Chapter 11 Salivary Gland Diseases Flashcards
Mumps
Paramyxovirus
Epididymoorchitis (M), oophoritis, mastitis (F)
Cheilitis glandularis
Swelling and eversion of the lower lip from inflammation of the minor salivary glands
Weeping” mucopurulent secretions often are seen
Middle aged to older males
List the malignant salivary neoplasms
Mucoepidermoid carcinoma
Acinic cell adenocarcinoma
Adenoid cystic carcinoma
Polymorphous low-grade adenocarcinoma (terminal duct adenocarcinoma)
Malignant mixed tumor
Sialolith, sialolithiasis
Anything that slows or inhibits salivary flow thru the duct system may predispose to development of calculi - Long and tortuous duct with thick secretions (Wharton’s)
Major salivary gland benign and malignant rates
Warthin’s tumor
Papillary Cystadenoma Lymphomatosum
Almost exclusively in parotid gland, second most common benign parotid tumor, may occur bilaterally
Smokers have an eightfold greater risk
Pleomorphic adenoma
The most common salivary neoplasm
Palate is the most common site for minor gland
Tumor is encapsulated
Mixture of ductal and myoepithelial cells
Ranula
Mucoceles in floor of mouth, usually lateral to the midline
rupture of the sublingual gland duct
Removal of the feeding sublingual gland and/or marsupialization
What is this?
Mucocele
Spillage of mucin due to ruptured salivary gland duct
Most common in the lower lip 81%
Clinical mucoceles of the upper lip are more likely to be a salivary gland tumor
Mucoceles of the retromolar region are distinctly unusual - Most will prove to be mucoepidermoid carcinoma
Summary of salivary gland neoplasms
more common in upper lip than lower lip
upper lip are mostly benign, salivary neoplasms in lower lip are mostly malignant
Salivary gland neoplasms in the retromolar area are mostly malignant (90%)
The most common neoplasm is pleomorphic adenoma (benign)
The most common malignant neoplasm is mucoepidermoid carcinoma
Adenoid cystic carcinoma
swiss cheese
Most common malignant salivary gland tumor of submand. gland
Slow-growing, widely infiltrative, a tendency for perineural spread
Pain, facial nerve paralysis
5 y survival rate: 70%
20 y survival rate: 20%
Polymorphous Low-grade Adenocarcinoma
Almost exclusively occurs in minor glands
Hard and soft palate
Mucoepidermoid Carcinoma
The most common malignant salivary neoplasm, F>M
The most common malignant salivary gland tumor in children
Parotid then palatal minor salivary glands
Prognosis depends on the grade and stage
Can occur intraosseously as well
Necrotizing sialometaplasia
Believed to be due to ischemia
Traumatic injuries, dental injections
Mimic malignancy clinically (except too acute onset) and histologically
Xerostomia
dry mouth
Complications: Candidiasis, Prone to cervical and root caries, Alteration of taste
Management: Elimination of alcohol, smoking, caffeine consumption
Drug modification, if possible
Sugarless candies, gum
Oral lubricants (mouthwash, gels, spray)
Prescription: pilocarpine (Salagen), cevimeline (Evoxac)
Minor salivary gland benign/malignant rates based on location
