimal glands. They may recur if complete surgical excision (including removal of tumor capsule) is not performed. Almost half of these tumors recur at the local site within a decade of surgery. Your mother has had LGPA for 30 years now, has undergone several surgeries including radical excision, and radiotherapy. Despite this, her tumor has continued to advance. She now has loco-regionally advanced tumor, with involvement of cheek skin and paranasal sinus. Since the tumor has spread to near her brain, and has become widespread, further surgery is neither feasible, nor likely to be helpful. Chemotherapy has not got a proven role in this tumor. Further radiotherapy, with palliative intent, may be beneficial to your mother. Thank you for using our service.  If you are satisfied with the answer or if you want a detailed answer for your question, please make a donation and request for further clarifications.  Our oncologists will provide an elaborate answer for your clarification.   Please make a donation by clicking the button below. You may donate using funds from your PayPal account or Credit Card. Please rate my answer (select the stars below, no need to log in.)
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