salivary neoplasm 2 Flashcards
Adenoid Cystic Carcinomas account for __% of all salivary gland neoplasms
5%
what locations are usually effected with Adenoid Cystic Carcinomas?
A) Parotid and submandibular gland are affected about equally
B) Intraorally, the palate is the most commonly affected site, with approximately half of the intraoral cases involving that location
what population groups are at the highest risk for Adenoid Cystic Carcinomas?
Slight female predilection
Age range has been reported from 15-88 years, with a mean of 55 years, and most tumors present in the fifth decade
clinical characteristics of adenoid cystic carcinomas:
1) Lesion initially presents as a slow-growing, non-ulcerated, infiltrative mass
2) Frequently associated with pain or tenderness
3) Ulceration may develop later in its course
Histological characteristics of Adenoid Cystic Carcinomas:
A) Hyperchromatic basaloid cells with minimal cytoplasm
B) Little pleomorphism or mitotic activity
C) Marked propensity for this lesion to exhibit perineural and intraneural invasion
what are the 3 possible “growth patterns” for Adenoid Cystic Carcinoma?
tubular - well-differentiated
cribriform - classic “Swiss cheese” pattern- intermediate dif
solid - poorly-differentiated
what is the treatment/prognosis for Adenoid Cystic Carcinoma?
Tx: Wide surgical excision, with radiation therapy afterwards
Prognosis: Generally poor - slow-growing and relentless, with death from disease up to 20-25 years after diagnosis
what does the prognosis for Adenoid Cystic Carcinoma depend on?
Depends on location of lesion, grade, anatomic structures involved, presence of tumor at surgical margins
Metastases from Adenoid cystic carcinomas typically go to what locations?
- go to the lung, followed by brain, bone and liver
- Lymph node involvement typically accounts for only 5% of metastatic deposits of adenoid cystic Ca
T/F: the 10 year survival of Adenoid cystic carcinoma is only 50%
TRUE
10-year survival – 50%
20-year survival – 25%
what is the Incidence of Acinic Cell Adenocarcinoma? where do they usually occur?
This neoplasm comprises only 2% of all salivary gland tumors, with the vast majority occurring in the parotid (90%)
The remaining 10% usually seen intraorally
what population group is at the highest risk for developing Acinic Cell Adenocarcinoma?
What are the clinical characteristics?
A) Age range is reported from 5-84 years, with a mean age of about 45 years
B) Fairly circumscribed, slow-growing mass in the parotid region; intraorally – buccal mucosa or palate
C) Pain or tenderness may eventually become evident in nearly half the cases
Histological characteristic of Acinic Cell Adenocarcinoma:
Often appear to be pseudo-encapsulated
Basophilic, bland cells histologically very similar to acinar cells
Treatment/prognosis/metastasis of Acinic Cell Adenocarcinoma
Tx: Surgical excision
Prognosis: Guarded
In AFIP series, 35% recurred, 16% metastasized (usually to lymph node) and 16% died of their disease
Most cases of Carcinoma ex-Mixed Tumor (Ca ex-PA) occur in what age groups?
what is the primary clinical symptom?
Peak incidence in the sixth to eighth decades of life
Long-standing asymptomatic mass that suddenly becomes tender or is associated with paresthesia
