Salivary gland malignancies are uncommon but can occur in major and minor salivary glands. Mucoepidermoid carcinoma and adenoid cystic carcinoma are the most common types. Mucoepidermoid carcinoma presents as a slow-growing mass and can be low, intermediate, or high grade based on histopathology. Adenoid cystic carcinoma often spreads along peripheral nerves and has a high rate of distant metastasis over time, though local recurrence is also common. Treatment depends on tumor stage, grade, and location but may include surgery with or without radiation or chemotherapy.
The document discusses parotid tumors and parotidectomy surgery. It provides information on the types and characteristics of benign and malignant parotid tumors, including the most common types. Evaluation, treatment, and complications of parotid surgery are described, with key points on identifying and preserving the facial nerve during parotidectomy procedures.
- The majority (90%) of salivary gland tumors arise in the parotid gland, with 75% of parotid tumors being pleomorphic adenomas. Mucoepidermoid carcinoma is the most common malignant parotid tumor.
- Benign salivary gland tumors are generally slow-growing painless masses, while indications of malignancy include facial nerve involvement, skin or mucous membrane induration/ulceration, and lymph node metastasis.
- The main classifications are epithelial tumors (including adenomas, mucoepidermoid tumors, acinic cell tumors, and carcinomas) and non-epithelial tumors. Pleomorphic adenoma is the most common benign tumor.
Salivarygland neoplasm by numan(h.k.d.e.t.dental clg)DrMohammad Uddin
This document provides information about salivary gland neoplasms. It discusses the anatomy of major and minor salivary glands. It describes different tumors that can occur in the parotid gland, submandibular gland and minor salivary glands. The most common benign tumor is pleomorphic adenoma, while mucoepidermoid carcinoma is the most common malignant tumor. Different tumors are classified as epithelial or connective tissue tumors. Clinical features, pathology, treatment and prognosis are outlined for various tumors including pleomorphic adenoma, adenolymphoma, oncocytoma and malignant tumors.
This document provides information on salivary gland tumors, including:
- Classification of benign and malignant salivary gland tumors and their characteristics.
- Epidemiology such as location, rates of benign vs malignant tumors.
- Presentation and treatment of common tumors like pleomorphic adenoma, Warthin's tumor, and mucoepidermoid carcinoma.
- Staging and evaluation of patients along with investigations like imaging and biopsy.
- Management approaches including surgery, radiation, chemotherapy based on tumor type, size, and extent.
This document discusses various tumors of the salivary glands. It begins by describing the major salivary glands and then covers topics such as pleomorphic adenoma, carcinoma ex pleomorphic adenoma, Warthin's tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, non-Hodgkin's lymphoma, and squamous cell carcinoma. Key points are that pleomorphic adenoma is the most common tumor of the major salivary glands, adenoid cystic carcinoma is most common in the minor salivary glands, and mucoepidermoid carcinoma is the most common malignant tumor overall.
Malinant Salivary Gland Tumours Dr.Shaji Thomas Additional Professor,Regional...shajithoma
This document discusses malignant salivary gland tumours. It begins by stating that tumours of the salivary glands account for 5% of head and neck cancers. The main subtypes of malignant salivary gland tumours are then described, including mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma. Diagnostic studies like CT, MRI and PET scans are outlined. Treatment options for the primary tumour and neck are also discussed, including surgical resection and postoperative radiation for high-risk features. Chemotherapy has a limited role and is used primarily for palliation.
The document summarizes salivary gland tumours. It discusses the various types of benign and malignant salivary gland tumours, their locations, characteristics, risk factors, clinical features, investigations and treatments. The major tumours discussed include pleomorphic adenoma, adenolymphoma, mucoepidermoid carcinoma and adenoid cystic carcinoma. It provides details on the incidence, presentation and management of tumours in the parotid, submandibular and minor salivary glands.
Pleomorphic adenoma is the most common salivary gland tumor, accounting for 60% of cases. It occurs most often in the parotid glands and presents as a painless, firm mass. Histologically, it contains both epithelial and mesenchymal elements arranged in a trabecular pattern within a fibrous stroma. Treatment involves complete surgical removal of the tumor with adequate margins to prevent recurrence due to microscopic projections outside the capsule. Imaging such as CT or MRI is used to identify the location and characteristics of the tumor prior to surgery.
