Salivary Flashcards
Mixed Tumor = Pleomorphic adenoma
site: Parotid and palate, lips
Age: 30-50, but also seen in children
Gender: female
Appearance: small, painless, slowly enlarging nodule, can reach weight of several pounds
Frequency: Both major and minor salivary glands: most common benign salivary gland neoplasm. It accounts for 80% of all benign salivary gland neoplasms.
Tx: remove with clean margins, can recur
Carcinoma ex Mixed Tumor
Etiology: High-grade adenocarcinoma. Occurs in patients 10 to 15 years older than mixed, history of sudden enlargement
tumor patients.
site: assuming same as mixed: Parotid and palate, lips
Age: if average age for mixed tumor is 30-50, then its around 40-65
Gender: female
Appearance: Pain and discomfort
Frequency:
Tx: Surgery, or combined surgery and radiation, High recurrence rate. 50% 5-year survival rate
Monomorphic Adenoma - basal cell adenoma
Etiology: benign salivary gland tumors
site: parotid most common, can occur in lips
Age: male
Gender: older
Appearance: : This is a painless, slow-growing nodule that is
Frequency: rare in oral cavity
Monomorphic adenoma - Canalicular adenoma
Etiology:
Site: minor salivary glands: 75% occur in upper lip, Rare in major salivary glands!
Age: 60yrs
Gender: females in 60s
Appearance: Circumscribed, movable, slow-growing,
painless nodule
Frequency:
TX: • Treated by simple enucleation, doesn’t recur
Warthin’s Tumor
Another name Papillary Cystadenoma Lymphomatosum
Etiology:
Site: Parotid most common, palate is reported too. bilateral up 14% of cases
Age: 60s
Gender: males, equal sex distribution also reported (?)
Appearance: Firm asymptomatic swelling
Frequency: 5-10% of all salivary gland neoplasms
Tx: Complete surgical removal, 6-12% recurrence rate
Oncocytoma = oxyphilic adenoma
Etiology:
Site: major salivary glands. parotid gland mainly. A variant of it also found in oral cavity and is called oncocytic cystadenoma: buccal mucosa and upper lip.
Age: 70s and 80s
Gender: females
Appearance: small, asymptomatic, encapsulated
nodule
Frequency: Rare neoplasm of salivary glands
Polymorphous Low Grade Adenocarcinoma
Etiology: Low grade malignant neoplasm of SG origin
Site: mostly minor salivary glands: mostly palate, upper lip and buccal mucosa. rare in major salivary glands.
Age: 6-8th decade
Gender: females
Appearance: rarely painful,
Frequency: Most common in minor salivary glands. Slow growing, rarely metastasizing neoplasm.
tx: Complete surgical removal, Multiple recurrences, metastasis rare
Mucoepidermoid Carcinoma
Etiology:
Site: majority in parotid. Occurs in minor salivary glands especially the palate, tongue, buccal mucosa, retromolar pad area.
Age: any. most common malignant salivary gland neoplasm in children.
Gender:
Appearance: Low grade: slowly enlarging, painless
lesion, sometimes resembling a mucocele especially
those at the retromolar pad area. High-grade presents as rapidly growing, painful lesions with facial nerve paralysis, sometimes with regional lymph node metastasis.
Frequency: most common malignant salivary gland neoplasm! 10% of all salivary gland neoplasms
tx: Complete surgical removal with clean margins.
radiotherapy & chemotherapy
Adenoid Cystic carcinoma
Etiology:
Site: both in minor and major salivary glands. lacrimal gland, pharynx, larynx, etc. palate, submandibular gland
and tongue common.
Age: middle aged, but also seen in younger patients
Gender:
Appearance: May present with local pain, facial nerve paralysis, fixation to deeper structures and local invasion. On the palate the
tumor may be covered with normal-looking epithelium and be indistinguishable from pleomorphic
adenoma or mucoepidermoid carcinoma, or may be ulcerated.
Frequency: 4% of all salivary gland neoplasms, the most common malignant neoplasm of the minor
salivary glands and the submandibular gland.
tx: Surgical removal & radiotherapy if margins are not clean
• High recurrence, may metastasize but late in course
• 80% 5-year survival rate, 18% 20-year survival rate
• Life-time follow-up is mandatory
Acinic Cell Carcinoma
Etiology:
Site: buccal mucosa and lip, bilateral parotid reported
Age: Young and middle-aged people, reported in
older patients
Gender: more in female
Appearance:
Frequency: 1-2% of all salivary gland neoplasms
Tx: Complete surgical removal, 90% 5-year survival rate, 65% 20-year survival rate, High recurrence rate, attributed to improper treatment
Necrotizing Sialometaplasia
Etiology: local ischemia. benign inflammatory reaction, can mimic a salivary gland malignancy
Site: Palate in 75%, About two-thirds of
cases are on the bilateral palate, buccal mucosa and lip
Age: 4-5 decade of age
Gender: male 2:1
Appearance: Ulcerated swelling-painless, usually well circumscribed and deep
TX: Debridement and saline rinses. It is a self-healing process.
Usually heals spontaneously over 6-10-week period. Healing is accelerated with biopsy.
Extravasation mucocele
Etiology: trauma to duct (mucous pulls, granulation tissue to wall it off)
Site: Most common on the lower lip, rare on the upper lip, can occur buccal mucosa, FOM, can be on the tongue. Really anywhere in the oral cavity.
Age:
Gender:
Appearance: Swelling, light blue or pink, increases and decreases in size. 17% are superficial, 83% deep.
Tx: Surgical excision of the deep with removal of minor
salivary gland, superficial no treatment
Salivary duct cyst = Mucus retention cyst
Etiology: not trauma (like mucocele), unknown etiology
Site: major and minor. Mostly FOM, BM & lips.
Age:
Gender:
Appearance: true cystic structure lined by epithelium
(columnar, cuboidal and others). It is considered to be
a true developmental cyst.
TX: conservative surgical excision
Ranula (Frog’s Belly)
Note: clinical term. Histologically, it represents the mucous retention cyst. However, it can also be
an extravasation type.
Etiology:
Site: FOM uni/bilateral
Age:
Gender:
Appearance: May penetrate myohyoid muscle,
‘plunging ranula’. presents as a deepseated normal color swelling in the floor of mouth.
Frequency: Plunging ranula requires complete excision via an extra-oral approach. High recurrence rate
