Salivary Gland Tumor Flashcards
Non epi sg tumor is even …
Neurofibroma Hemangioma Lymphangioma 50% of children 5% of adults
Salivary tumors In adults and children
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
Macroscopic picture of pleomorphic adenoma
- oval or round nodular or smooth
- capsule is not continuous and tissues may be continuous with surrounding sg tissue
Pleomorphic adenoma size and site
- smaller if minor sg
- large if major
- palate
- tail of patotid
Wharthin tumor names
Papillary cyst adenoma lymphomatosum
Adenolymphoma
Prevalence and factors related to warthin tumors
2nd most common sg benign tumor
Related to smoking
Warthin tumors special signes
3 to 4cm
May be bilateral
Fluctuant
Macro pic of warthin
- mucoid or gelatinous or chocolate
- well capsulated
- round oval nodular smooth
Histology of warthin
--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
Site of warthin vs oncocytoma
Both in parotid and minot sg
Onco is in buccal and palate
And make up 1% of parotid gland tumors
Oncocytoma factors
Age
Rarely before 60y
20% of patients associated with radiation exposure
Histology of oncocytoma
-well capsulated Ct septa separating lobules Large round or polygonal cells Central nucleus Esinophylic Granular cytoplasm of atypical mitocondria
Cellular origin of the 3 malig sg tumors
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
Origin of intra-osseous tumors (central MEC
:
- Salivary tissue entrapped within the mandible. 2. Entrapped oral epithelium → mucous metaplasia.
- Odontogenic cysts (lining of dentigerous cyst).
- Lining of maxillary sinus
Central malignant s g tumors
Acinic
MEC
Most common malig. S g tumor in sub mand gland
Adenoid C.C.
Site of acinic c c
Central–
..minor >major
Peripheral–
..mand >max
Site of mec
Central
..mand pm and m more than max
Peri.
..minor than major
Lower lip
Adenoids cystic site
Minor more than major
- parotid >submandibular >sub lingual
- most common malig tumor of sub m gland
Clinical of both acinic cell and mec
Low grade tumor
Same as pleomorphic
High grade tumor
Painful,rapidly infiltrative leading
to fixation and ulceration
Clinical of ACC
- Slow growth, painful mass.
- Ulceration of the oral mucosa may be seen. 3. Fixation to the deeper structures
- Neurological symptoms →→ as turnor spreads along nerve pathway then numbness.
sensation then cut of nerve leading to loss of sensation or facial palsy.
- 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.
Clinical of acc
- Slow growth, painful mass.
- Ulceration of the oral mucosa may be seen. 3. Fixation to the deeper structures.
Low grade tumor
High grade tumor
- Similar
a 1 Painful,
rapidly infiltrative leading
growing and to fixation
- 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.
- 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.
X ray of 3 malig sg tumor
All ill defined multi locular
Except acc has no xray in early lesion
Capsule of 3 malig sg tumor
Acc —not
Mec—partual or un –also cystic or solid
Acinic cell – partially cap or not
