24 Neoplastic - Salivary

Question 1

What percent of parotid tumors are benign

Answer 1

75-80%

Question 2

What is mc site of salivary gland neoplasm

Answer 2

Parotid 73%

Question 3

Least common site of salivary neoplasm

Answer 3

Submandibular 11%

Question 4

What is m/c site of malig gland neoplasm

Answer 4

Minor salivary glands 60%; 40% occur on palate

Question 5

What is least common site of malig salivary gland neoplasm

Answer 5

Parotid 32%

Question 6

Which salivary gland has best prog for malig tumor

Answer 6

parotid

Question 7

which salivary gland has worst prog for malig tumor

Answer 7

SMG

Question 8

M/c tumor of parotid

Answer 8

Pleomorphic adenoma in adult, hemangioma in kid (other sources say BMT in both)

Question 9

How does metastasizing BMT differ from carcinoma ex-pleomorphic adenoma

Answer 9

Histologically benign, lacking malig epithelial components

Question 10

M/c malig tumor of parotid in adults

Answer 10

Mucoep CA

Question 11

Most imp prog factor for malign salivary gland neoplasms

Answer 11

stage

Question 12

Which 5 salivary gland tumors have worst prog

Answer 12

• High grade mucoep
• AdenoCA
• SCCa
• Undifferentiated CA
• Carcinoma ex-pleomorphic adenoma

Question 13

Indications for postop RT after parotid

Answer 13

• High probability of residual microscopic dz
• • margins
• Advanced stage
• High grade
• Deep lobe tumors
• Recurrent tumors
• Presence of regional mets
• Angiolymphatic invasion

Question 14

What factors are predictors of occult regional dz in parotid CA

Answer 14

• Extracapsular extension
• Preop facial paralysis
• Age > 54
• Perilymphatic invasion

Question 15

Indications for neck dissection in tx of salivary gland malignancies

Answer 15

• Clinical mets
• Submandibular tumor
• SCCa
• Undifferentiated CA
• Size > 4 cm
• High grade mucoep CA

Question 16

M/c site of distant mets for adenoid cystic CA

Answer 16

Lung

Question 17

Incidence of subclinical neck dz w/ adenoid cystic CA of parotid

Answer 17

10%

Question 18

M/c salivary gland malig following RT

Answer 18

Mucoep

Question 19

M/c malig of SMG and minor salivary glands

Answer 19

adenoid cystic

Question 20

Type of tumor comprises 50% of all lacrimal gland neoplasms

Answer 20

Adenoid cystic

Question 21

4 types of growth patterns of ACC and which is m/c

Answer 21

• Cribriform (m/c, looks like swiss cheese)
• Tubular/ductular
• Trabecular
• Solid

Question 22

Which type of RT does ACC respond best to

Answer 22

Neutron beam

Question 23

What is m/c salivary gland malig to occur bilaterally

Answer 23

Acinic cell

Question 24

What are the 2 m/c malig tumors of parotid in children < 12

Answer 24

Mucoep is m/c followed by acinic cell

Question 25

Incidence of cervical mets of mucoep CA

Answer 25

30-40%

Question 26

Your patient has a mucoepidermoid carcinoma of the parotid gland. Histologic evaluation of the biopsy specimen reveals a scant amount of mucin. There is no clinical evidence of regional metastasis. Do you treat the neck?

Answer 26

Yes (this is high grade)

Question 27

What is the 2nd m/c malign tumor of minor salivary glands

Answer 27

AdenoCA

Question 28

What are the 4 types of monomorphic adenomas

Answer 28

Basal cell Trabecular Canalicular Tubular

Question 29

Which salivary gland tumor is more common in women with a h/o breast CA

Answer 29

Mucoep CA

Question 30

What is the tx of choice for met cutaneous SCCa to the parotid

Answer 30

Total parotid with preservation of VII (unless invaded by tumor) and postop RT to parotid and IPSI neck

Question 31

What % of malig tumors of parotid p/w facial nerve weakness or paralysis

Answer 31

20%

Question 32

Which salivary gland tumor has high propesity for PNI

Answer 32

ACC

Question 33

What are the clinical features of salivary duct carcinomas

Answer 33

M/c involve the parotid gland and present as an Asx mass; higher incidence in males; distant mets are the m/c cause of death

Question 34

Parapharyngeal tumors arising from deep lobe of parotid will involve which compartment

Answer 34

Prestyloid

Question 35

What happens to carotid sheath with deep lobe parotid tumors extending into PPS

Answer 35

displaced posteriorly

Question 36

Which compartment of PPS are neurogenic tumors most likely to arise in

Answer 36

Poststyloid

Question 37

What is m/c tumor of PPS

Answer 37

BMT