Salivary Gland Neoplasms Flashcards
benign salivary gland neoplasms
- pleomorphic adenoma
- papillary cystadenoma lymphomatosum “Warthin tumor”
- canalicular adenoma
malignant salivary gland neoplasms
- mucoepidermoid carcinoma
- polymorphous adenocarcinoma
- adenoid cystic carcinoma
- acinic cell carcinoma
- carcinoma ex-pleomorphic adenoma
approximately what percent of all head and neck neoplasms are salivary gland neoplasms?
~6%
T/F: salivary gland neoplasms are common
false, they’re uncommon, but not rare
T/F: salivary gland neoplasms have a slight MALE predilection
false, female
when do vast majority of salivary gland neoplasms arise?
during adulthood
what is the etiology of salivary gland neoplasms?
unknown etiology
which salivary gland had the most neoplasms?
parotid
which sites are involved in salivary gland neoplasms?
- parotid
- submandibular
- sublingual
- minor
list the sites involved in salivary gland neoplasms from most to least
parotid > minor > submandibular > sublingual
where are the most common locations for minor salivary glands?
- palate
- lips
- buccal mucosa
which location has the most minor salivary glands?
palate
which major gland has the most malignancies?
sublingual
list the MAJOR glands from the most to least prevalent malignancies
sublingual > submandibular > parotid
prevalence of sites for MALIGNANT INTRAORAL MINOR glands
- retromolar region & tongue (90%)
- lower lip (60%)
- buccal mucosa (50%)
- palate (45%)
- upper lip (20%)
what is pleomorphic adenoma also known as?
benign mixed tumor
where is the name pleomorphic adenoma derived from?
from diverse microscopic appearance of different tumors
what is the most common salivary gland neoplasm (benign OR malignant)?
pleomorphic adenoma
where is the site predilection for pleomorphic adenoma?
parotid gland
what percent of pleomorphic adenoma occur in the parotid gland?
80%
list the site predilection for pleomorphic adenoma in order from most often to least
parotid gland (80%) > submandibular gland and intraoral minor salivary glands (10% each)
T/F: pleomorphic adenoma develops more often in children
false, adults
who are most often affected by pleomorphic adenoma?
4th -6th decade (mean age 45 y.o)
T/F: pleomorphic adenoma has a slight male predilection
false, FEMALE predilection
clinical features of pleomorphic adenoma
- slow-growing
- painless
- moveable
- rubbery-firm on palpation
- usually non-ulcerated, but ulceration may be present secondary to trauma
- usually round when small, bosselated as it grows
T/F: pleomorphic adenoma lesions on the hard palate are not moveable due to normal anatomy of the palate
true
T/F: pleomorphic adenoma palatal lesions are usually lateral to the midline
true
predilection of minor gland sites for pleomorphic adenoma
palate > upper lip > buccal mucosa
histopathologic features of pleomorphic adenoma
- encapsulated
- proliferation of ductal and myoepithelial cells
- myoepithelial cells may appear plasmacytoid or spindled
T/F: proportions of proliferation vary tremendously among different pleomorphic adenoma lesions
true
what can myoepithelial cells produce?
- myxoid stroma
- hyaline material
- cartilaginous material
- osteoid
treatment for pleomorphic adenoma depends on what?
location
treatment of pleomorphic adenoma lesion on parotid
remove lesion with the involved lobe
treatment of pleomorphic adenoma lesion on submandibular
remove lesion and the involved gland
treatment of pleomorphic adenoma lesion on hard palate
remove lesion, including overlying mucosa down to periosteum
treatment of pleomorphic adenoma lesion on soft palate, labial and buccal mucosa
enucleation
T/F: pleomorphic adenoma lesions will recur if inadequately treated
true
T/F: pleomorphic adenoma lesions in the minor gland have more recurrences than the parotid
false, parotid lesions have more recurrences than minor glands
what percent of pleomorphic adenoma lesions will undergo malignant transformation if not removed?
5%
how does papillary cystadenoma lymphomatosum “Warthin tumor” arise?
from salivary duct epithelium entrapped in parotid lymph nodes during development
Warthin tumor is exclusively seen where?
parotid gland
who is most affected by Warthin tumor?
6th-7th decade (mean age 55-60 y.o)
what is the 2nd most common BENIGN tumor of salivary glands?
Warthin tumor
Warthin tumor has a strong association with what?
cig smoking; 8-fold greater risk in people who smoke
T/F: Warthin tumor occur more often in males
false, more often in males but recent studies suggest more equal gender ratio
clinical features of Warthin tumor
- non-tender
- slow-growing
- freely moveable
- parotid region, especially tail
what percent of Warthin tumor lesions are synchronous or metachronous?
10%
T/F: Warthin tumor lesions only occur bilaterally
false, unilateral or bilateral
histopathologic features of Warthin tumor
- encapsulated
- collection of lymphoid tissue, often shows germinal centers
- cystic spaces containing serous fluid
- papillary infoldings lined by a double row of cuboidal and columnar oncocytes (altered ductal epithelial cells) which project into the cystic spaces
tx for Warthin tumor
surgical excision
prognosis of Warthin tumor
good