Salivary Gland Tumor

Question 1

Non epi sg tumor is even …

Answer 1

Neurofibroma
Hemangioma
Lymphangioma
50% of children 
5% of adults

Question 2

Salivary tumors In adults and children

Answer 2

Adults

• Salivary gland tumors occur primarily in older adults

Females more commonly affected, except Warthin’s tumor and high-grade

carcinomas Epithelial (80%) tumors

predominate Benign neoplasms are more common (75%) among the

epithelial tumors

The smaller the salivary gland, the higher the proportion of malignant tumors:

parotid gland (15-32%); submandibular gland (41-45%);

sublingual gland (70-90%); minor salivary gland (>50%)

Children (under age of 18)

Rare in general; only 1.7-3% of all salivary tumors occur in children

In infants, mesenchymal tumors (hemangioma and lymphangioma) are the commonest tumors; in older children, epithelial tumors predominate

F Malignant neoplasms are common (60%) among the epithelial tumors

Most malignant tumors in children are low grade, hence tumor mortality and morbidity are low

Question 3

Macroscopic picture of pleomorphic adenoma

Answer 3

• oval or round nodular or smooth

- capsule is not continuous and tissues may be continuous with surrounding sg tissue

Question 4

Pleomorphic adenoma size and site

Answer 4

• smaller if minor sg
• large if major
• palate
• tail of patotid

Question 5

Wharthin tumor names

Answer 5

Papillary cyst adenoma lymphomatosum

Adenolymphoma

Question 6

Prevalence and factors related to warthin tumors

Answer 6

2nd most common sg benign tumor

Related to smoking

Question 7

Warthin tumors special signes

Answer 7

3 to 4cm
May be bilateral
Fluctuant

Question 8

Macro pic of warthin

Answer 8

• mucoid or gelatinous or chocolate
• well capsulated
• round oval nodular smooth

Question 9

Histology of warthin

Answer 9

--Epi--
..2 layers
..Inner col palisades with round to oval nucleus vesicular  and granular eosinophil cytoplasm
Between them goblet cells
..outer flat or cuboidal cells

–lymphoid–
..Reticular lymphatic aggregates with germinal centers
..convoluted

Question 10

Site of warthin vs oncocytoma

Answer 10

Both in parotid and minot sg
Onco is in buccal and palate
And make up 1% of parotid gland tumors

Question 11

Oncocytoma factors

Answer 11

Age
Rarely before 60y
20% of patients associated with radiation exposure

Question 12

Histology of oncocytoma

Answer 12

-well capsulated
Ct septa separating lobules
Large round or polygonal cells
Central nucleus
Esinophylic Granular cytoplasm of atypical mitocondria

Question 13

Cellular origin of the 3 malig sg tumors

Answer 13

Acc—myoepi cells and intercalated ducts cells

Mec—totipotent cells of excretory duct that has potential for transformation into columnar squamous and mucous cells

Acinic– serous acini cells

Question 14

Origin of intra-osseous tumors (central MEC

Answer 14

:

1. Salivary tissue entrapped within the mandible. 2. Entrapped oral epithelium → mucous metaplasia.
2. Odontogenic cysts (lining of dentigerous cyst).
3. Lining of maxillary sinus

Question 15

Central malignant s g tumors

Answer 15

Acinic

MEC

Question 16

Most common malig. S g tumor in sub mand gland

Answer 16

Adenoid C.C.

Question 17

Site of acinic c c

Answer 17

Central–
..minor >major
Peripheral–
..mand >max

Question 18

Site of mec

Answer 18

Central
..mand pm and m more than max

Peri.
..minor than major
Lower lip

Question 19

Adenoids cystic site

Answer 19

Minor more than major

• parotid >submandibular >sub lingual
• most common malig tumor of sub m gland

Question 20

Clinical of both acinic cell and mec

Answer 20

Low grade tumor
Same as pleomorphic

High grade tumor
Painful,rapidly infiltrative leading
to fixation and ulceration

Question 21

Clinical of ACC

Answer 21

1. Slow growth, painful mass.
2. Ulceration of the oral mucosa may be seen. 3. Fixation to the deeper structures
3. Neurological symptoms →→ as turnor spreads along nerve pathway then numbness.

sensation then cut of nerve leading to loss of sensation or facial palsy.

5. Bone may be involved, as it grows through marrow spaces at 1” without destroying the trabeculae then in late stage cause destruction of bone trabecula.

Question 22

Clinical of acc

Answer 22

1. Slow growth, painful mass.
2. Ulceration of the oral mucosa may be seen. 3. Fixation to the deeper structures.

Low grade tumor

High grade tumor

1. Similar

a 1 Painful,

rapidly infiltrative leading

growing and to fixation

4. Neurological symptoms →→ as turnor spreads along nerve pathway then numbness

pleomorphic

adenoma.

ulceration.

sensation then cut of nerve leading to loss of sensation or facial palsy.

5. Bone may be involved, as it grows through marrow spaces at 1” without destroying the trabeculae then in late stage cause destruction of bone trabecula.

Question 23

X ray of 3 malig sg tumor

Answer 23

All ill defined multi locular

Except acc has no xray in early lesion

Question 24

Capsule of 3 malig sg tumor

Answer 24

Acc —not
Mec—partual or un –also cystic or solid

Acinic cell – partially cap or not