Salivary gland tumors

From WikiLectures

1. Parotid gland 2. Sublingual gland 3. Sublingual gland (sublingual gland)
File:Parotid Tumor.jpg
Parotid gland tumor
  • Salivary gland tumors affect both the large and small salivary glands.
  • The parotid gland is most often affected .
  • They mainly affect adults.
  • Clinically, they may manifest as a rigid, painless enlargement of the gland.

Classification[edit | edit source]

Benign epithelial tumors[edit | edit source]

File:Mixed Tumor of the Salivary Gland
Pleomorphic adenoma of the salivary gland
  • Pleomorphic adenoma.
  • Monomorphic adenoma (eg papillary cystadenolymphoma).

Malignant epithelial tumors[edit | edit source]

  • Mucoepidermoid carcinoma.
  • Acinocellular carcinoma.
  • Adenoid cystic carcinoma.
  • Adenocarcinoma.
  • Epidermoid Carcinoma.
  • Undifferentiated carcinoma.
  • Carcinoma in pleomorphic adenoma.

Mesenchymal tumors[edit | edit source]

Metastases of malignant tumors of other organs[edit | edit source]

Benign tumors of the salivary glands[edit | edit source]

  • Benign tumors of the salivary glands are very variable.
  • Occurrence is independent of gender.
  • They usually grow slowly and painlessly.
  • Epithelium is more common than mesenchymal.
  • The therapy is surgical.
  • The most common are pleomorphic adenoma (mixed tumor, myxochondroepithelioma) and papillary cystadenolymphoma (Warthin's tumor).

Here are some types of tumors:

Pleomorphic adenoma[edit | edit source]

  • The so-called myxochondroepithelioma .
  • The most common tumor of the salivary glands.
  • Epithelial tumor, most often in the parotid gland (and also the most common gl. Parotis tumor).
  • Especially in old and middle age, it is slowly growing.
Pleomorphic adenoma, S-100 positive
  • Possible recurrences.
  • The tumor often grows into the capsule, which increases the possibility of malignancy.
  • Clinically, it manifests as painless swelling.
  • In the histological picture, several components alternate - an epitheliomatous component with trabecular, ductal, acinous or solid treatment, as well as a myxoid and chondroid component.

Papillary cystadenolymphoma (Warthin's tumor))[edit | edit source]

  • The second most common benign salivary gland tumor.
  • Occurrence mainly in gl. parotid and submandibular glands (9% of tumors in the parotid gland).
  • After the age of 40, more often men.
  • It is usually limited, rigid, well-moving against the base, spherical, it can imitate a cyst on sonography.
  • It grows slowly.
  • 10% recurrence, malignant reversal is very rare.
  • It is formed by the proliferation of epithelial inclusions in the intraparotic lymph nodes.
  • The characteristic histological picture is dominated by bilayer epithelium with nuclei facing the lumen, the stroma is formed by lymphatic tissue.

Basal cell adenoma[edit | edit source]

  • 70% in gl. parotid, 20% small lip glands.
  • Maximum occurrence in the 7th decade.
  • Possible transition to basal cell carcinoma .

Myoepithelioma[edit | edit source]

  • Rare.
  • It mainly affects gl. parotis.
  • It can progress to malignancy.
  • Unlike pleomorphic adenoma, they do not form ductal structures.

Oncocytoma[edit | edit source]

  • Occurrence in the 6th to 7th decade, more often in women.
  • It grows slowly, is mobile, small (up to 2 cm).
  • Creates a case, gray-red in cross section.
  • There are no recurrences, malignancies are very rare.
  • Eosinophilic finely granulated cells with increased mitochondria are evident in the histological picture.

Channel adenoma[edit | edit source]

  • Occurrence over 50 years.
  • Usually in the upper lip.

Sebaceous adenoma[edit | edit source]

  • Rare.
  • Well demarcated, cystic, various sizes.

Ductal papilloma[edit | edit source]

  • Not very common.
  • It arises from the epithelium of the small salivary glands

Malignant tumor of the salivary gland[edit | edit source]

Malignant tumors of the salivary glands are divided into epithelial and mesenchymal. The most common are Acinocellular carcinoma , mucoepidermoid carcinoma , adenoid cystic carcinoma (cylindrical) and pleomorphic adenoma . The therapy is surgical - radical. Patients with Sjögren's syndrome have an increased incidence of salivary gland lymphomas.

Malignant epithelial tumors[edit | edit source]

They come from the glandular parenchyma. These include acinocellular carcinoma , mucoepidermoid carcinoma, adenoid cystic carcinoma.

Acinocellular carcinoma[edit | edit source]

  • The most common malignant tumor from salivary gland acins (the following cancers are from ductal / myoepithelial cells).
  • Finding mainly in gl. parotis.
  • More common in women.
  • Mucoepidermoid carcinoma
  • They make up about 5% of salivary gland tumors.
  • It consists of mucus-producing cells, epidermoid bb and bb of the transitional type, and is usually imperfectly *encapsulated.
  • Low malignant - well-differentiated, cystic structures lined with mucous bb.
  • Highly malignant - low-differentiated, solid epidermoid bb, mucus bb are in the minority.
  • Prognosis: 70-90% of patients survive 5 years.

Adenoid cystic carcinoma[edit | edit source]

  • They make up 40% of glandular cancers.
  • It occurs in three forms - glandular, solid and tubular.
  • It consists of ductal and myoepithelial cells .
  • Metastasizes to regional nodes and remotely to the lungs, skeleton.
  • The prognostic depends on the extent of the tumor and the radicality of the surgical procedure.
  • The solid form is the least favorable.
  • It mainly affects the small salivary glands of the palate, less often the large salivary glands.
  • It also spreads perineurally, sometimes intraneurally.

Carcinoma in pleomorphic adenoma[edit | edit source]

  • It is caused by a malignant transformation of a benign tumor.
  • This is reported to be 3-4%.
  • We distinguish according to the histological structure into true, malignant and mixed.
  • Acceleration of growth will indicate a malignant transformation.

Malignant mesenchymal tumors[edit | edit source]

Benign mesenchymal tumors such as hemangioendothelioma, lipoma , neurinoma, neurofibroma most often appear in the salivary glands . Of the malignant tumors, only malignant lymphoma is included . Malignant lymphoma is divided into two categories according to etiology: primary, arising in Sjogren's syndrome, or secondary in generalization.

Links[edit | edit source]

References[edit | edit source]

  • PAZDERA, Jindřich. Základy ústní a čelistní chirurgie. 1.. edition. Olomouc : Universita Palackého v Olomouci, 2007. 0 pp. ISBN 978-80-244-1670-0.