The document discusses parotid tumors and parotidectomy surgery. It provides information on the types and characteristics of benign and malignant parotid tumors, including the most common types. Evaluation, treatment, and complications of parotid surgery are described, with key points on identifying and preserving the facial nerve during parotidectomy procedures.
- The majority (90%) of salivary gland tumors arise in the parotid gland, with 75% of parotid tumors being pleomorphic adenomas. Mucoepidermoid carcinoma is the most common malignant parotid tumor.
- Benign salivary gland tumors are generally slow-growing painless masses, while indications of malignancy include facial nerve involvement, skin or mucous membrane induration/ulceration, and lymph node metastasis.
- The main classifications are epithelial tumors (including adenomas, mucoepidermoid tumors, acinic cell tumors, and carcinomas) and non-epithelial tumors. Pleomorphic adenoma is the most common benign tumor.
Salivarygland neoplasm by numan(h.k.d.e.t.dental clg)DrMohammad Uddin
This document provides information about salivary gland neoplasms. It discusses the anatomy of major and minor salivary glands. It describes different tumors that can occur in the parotid gland, submandibular gland and minor salivary glands. The most common benign tumor is pleomorphic adenoma, while mucoepidermoid carcinoma is the most common malignant tumor. Different tumors are classified as epithelial or connective tissue tumors. Clinical features, pathology, treatment and prognosis are outlined for various tumors including pleomorphic adenoma, adenolymphoma, oncocytoma and malignant tumors.
This document provides information on salivary gland tumors, including:
- Classification of benign and malignant salivary gland tumors and their characteristics.
- Epidemiology such as location, rates of benign vs malignant tumors.
- Presentation and treatment of common tumors like pleomorphic adenoma, Warthin's tumor, and mucoepidermoid carcinoma.
- Staging and evaluation of patients along with investigations like imaging and biopsy.
- Management approaches including surgery, radiation, chemotherapy based on tumor type, size, and extent.
This document discusses various tumors of the salivary glands. It begins by describing the major salivary glands and then covers topics such as pleomorphic adenoma, carcinoma ex pleomorphic adenoma, Warthin's tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, non-Hodgkin's lymphoma, and squamous cell carcinoma. Key points are that pleomorphic adenoma is the most common tumor of the major salivary glands, adenoid cystic carcinoma is most common in the minor salivary glands, and mucoepidermoid carcinoma is the most common malignant tumor overall.
Malinant Salivary Gland Tumours Dr.Shaji Thomas Additional Professor,Regional...shajithoma
This document discusses malignant salivary gland tumours. It begins by stating that tumours of the salivary glands account for 5% of head and neck cancers. The main subtypes of malignant salivary gland tumours are then described, including mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma. Diagnostic studies like CT, MRI and PET scans are outlined. Treatment options for the primary tumour and neck are also discussed, including surgical resection and postoperative radiation for high-risk features. Chemotherapy has a limited role and is used primarily for palliation.
The document summarizes salivary gland tumours. It discusses the various types of benign and malignant salivary gland tumours, their locations, characteristics, risk factors, clinical features, investigations and treatments. The major tumours discussed include pleomorphic adenoma, adenolymphoma, mucoepidermoid carcinoma and adenoid cystic carcinoma. It provides details on the incidence, presentation and management of tumours in the parotid, submandibular and minor salivary glands.
Pleomorphic adenoma is the most common salivary gland tumor, accounting for 60% of cases. It occurs most often in the parotid glands and presents as a painless, firm mass. Histologically, it contains both epithelial and mesenchymal elements arranged in a trabecular pattern within a fibrous stroma. Treatment involves complete surgical removal of the tumor with adequate margins to prevent recurrence due to microscopic projections outside the capsule. Imaging such as CT or MRI is used to identify the location and characteristics of the tumor prior to surgery.
This document discusses salivary gland tumors. It begins with definitions of tumors and classifications of salivary glands and salivary gland tumors. It then covers the incidence, clinical features, histopathological features, and treatment plans for various benign and malignant salivary gland tumors. The document emphasizes that surgical resection is usually the primary treatment for salivary gland tumors, with adjuvant radiotherapy sometimes used as well.
Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. So here are slides containing information about salivary gland tumours with images.
