24 Neoplastic - Salivary Flashcards
What percent of parotid tumors are benign
75-80%
What is mc site of salivary gland neoplasm
Parotid 73%
Least common site of salivary neoplasm
Submandibular 11%
What is m/c site of malig gland neoplasm
Minor salivary glands 60%; 40% occur on palate
What is least common site of malig salivary gland neoplasm
Parotid 32%
Which salivary gland has best prog for malig tumor
parotid
which salivary gland has worst prog for malig tumor
SMG
M/c tumor of parotid
Pleomorphic adenoma in adult, hemangioma in kid (other sources say BMT in both)
How does metastasizing BMT differ from carcinoma ex-pleomorphic adenoma
Histologically benign, lacking malig epithelial components
M/c malig tumor of parotid in adults
Mucoep CA
Most imp prog factor for malign salivary gland neoplasms
stage
Which 5 salivary gland tumors have worst prog
- High grade mucoep
- AdenoCA
- SCCa
- Undifferentiated CA
- Carcinoma ex-pleomorphic adenoma
Indications for postop RT after parotid
- High probability of residual microscopic dz
- margins
- Advanced stage
- High grade
- Deep lobe tumors
- Recurrent tumors
- Presence of regional mets
- Angiolymphatic invasion
What factors are predictors of occult regional dz in parotid CA
- Extracapsular extension
- Preop facial paralysis
- Age > 54
- Perilymphatic invasion
Indications for neck dissection in tx of salivary gland malignancies
- Clinical mets
- Submandibular tumor
- SCCa
- Undifferentiated CA
- Size > 4 cm
- High grade mucoep CA
M/c site of distant mets for adenoid cystic CA
Lung
Incidence of subclinical neck dz w/ adenoid cystic CA of parotid
10%
M/c salivary gland malig following RT
Mucoep
M/c malig of SMG and minor salivary glands
adenoid cystic
Type of tumor comprises 50% of all lacrimal gland neoplasms
Adenoid cystic
4 types of growth patterns of ACC and which is m/c
- Cribriform (m/c, looks like swiss cheese)
- Tubular/ductular
- Trabecular
- Solid
Which type of RT does ACC respond best to
Neutron beam
What is m/c salivary gland malig to occur bilaterally
Acinic cell
What are the 2 m/c malig tumors of parotid in children < 12
Mucoep is m/c followed by acinic cell
Incidence of cervical mets of mucoep CA
30-40%
Your patient has a mucoepidermoid carcinoma of the parotid gland. Histologic evaluation of the biopsy specimen reveals a scant amount of mucin. There is no clinical evidence of regional metastasis. Do you treat the neck?
Yes (this is high grade)
What is the 2nd m/c malign tumor of minor salivary glands
AdenoCA
What are the 4 types of monomorphic adenomas
Basal cell
Trabecular
Canalicular
Tubular
Which salivary gland tumor is more common in women with a h/o breast CA
Mucoep CA
What is the tx of choice for met cutaneous SCCa to the parotid
Total parotid with preservation of VII (unless invaded by tumor) and postop RT to parotid and IPSI neck
What % of malig tumors of parotid p/w facial nerve weakness or paralysis
20%
Which salivary gland tumor has high propesity for PNI
ACC
What are the clinical features of salivary duct carcinomas
M/c involve the parotid gland and present as an Asx mass; higher incidence in males; distant mets are the m/c cause of death
Parapharyngeal tumors arising from deep lobe of parotid will involve which compartment
Prestyloid
What happens to carotid sheath with deep lobe parotid tumors extending into PPS
displaced posteriorly
Which compartment of PPS are neurogenic tumors most likely to arise in
Poststyloid
What is m/c tumor of PPS
BMT
