Salivary gland tumors
- 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]
- Pleomorphic adenoma.
- Monomorphic adenoma (eg papillary cystadenolymphoma).
Malignant epithelial tumors[edit | edit source]
- Mucoepidermoid carcinoma.
- Acinocellular carcinoma.
- Adenoid cystic carcinoma.
- Epidermoid Carcinoma.
- Undifferentiated carcinoma.
- Carcinoma in pleomorphic adenoma.
Mesenchymal tumors[edit | edit source]
- Benign – lipoma, hemangioma, hemangioendothelioma, lymphangioma, neurinoma, neurofibroma.
- Malignant – lymphoma, Sarcoma.
Metastases of malignant tumors of other organs[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.
- 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]
- 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]
- Well demarcated, cystic, various sizes.
Ductal papilloma[edit | edit source]
- Not very common.
- It arises from the epithelium of the small salivary glands
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.