benign and malignant salivary gland tumors Flashcards
what are the major salivary glands ?
parotid
submandibular
sublingual
what are the three structures that pierce the parotid gland ?
external carotid artery
facial nerve
retromandibular vein
what are the benign tumors of the salivary glands ?
pleomorphic adenoma
warthins tumor
what is the other name for warthin’s tumor ?
papillary cystadenoma lymphomatosum
what is the commonest benign tumor of the parotid ?
pleomorphic adenoma
what is sen on gross evaluation of a pleomorphic adenoma ?
smooth
multilobular
encapsulated
what are the microscopic features of a pleomorphic adenoma ?
presence of both epithelial cells and mesenchymal like elements
epithelial cells make up most of the cellular region
myoepithelial cells make up the stromal areas
what is the percentage of malignant transformation of pleomorphic adenomas ?
5% malignant transformation , which comes with facial nerve affection
what is the treatment for pleomorphic adenoma ?
parotidectomy - only treatment
which age group is highly affected by warthin’s tumors ?
papillary cystadenoma lymphomatosum commonly affect those in the age range of 60-70 yrs old who have history of heavy smoking
what modifiable factor is highly associated with warthin’s tumor ?
smoking
what is observed on gross examination of warthin’s tumor ?
ovoid mass at the tail of the parotid
smooth capsule
when incised have multiplee cystic space filled with mucinous material
what is the microscopic picture of warthin’s tumor ?
multiple papillae are seen projecting into the cystic spaces
what is the percentage of malignant transformation in warthin’s tumor ?
no malignant transformation
what is the management of warthin’s tumor ?
parotidectomy or conservative if slowly growing and small in size
what are the malignant tumors associated with the salivary glands ?
mucoepidermoid carcinoma
acinic cell tumor
adenoid cystic carcinoma
lymphoma
what is the most common salivary gland malignancy ?
mucoepidermoid carcinoma
what is the most common submandibular gland malignancy ?
adenoid cystic carcinoma
what is the most common lymphoma associated with the salivary glands ?
non-hodgkins lymphoma
what puts a patient at a higher risk of developing non hodgkin lymphoma ?
pre existing sjogren’s syndrome
what are mucoepidermoid carcinomas divided into ?
high grade
intermediate
low grade
what does the grading system of the mucoepidermoid carcinoma depend on ?
low grade tumors have a higher predominance of mucous cells rather than epidermoid cells
high grade looks more like a squamous cell carcinoma
what is the treatment for a mucoepidermoid carcinoma ?
parotidectomy
what are the cellular components of acinar cell tumors ?
consist of mainly serous cells
what is the percentage of metastasis turnover for acinar cell tumors ?
10% gives rise to metastasis
what type of spreadd is associated with adenoid cystic carcinoma ?
perivascular and perineural spread especially for the facial nerve
what is the most common place for metastasis associated with adenoid cystic carcinoma ?
more commonly tthe lungs
what are the three types of adenoid cystic carcinomas in terms of architecture ?
cribriform
tubular
solid
what are the red flags associated with parotid gland masses ?
hardness
rapid growth
tenderness
infiltration of surrounding structures
overlying skin ulceration
facial weakness
