Salivary Gland Neoplasms Flashcards
T/F: Salivary gland neoplasms have a slight female predilection.
True
What is the most common site for a salivary gland neoplasm (benign or malignant)?
Parotid gland
What is the most common site for a salivary gland neoplasm in the minor glands?
Palate
Which major salivary gland has the highest percentage of malignancies per neoplasm?
Sublingual
Neoplasms in the sublingual glands are the most likely to be malignant
Which intraoral minor salivary glands are most likely to have a malignant neoplasms?
Retromolar region and tongue
______________ is the most common salivary gland neoplasm.
Pleomorphic adenoma
What percentage of pleomorphic adenomas are found in the parotid gland?
80% of pleomorphic adenomas are in the parotid gland
T/F: Pleomorphic adenomas will cause pain to the patient.
False
Slow-growing, painless, moveable, rubbery-firm
Which minor salivary gland is most likely to develop a pleomorphic adenoma?
Palate
T/F: Pleomorphic adenomas will look encapsulated histologically.
True
T/F: Pleomorphic adenomas are benign.
True
_____________ may appear plasmacytoid or spindled in pleomorphic adenomas.
Myoepithelial cells
Which gland is least likely to have a salivary gland neoplasm (benign or malignant)?
Sublingual
Which salivary gland has the lowest percentage of malignancies per neoplasm in that area?
Parotid
Most neoplasms in the palate are benign
T/F: Pleomorphic adenoma has a very specific histological appearance.
False
Can look very different
What is the second most frequent site for a pleomorphic adenoma?
Upper lip
T/F: To remove a pleomorphic adenoma in the parotid, the lesion must be removed along with the parotid gland.
False
Parotid - lesion and lobe involved
Submandibular - lesion and involved gland
What percentage of pleomorphic adenomas will become malignant if not removed?
5%
T/F: Parotid pleomorphic adenomas are more likely to recur than those in minor glands.
True
What is the second most common benign tumor of the salivary glands?
Papillary cystadenoma lymphomatosum - “Warthin tumor”
T/F: Warthin tumor has a strong association with cigarette smoking and has a male predominance.
True
Where on the parotid are Warthin tumors most commonly found?
Tail
T/F: Pleomorphic adenoma will show cystic spaces containing serous fluid histopathologically.
False
Papillary cystadenoma lymphomatosum
T/F: Papillary cystadenoma lymphomatosum is encapsulated.
True
Oncocytes are seen projecting into the cystic space in which type of tumor?
Warthin tumor (Papillary cystadenoma lymphomatosum)
T/F: Warthin tumors have a good prognosis.
True
Surgical excision - low recurrence rate
T/F: Canalicular adenoma is more common in minor salivary glands.
True
Which benign salivary tumor occurs more often in much older patients (7th decade)?
Canalicular adenoma
What will be seen histopathologically in a Canalicular adenoma?
Tubules and narrow trabecular cords appearing like channels
What is the prognosis for a Canalicular adenoma?
Excellent
Enucleation - no tendency to recur
What is the most common salivary gland malignancy?
Mucoepidermoid carcinoma
T/F: Mucoepidermoid carcinoma is unlikely to be seen in people less than 40 years old.
False
15% in patients <15 y.o.
T/F: Mucoepidermoid carcinoma is seen in only major glands.
False
Both major and minor
What are the two most common minor salivary regions to see mucoepidermoid carcinoma?
Palate and retromolar region
You see a mucocele-appearing lesion in the retromolar area. What should be #1 on you differential?
Mucoepidermoid carcinoma
Why might a mucoepidermoid carcinoma have a blue tint?
Trapped mucin
T/F: Mucoepidermoid carcinoma will show significant pleomorphism and increased mitotic activity.
False
Must show intracellular mucin and have mucous and Epidermoid cells
What are the two distinct histopathologic features of mucoepidermoid carcinoma?
- Mucous cells
2. Epidermoid cells
T/F: All mucoepidermoid carcinomas need excision and radiation.
False
Only high-grade need radiation after excision
What is the second most common minor salivary gland malignancy?
Polymorphous adenocarcinoma (PAC)
T/F: Polymorphous adenocarcinoma is more prevalent in females.
True
What are the clinical features of a polymorphous adenocarcinoma?
Slow-growing, firm and painless
May have ulceration
Starts as well demarcated then infiltrates
T/F: Polymorphous adenocarcinoma is almost exclusive to the parotid glands.
False
Exclusive to minor salivary glands
62% in palate
What are some histopathological features of a Polymorphous adenocarcinoma?
Variety of growth patterns
Lobular growth pattern infiltrating surrounding tissue
Pseudocapsule
What is the prognosis for Polymorphous adenocarcinoma?
Good
Wide surgical excision
20% recurrence
Where are the majority of adenoid cystic carcinomas found?
Often in minor salivary glands, especially the palate
What is the most common malignancy of the submandibular gland?
Adenoid cystic carcinoma
T/F: Adenoid cystic carcinoma is typically associated with pain or tenderness.
True
NSAIDs and acetaminophen do not help
What are some histopathological features of adenoid cystic carcinoma?
Unencapsulated
Perinueral and intraneural invasion
What are the three possible growth patterns for adenoid cystic carcinoma?
- Tubular - well-differentiated
- Cribriform - “Swiss cheese”
- Solid - poorly-differentiated
T/F: There is lots of pleomorphism and mitotic activity with adenoid cystic carcinoma.
False
T/F: Radiation treatment is required with adenoid cystic carcinoma.
True
What is the prognosis for adenoid cystic carcinoma?
Poor
What is the most common path of metastasis for adenoid cystic carcinoma?
Blood -> lung, brain, bone, liver
Where are the majority of acinic cell carcinomas?
Parotid gland
