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Y3R6: Surgery I 👨‍⚕️ > L10: Salivary Gland Neoplasm > Flashcards

L10: Salivary Gland Neoplasm Flashcards

1
Q

Incidenece of Salivary Neoplasm

A
  • Around 1.2% of all neoplasms of the body & 5% of head and neck tumors.
  • 85% are benign & 15 % are malignant.
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2
Q

What age group is affected by salivary neoplasm?

A
  • Benign usually appear after the age of 40 y,
  • Malignant after the age of 60y.
  • Salivary tumors are rare in children, and mostly are malignant.
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3
Q

Site of Salivary Neoplasm

A
  • 80% arise in the parotid glands.
  • 10-15% arise in the submandibular glands.
  • Remainder arises in the sublingual and minor salivary glands
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4
Q

Percentage of Benign & Malignant Tumors in salivary galnds

A
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5
Q

Origin of Salivary Neoplasm

A

These tumors may arise from the secretory tissue, the duct system, or from the stromal tissue (mainly lymphoid tissue).

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6
Q

Types of Salivary Neoplasm

A
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7
Q

Etiology of Salivary Neoplasm

A
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8
Q

Incidence of Pleomorphic adenoma

A
  • Represent 75% of parotid and 50% of submandibular gland neoplasms.
  • Males = females.
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9
Q

Origin of Pleomorphic adenoma

A

Arises from epithelial, myoepithelial, and stromal components.

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10
Q

Pathology of Pleomorphic adenoma

A
  • Exhibit wide variations in cellular and architectural morphology.
  • The capsule may be incomplete with the extension of tumor tissue into the surroundings.
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11
Q

Complications of Pleomorphic adenoma

A
  • It grows slowly without infiltration of the facial nerve.
  • Long-standing (more than 10 years) pleomorphic adenoma rarely turns malignant.
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12
Q

Why is Pleomorphic adenoma Called by this name?

A
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13
Q

what is another name of Adenolymphoma (Warthin’s tumor)?

A

Warthin’s tumor (benign papillary cystadenoma lymphomatosum)

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14
Q

Incidence & Side of Adenolymphoma (Warthin’s tumor)

A
  • The second most common benign tumor of the parotid gland.
  • It accounts for 2-10% of all parotid gland tumors.
  • Bilateral in 10% of the cases.
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15
Q

Origin of Adenolymphoma (Warthin’s tumor)

A

Arises from epithelial, myoepithelial, and stromal components.

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16
Q

Pathology of Adenolymphoma (Warthin’s tumor)

A
  • Epithelial Component
  • Lymphoid Component
  • Both lymphoid and oncolytic epithelial elements must be present to diagnose Warthin’s.
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17
Q

Investigations for Adenolymphoma (Warthin’s tumor)

A
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18
Q

Epithelial Comonent of Adenolymphoma (Warthin’s tumor)

A
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19
Q

Lymphoid Component of Adenolymphoma (Warthin’s tumor)

A
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20
Q

what are types of Benign Salivary Neoplasm?

A
  • pleomorphic adenoma
  • Warthin’s tumor
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21
Q

What are types of malignant salivary Neoplasm?

A
  • Mucoepidermoid carcinoma
  • Adenoid cystic carcinoma
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22
Q

Incidence of Mucoepidermoid carcinoma

A

The commonest malignant salivary tumor → usually affects the parotid.

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23
Q

Origin of Mucoepidermoid carcinoma

A

Arises from the ductal epithelium.

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24
Q

Grades of Mucoepidermoid carcinoma

A

Three grades are → low, intermediate, and high-grade tumors.

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25
Q

Characters of Low Grade Mucoepidermoid carcinoma

A
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26
Q

Incidence of Adenoid cystic carcinoma

A

The commonest malignancy affecting the minor salivary glands.

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27
Q

Origin of Adenoid cystic carcinoma

A

Arises from ductal and myoepithelial cells.

