Salivary Glands

Question 1

Define pleomorphic adenoma of the salivary glands

Answer 1

• Most common benign tumour, mostly parotid.
• painless, firm, mobile.
• older females

Question 2

Treatment pleomorphic adenoma of parotid gland?

Answer 2

Superficial parotidectomy

Question 3

Which benign parotid tumour is soft to cystic, mostly bilateral and more common in males?

Answer 3

Warthin’s tumour: papillary cystadenoma lymphomatosum

Question 4

Which benign tumour is the retention cyst of sublingual gland?

Answer 4

Ranula

Question 5

Name 4 benign tumour of the salivary gland

Answer 5

• Pleomorphic adenoma: most common
• Warthin’s tumour (papillary cystadenoma lymphomatosum)
• oncocytoma: mainly bilateral, parotid
• Rama

Question 6

Name 4 features malignant tumours of the salivary glands

Answer 6

•Rapid growth
• infiltration to local structures and skin ulceration
• facial nerve involve
• cervical lymphadenopathy

Question 7

Which salivary gland has highest incidence malignant tumous?

Answer 7

Sublingual
Bigger glands = smaller chance malignancy

Question 8

Diagnostic tests for salivary gland malignancy? (3)

Answer 8

• Ultrasound: very sensitive, can distinguish between lymph nodes and other path
• CT scan: delineate extent lesion and relation to other structures, features malignancy and irregular margins, local infiltration.
• MRI: delineate nerve and bone invasion
Plain xray and sialography limited role

Question 9

Name 4 malignant salivary gland tumours

Answer 9

• Mucoepidermoid carcinoma: most common, age 40-50, female
• adenoid cystic carcinoma: infiltrate nerve pathways, may invade cranial cavity.
• adenocarcinoma: rare
• acinic cell carcinoma: specific to parotid gland

Question 10

Name the Milan system for reporting salivary gland cytopathology, risk malignancy and management

Answer 10

• I: non-diagnostic : 25%, clinical and radiological correlations or repeat FNAC
• II: non-neo plastic: 10%, clinical follow up and radiological correlation
• III: atypia of undetermined significance (aus): 20 % , repeat FNAC or surgery
• iv : neoplasm benign- <5%, surgery or follow up
Neoplasm salivary gland of uncertain malignant potential (sump) - 35%, surgery
. V: suspicious for malignancy (SM): 60% , surgery
• vi : malignant: 90% , surgery

Question 11

Management salivary gland tumours?

Answer 11

Surgery with adjuvant radiotherapy.
Resistant to chemo.