Most salivary gland tumors are benign, with pleomorphic adenoma being the most common benign tumor of the parotid gland in children. Malignancy is more common in smaller salivary glands. Surgery is the primary treatment and includes superficial parotidectomy for tumors of the superficial lobe or total conservative parotidectomy for tumors involving the deep lobe or with high risk of metastasis. Postoperative radiotherapy improves local control for T3/T4 tumors, close or positive margins, lymph node metastasis, adenoid cystic carcinoma, or high/intermediate grade tumors. Elective nodal radiotherapy is recommended for high grade tumors but not usually for adenoid cystic or acinic cell tumors due to their low
Mr. X, a 55-year-old male, presented with a gradually enlarging painless swelling in his left parotid region over the past 5 years. Examination revealed a 7 cm x 6 cm firm, non-tender mass that was mobile and had a well-defined margin. Investigations including FNAC, USG, and MRI confirmed a diagnosis of pleomorphic adenoma. The patient underwent a superficial parotidectomy to remove the tumor. Histopathology of the resected specimen confirmed pleomorphic adenoma. The postoperative course was uneventful with intact facial nerve function and no complications.
1) Salivary gland cancers account for 6% of head and neck cancers, with 80% originating in the parotid gland. Risk factors include smoking, radiation exposure, and certain occupations.
2) The document discusses the pathology, staging, and treatment of salivary gland cancers. Surgery is the main treatment, along with radiation for high-risk cases.
3) Outcomes depend on cancer type and stage. Follow up involves regular exams and imaging to monitor for recurrence or metastases.
This document provides an outline on parotid gland tumors. It discusses the normal anatomy of the parotid gland and classification of parotid tumors. It also covers the important features and management of parotid gland tumors, types of parotidectomy surgery and their potential complications. Key topics include the most common benign and malignant tumors of the parotid gland, their incidence rates, histopathological features, staging systems and treatment approaches.
The document discusses management of salivary gland tumors. It provides details on:
1) The major and minor salivary glands and their distribution in the head and neck region.
2) Evaluation of salivary gland tumors including imaging techniques like CT, MRI, and needle biopsies.
3) Histologic classification and grading of salivary gland tumors as well as their distribution by site of origin.
4) Surgical management principles for salivary gland tumors depending on factors like tumor size, location, and involvement of surrounding structures.
MUCOEPIDERMOID CARCINOMA /certified fixed orthodontic courses by Indian denta...Indian dental academy
The document discusses Mucoepidermoid carcinoma, which is the most common malignant salivary gland tumor. It arises from the ductal system of major and minor salivary glands. The document describes the clinical features, histopathological features, grading, variants, differential diagnosis and management of Mucoepidermoid carcinoma. It is graded as low, intermediate or high grade based on histopathological characteristics like presence of cystic spaces, cellular atypia and proportion of cell types. Low grade tumors have a better prognosis compared to intermediate and high grade tumors.
Malignant Salivary Gland Pathologies, Tumors & Its Treatment Plan by Dr. Adit...Aditya Tiwari
This document discusses malignant pathologies of the salivary glands. It begins by describing the major and minor salivary glands and notes that malignant neoplasms can exhibit a wide range of behaviors from slow-growing to highly aggressive. It then covers surgical pathology aspects like incidence rates and common tumor types by gland. The document also discusses etiology, cellular origins, WHO classifications, and provides detailed descriptions of common malignant tumor types like mucoepidermoid carcinoma and adenoid cystic carcinoma. It concludes with treatment approaches for different malignant salivary gland tumors.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides information on benign and malignant diseases of the salivary glands, including:
1. It discusses the embryology, surgical anatomy, non-neoplastic conditions, benign tumors, and malignant tumors of the major and minor salivary glands.
2. It describes common benign tumors like pleomorphic adenoma and Warthin's tumor, as well as malignant tumors such as mucoepidermoid carcinoma.
3. It provides details on the classification, clinical features, histology, treatment and prognosis of various salivary gland neoplasms.
This document discusses squamous cell carcinoma (SCC), a type of non-melanoma skin cancer. It notes that SCC comprises about 20% of non-melanoma skin cancers. Risk factors for SCC include cumulative sun exposure, fair skin, genetic conditions, immunosuppression, arsenic exposure, and other skin damage or diseases. Actinic keratosis is a precancerous lesion that can progress to SCC. Diagnosis involves biopsy and imaging if needed to assess spread. Treatment depends on risk factors and location but commonly includes surgery, Mohs surgery, radiation, or a combination for more advanced cases.
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.
This document discusses tumors of the salivary glands, dividing them into benign and malignant types. The most common benign tumor is the pleomorphic adenoma, which usually presents as a slow-growing, painless mass in the parotid gland or palate. Malignant tumors are graded based on appearance and include mucoepidermoid carcinoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma. Treatment depends on the type and location of the tumor but generally involves surgical excision with radiation therapy for malignant types.
