Salivary Gland

Question 1

what is salivary gland inflammation usually due to

Answer 1

infection or obstructing calculus

Question 2

sialolithiasis

Answer 2

calcium phosphate and carbonate stones

usually form in the submandibular gland

Question 3

symptoms of sialolithiasis

Answer 3

• colicky pian, post prandial gland swelling
• pain can be recreated by squeezing acid (eg lemon juice)into the oral cavity to stimulate secretion

Question 4

acute bilateral symptoms

Answer 4

usually due to mumps

Question 5

when should the MMR vaccine be received

Answer 5

1y and 3y4m

Question 6

what is there a risk of with mumps

Answer 6

secondary meningitis

Question 7

inflammation of which body part associated with mumps

Answer 7

orchitis

Question 8

acute unilateral symptoms

Answer 8

often due to mumps again

acute parotitis may occur by ascending oral infection

Question 9

when does acute parotitis from ascending oral infection usually occur

Answer 9

post-op

however, rare unless dehydrated or poor oral hygeine

Question 10

recurrent unilateral symptoms

Answer 10

often from stones

gland may be swollen, red and tender

these are all worse on eating

Question 11

which gland do stones most regularly form in

Answer 11

submandibular gland in 80%

Question 12

chronic bilateral symptoms

Answer 12

may be associated with dry eyes and mouth ± Sjögren’s syndrome (also causes bilateral parotid gland enlargement)

Question 13

where do most tumours occur, and what are most tumours

Answer 13

80% in parotid gland - 80% in superficial lobe

80% are benign pleomorphic adenomas

Question 14

can benign pleomorphic adenomas become malignant

Answer 14

if longstanding, there is a risk

Question 15

pathology of benign pleomorphic adenoma

Answer 15

• proliferation of epithelial and myoepithelial cells of the ducts and increase in stromal components – biphasic appearance

Question 16

how does benign pleomorphic adenoma usually present

Answer 16

• painless lump, slowly enlarging
• typical of a benign tumour

Question 17

what percentage of submandibular gland tumours are malignant

Answer 17

50% - adenoid cystic carcinoma

Question 18

what is the most common benign bilateral neoplasm of the parotid

Answer 18

warthin’s tumour

Question 19

should salivary gland swellings be removed

Answer 19

ANY should be removed if present > 1 month

Question 20

what does CNVII paralysis suggest

Answer 20

malignancy

Question 21

Warthin’s tumour

Answer 21

Adenolymphoma

this is the 2nd most common benign tumour

Question 22

Warthin’s tumour pathology

Answer 22

• Cystic tumour, contains abundant lymphocytes and germinal centres
• Most common bilateral benign neoplasm of the parotid

Question 23

where are Warthin’s tumours usually found

Answer 23

they are rare outwith the parotid

Question 24

typical patient with Warthin’s tumour

Answer 24

male over 50, strong association with smoking

Question 25

adenoid cystic carcinoma

Answer 25

rare tumour of the exocrine glands (salivary, lacrimal, lid), it is the most common malignant tumour of the palate and represents 30% of all malignant submandibular tumours

Question 26

describe the presentation of adenoid cystic carcinoma

Answer 26

painful slow growing mass and late recurrences, perineural infiltration (the space surrounding a nerve, resulting in pain/loss of function)

generally well-differentiated

Question 27

identifying features of carcinomas

Answer 27

rapid growth

CNVII palsy

pain

hard fixed mass

Question 28

name 3 classical features of adenoid cystic carcinoma

Answer 28

• peri neural infiltration
• distant metastases
• late recurrence