This document discusses malignant salivary gland tumors, including polymorphous low-grade adenocarcinoma, malignant pleomorphic adenoma, and mucoepidermoid carcinoma. It provides information on the objectives, etiology, clinical features, and histopathological features of each tumor type. Key points include that polymorphous low-grade adenocarcinoma occurs exclusively in minor salivary glands, malignant pleomorphic adenoma can arise from pre-existing benign pleomorphic adenoma, and mucoepidermoid carcinoma has varying mucus-producing cells and epithelial cells.

1. Malignant Salivary Glands
Tumors-III
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
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2. OBJECTIVES
By the end of the lecture student should be able to :
•Describe Etiology, clinical features, histopathological features of
•Polymorphous low grade adenocarcinoma
•Malignant pleomorphic adenoma
• Mucoepidermoid carcinoma
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3. Polymorphous Low-Grade
Adenocarcinoma
Essentially a minor salivary gland malignancy.
Characterized by bland ,uniform nuclear
features, diverse but characteristic architecture,
infiltrative growth,& perineural invasion
Malignant Salivary Gland Tumors
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4. Clinical features
Exclusively in minor salivary glands
Rarely in major salivary glands
6th to 8th decade
Female predilection
Localized painless swelling with a history of
steady increase in size over a period of time
Malignant Salivary Gland Tumors
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5. Histopathology
Uniform cytologic features
Round to polygonal in
shape, with indistinct cell
borders
Diverse growth patterns
Solid
Ductal
Cystic
Tubular
=Polymorphous
Malignant Salivary Gland Tumors
Solid pattern
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6. Malignant Salivary Gland Tumors
Cystic spaces
Mucoid
material
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7. Malignant Salivary Gland Tumors
Tumor
cells
Arrange
in
tubular
pattern
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8. Perineural invasion
Malignant Salivary Gland Tumors
Perineural
invasion
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9. Sometimes a benign pleomorphic adenoma
show metastasis resembling
Primary lesion i.e. benign pleomorphic adenoma.
This metastasis have cytologically malignant area.
Classified as malignant pleomorphic adenoma.
Majority of tumors are malignant from the onset.
Malignant Pleomorphic
Adenoma.
Malignant Salivary Gland Tumors
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10. Clinical Features
Same as benign pleomorphic adenoma.
Often there is fixation of tumor to underlying
structures as well as to the overlying skin or
mucosa.
presence of surface ulceration.
Pain ++
Malignant Salivary Gland Tumors
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11. Histopathology
Nuclear changes of
malignancy.
Malignant component
overgrow benign one.
Malignant Salivary Gland Tumors
Malignant component
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12. Invasion of blood vessels, lymphatics or nerves.
Focal necrosis
Peripheral infiltration and destruction of normal
tissue.
Malignant Salivary Gland Tumors
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13. Malignant Salivary Gland Tumors
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14. Treatment
Surgery
Recurrence is high
High incidence of regional lymph node
metastasis.
Malignant Salivary Gland Tumors
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15. SUMMARY
Etiology, clinical features, histopathological
features of
•Polymorphous low grade adenocarcinoma
•Malignant pleomorphic adenoma
• Mucoepidermoid carcinoma
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16. BIBLIOGRAPHY
• Text book of oral pathology Shafer's, 5 & 6th
edition
• Surgical Pathology of Salivary Glands Ellis 1st
Edition
• Color Atlas of Oral Diseases Cawson, R. 2nd
edition
• Oral and Maxillofacial Pathology Neville, Brad
W. 2nd
• Lucas’s Pathology Of Tumor’s of the Oral
Tissues
• Cawson, R. A., Bennie, W. H 5th edition
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