Pleomorphic adenoma is the most common benign salivary gland tumor, arising most commonly in the parotid gland. It typically presents as a slow-growing, painless, firm, nodular mass in patients aged 30-40 years old. On histology, it demonstrates a biphasic appearance with both epithelial and myoepithelial cells within a variable stromal component. Diagnosis is made through imaging such as ultrasound, CT or MRI followed by surgical excision via enucleation or parotidectomy. Adenolymphoma, also known as Warthin's tumor, most commonly arises in the tail of the parotid gland in older males, appearing as an encapsulated cystic n
Childhood mumps, certain bacterial infections (for example, of the tonsils or teeth), and other diseases that are typically more common among adults (such as AIDS, Sjögren syndrome, diabetes mellitus, sarcoidosis, and bulimia) often cause swelling of the major salivary glands.
1. Salivary gland neoplasms are relatively rare, accounting for 6% of head and neck tumors, with parotid gland tumors making up 80% of cases.
2. Clinical presentation depends on whether the tumor is benign or malignant. Benign tumors usually present as asymptomatic swellings while malignant tumors can present with pain, nerve palsies, or nodal metastases.
3. Diagnosis involves investigations like ultrasound, CT, MRI and biopsy to determine the nature and extent of the tumor. However, differentiating between benign and malignant, and identifying the exact histology can still be challenging.
1. The three major salivary glands are the parotid, submandibular, and sublingual glands. The parotid gland is the largest.
2. Pleomorphic adenoma is the most common benign salivary gland tumor, accounting for 80% of parotid tumors.
3. Mucoepidermoid carcinoma is the most common malignant salivary gland tumor. It typically presents as a slow growing swelling in the parotid or submandibular region.
4. Surgery is the primary treatment for salivary gland tumors. For malignant tumors, surgery may be combined with radiation or chemotherapy.
Salivary gland tumors can be benign or malignant. The majority are benign and arise most commonly in the parotid gland. Histologically, tumors are best classified based on their patterns. Treatment depends on the type and severity of the tumor, with more aggressive surgery and radiation used for malignant tumors. Prognosis varies significantly depending on the specific tumor type.
This document discusses treatment modalities for ocular surface squamous neoplasia (OSSN), with an emphasis on mitomycin C (MMC). It describes OSSN classification, risk factors, diagnosis, and various treatment options including surgical excision with cryotherapy, chemotherapy with MMC or 5-fluorouracil, and immunotherapy with interferon alfa-2b. Surgical excision with clear margins followed by cryotherapy provides good tumor control but has a 5-10% recurrence rate. Chemotherapy, especially with MMC, is an effective alternative or adjunctive treatment that can help avoid recurrence by treating microscopic disease. MMC has shown good response rates in multiple case examples presented. Interferon al
This document discusses salivary gland tumors. It begins with definitions of tumors and classifications of salivary glands and salivary gland tumors. It then covers the incidence, clinical features, histopathological features, and treatment plans for various benign and malignant salivary gland tumors. The document emphasizes that surgical resection is usually the primary treatment for salivary gland tumors, with adjuvant radiotherapy sometimes used as well.
Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. So here are slides containing information about salivary gland tumours with images.
Most salivary gland tumors are benign, with pleomorphic adenoma being the most common benign tumor of the parotid gland in children. Malignancy is more common in smaller salivary glands. Surgery is the primary treatment and includes superficial parotidectomy for tumors of the superficial lobe or total conservative parotidectomy for tumors involving the deep lobe or with high risk of metastasis. Postoperative radiotherapy improves local control for T3/T4 tumors, close or positive margins, lymph node metastasis, adenoid cystic carcinoma, or high/intermediate grade tumors. Elective nodal radiotherapy is recommended for high grade tumors but not usually for adenoid cystic or acinic cell tumors due to their low
Mr. X, a 55-year-old male, presented with a gradually enlarging painless swelling in his left parotid region over the past 5 years. Examination revealed a 7 cm x 6 cm firm, non-tender mass that was mobile and had a well-defined margin. Investigations including FNAC, USG, and MRI confirmed a diagnosis of pleomorphic adenoma. The patient underwent a superficial parotidectomy to remove the tumor. Histopathology of the resected specimen confirmed pleomorphic adenoma. The postoperative course was uneventful with intact facial nerve function and no complications.
