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ENT > benign and malignant salivary gland tumors > Flashcards

benign and malignant salivary gland tumors Flashcards

1
Q

what are the major salivary glands ?

A

parotid
submandibular
sublingual

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2
Q

what are the three structures that pierce the parotid gland ?

A

external carotid artery
facial nerve
retromandibular vein

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3
Q

what are the benign tumors of the salivary glands ?

A

pleomorphic adenoma
warthins tumor

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4
Q

what is the other name for warthin’s tumor ?

A

papillary cystadenoma lymphomatosum

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5
Q

what is the commonest benign tumor of the parotid ?

A

pleomorphic adenoma

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6
Q

what is sen on gross evaluation of a pleomorphic adenoma ?

A

smooth
multilobular
encapsulated

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7
Q

what are the microscopic features of a pleomorphic adenoma ?

A

presence of both epithelial cells and mesenchymal like elements
epithelial cells make up most of the cellular region
myoepithelial cells make up the stromal areas

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8
Q

what is the percentage of malignant transformation of pleomorphic adenomas ?

A

5% malignant transformation , which comes with facial nerve affection

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9
Q

what is the treatment for pleomorphic adenoma ?

A

parotidectomy - only treatment

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10
Q

which age group is highly affected by warthin’s tumors ?

A

papillary cystadenoma lymphomatosum commonly affect those in the age range of 60-70 yrs old who have history of heavy smoking

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11
Q

what modifiable factor is highly associated with warthin’s tumor ?

A

smoking

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12
Q

what is observed on gross examination of warthin’s tumor ?

A

ovoid mass at the tail of the parotid
smooth capsule
when incised have multiplee cystic space filled with mucinous material

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13
Q

what is the microscopic picture of warthin’s tumor ?

A

multiple papillae are seen projecting into the cystic spaces

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14
Q

what is the percentage of malignant transformation in warthin’s tumor ?

A

no malignant transformation

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15
Q

what is the management of warthin’s tumor ?

A

parotidectomy or conservative if slowly growing and small in size

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16
Q

what are the malignant tumors associated with the salivary glands ?

A

mucoepidermoid carcinoma
acinic cell tumor
adenoid cystic carcinoma
lymphoma

17
Q

what is the most common salivary gland malignancy ?

A

mucoepidermoid carcinoma

18
Q

what is the most common submandibular gland malignancy ?

A

adenoid cystic carcinoma

19
Q

what is the most common lymphoma associated with the salivary glands ?

A

non-hodgkins lymphoma

20
Q

what puts a patient at a higher risk of developing non hodgkin lymphoma ?

A

pre existing sjogren’s syndrome

21
Q

what are mucoepidermoid carcinomas divided into ?

A

high grade
intermediate
low grade

22
Q

what does the grading system of the mucoepidermoid carcinoma depend on ?

A

low grade tumors have a higher predominance of mucous cells rather than epidermoid cells
high grade looks more like a squamous cell carcinoma

23
Q

what is the treatment for a mucoepidermoid carcinoma ?

A

parotidectomy

24
Q

what are the cellular components of acinar cell tumors ?

A

consist of mainly serous cells

25
Q

what is the percentage of metastasis turnover for acinar cell tumors ?

A

10% gives rise to metastasis

26
Q

what type of spreadd is associated with adenoid cystic carcinoma ?

A

perivascular and perineural spread especially for the facial nerve

27
Q

what is the most common place for metastasis associated with adenoid cystic carcinoma ?

A

more commonly tthe lungs

28
Q

what are the three types of adenoid cystic carcinomas in terms of architecture ?

A

cribriform
tubular
solid

29
Q

what are the red flags associated with parotid gland masses ?

A

hardness
rapid growth
tenderness
infiltration of surrounding structures
overlying skin ulceration
facial weakness

ENT (30 decks)

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