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28
Q

Pathology & Growth of Adenoid cystic carcinoma

A
  • It has a slow rate of growth.
  • It may grow in different patterns: tubular, cribriform, and/or solid.
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28
Q

Complications of Adenoid cystic carcinoma

A
  • Great tendency for perineural invasion, thus it usually invades the facial nerve.
  • It has a high frequency of local and distant recurrence and poor long- term prognosis.
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29
Q

Characters of Adenoid cystic carcinoma

A
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30
Q

Type of Patient of Benign Neoplasm

A

Male = female & age around 40yr

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31
Q

Characters of Benign Neoplasm

A

Slowly growing, Painless swelling.

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31
Q

Signs of Benign Neoplasm

A
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32
Q

Type of Patient in Malignant Neoplasm

A
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33
Q

Characters of Malignant Neoplasm

A
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34
Q

Signs of Malignant Neoplasm

A
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35
Q

DDx of Salivary Neoplasm

A
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36
Q

Spread of Salivary Neoplasm

A
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37
Q

Complications of Salivary Neoplasm

38
Q

Prognosis of Salivary Neoplasm

39
Q

Investigations for Salivary Neoplasm

40
Q

Low growing parotid tumors should not be subjected to biopsy for 2 reasons:

A

1) Injury to the facial nerve.

2) Seeding of tumor cells in the subcutaneous plane which causes recurrence in about 40-50% of cases.

41
Q

FNAC

Investigtions of Salivary Neoplasm

A
  • It is done to confirm the diagnosis and rule out malignancy.
  • FNAC of the LNs that are palpable in the neck in malignancy cases of the parotid gland.
42
Q

Radiological

Investigtions of Salivary Neoplasm

A
  • CT
  • MRI
  • X-Ray
43
Q

Indication of CT Scan

Investigtions of Salivary Neoplasm

A

Done for tumor arising from the deep lobe.

It helps to:
1) Define the extraglandular spread,
2) The extent of parapharyngeal disease,
3) Cervical lymph nodes and bony infiltration.

44
Q

MRI

Investigtions of Salivary Neoplasm

A
  • MRI is a better investigation. However, it is expensive,
  • CT scan and MRI lack specificity for differentiating between benign and malignant lesion.
45
Q

X-Ray

Investigtions of Salivary Neoplasm

A

X-ray of the bones (mandible and mastoid process) to look for bony resorption if malignancy is suspected.

46
Q

Radioactive Isotope scan

Investigtions of Salivary Neoplasm

63
Q

General Considerations in TTT of salivary neoplasm

64
Q

Superficial Conservative Parotidectomy

TTT of Salivary Neoplasm

65
Q

Simple enuculation

TTT of Salivary Neoplasm

66
Q

Total Conservative Parotidectomy

TTT of Salivary Neoplasm

67
Q

TTT of Facial Nerve Injury

TTT of Salivary Neoplasm

68
Q

Operation of choice in Benign tumors of the submandibular

69
Q

Procedure in Benign tumors of the submandibular

70
Q

Cautions during TTT in Benign tumors of the submandibular

71
Q

Confirmation of Diagnosis in malignant neoplasm

72
Q

Examples of Low grade salivary tumors

73
Q

Procedure of Low grade salivary tumors

74
Q

Operation in Low grade salivary tumors in case of parotid gland

75
Q

TTT in case of High grade tumors in case of parotid gland

76
Q

How to deal with LNs in salivary tumors?

77
Q

Managment of inoperable salivary gland cases

78
Q

complications of parotidectomy

79
Q

Cause of Frey’s syndrome

80
Q

Incidence of Frey’s syndrome

81
Q

Symptoms of Frey’s syndrome

82
Q

pathophysiology of Frey’s syndrome

83
Q

TTT of Frey’s syndrome

84
Q

Identification of facial nerve

85
Q

Comparison between pleomorphic adenoma and adenolymphoma

86
Q

Comparison between submandibular and parotid tumors

87
Q

The commonest malignancy in adult

88
Q

The commonest malignancy in Children

89
Q

The commonest malignancy in parotid

90
Q

The commonest malignancy in submandibular

91
Q

Differential diagnosis of swelling in parotid region

92
Q

Differential diagnosis of swelling in sabmandibular region

Y3R6: Surgery I 👨‍⚕️ (36 decks)

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