1) Salivary gland cancers account for 6% of head and neck cancers, with 80% originating in the parotid gland. Risk factors include smoking, radiation exposure, and certain occupations.
2) The document discusses the pathology, staging, and treatment of salivary gland cancers. Surgery is the main treatment, along with radiation for high-risk cases.
3) Outcomes depend on cancer type and stage. Follow up involves regular exams and imaging to monitor for recurrence or metastases.
This document provides an outline on parotid gland tumors. It discusses the normal anatomy of the parotid gland and classification of parotid tumors. It also covers the important features and management of parotid gland tumors, types of parotidectomy surgery and their potential complications. Key topics include the most common benign and malignant tumors of the parotid gland, their incidence rates, histopathological features, staging systems and treatment approaches.
The document discusses management of salivary gland tumors. It provides details on:
1) The major and minor salivary glands and their distribution in the head and neck region.
2) Evaluation of salivary gland tumors including imaging techniques like CT, MRI, and needle biopsies.
3) Histologic classification and grading of salivary gland tumors as well as their distribution by site of origin.
4) Surgical management principles for salivary gland tumors depending on factors like tumor size, location, and involvement of surrounding structures.
MUCOEPIDERMOID CARCINOMA /certified fixed orthodontic courses by Indian denta...Indian dental academy
The document discusses Mucoepidermoid carcinoma, which is the most common malignant salivary gland tumor. It arises from the ductal system of major and minor salivary glands. The document describes the clinical features, histopathological features, grading, variants, differential diagnosis and management of Mucoepidermoid carcinoma. It is graded as low, intermediate or high grade based on histopathological characteristics like presence of cystic spaces, cellular atypia and proportion of cell types. Low grade tumors have a better prognosis compared to intermediate and high grade tumors.
Malignant Salivary Gland Pathologies, Tumors & Its Treatment Plan by Dr. Adit...Aditya Tiwari
This document discusses malignant pathologies of the salivary glands. It begins by describing the major and minor salivary glands and notes that malignant neoplasms can exhibit a wide range of behaviors from slow-growing to highly aggressive. It then covers surgical pathology aspects like incidence rates and common tumor types by gland. The document also discusses etiology, cellular origins, WHO classifications, and provides detailed descriptions of common malignant tumor types like mucoepidermoid carcinoma and adenoid cystic carcinoma. It concludes with treatment approaches for different malignant salivary gland tumors.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides information on benign and malignant diseases of the salivary glands, including:
1. It discusses the embryology, surgical anatomy, non-neoplastic conditions, benign tumors, and malignant tumors of the major and minor salivary glands.
2. It describes common benign tumors like pleomorphic adenoma and Warthin's tumor, as well as malignant tumors such as mucoepidermoid carcinoma.
3. It provides details on the classification, clinical features, histology, treatment and prognosis of various salivary gland neoplasms.
This document discusses squamous cell carcinoma (SCC), a type of non-melanoma skin cancer. It notes that SCC comprises about 20% of non-melanoma skin cancers. Risk factors for SCC include cumulative sun exposure, fair skin, genetic conditions, immunosuppression, arsenic exposure, and other skin damage or diseases. Actinic keratosis is a precancerous lesion that can progress to SCC. Diagnosis involves biopsy and imaging if needed to assess spread. Treatment depends on risk factors and location but commonly includes surgery, Mohs surgery, radiation, or a combination for more advanced cases.
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.
This document discusses tumors of the salivary glands, dividing them into benign and malignant types. The most common benign tumor is the pleomorphic adenoma, which usually presents as a slow-growing, painless mass in the parotid gland or palate. Malignant tumors are graded based on appearance and include mucoepidermoid carcinoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma. Treatment depends on the type and location of the tumor but generally involves surgical excision with radiation therapy for malignant types.
Pleomorphic adenoma is the most common benign salivary gland tumor, arising most commonly in the parotid gland. It typically presents as a slow-growing, painless, firm, nodular mass in patients aged 30-40 years old. On histology, it demonstrates a biphasic appearance with both epithelial and myoepithelial cells within a variable stromal component. Diagnosis is made through imaging such as ultrasound, CT or MRI followed by surgical excision via enucleation or parotidectomy. Adenolymphoma, also known as Warthin's tumor, most commonly arises in the tail of the parotid gland in older males, appearing as an encapsulated cystic n
Childhood mumps, certain bacterial infections (for example, of the tonsils or teeth), and other diseases that are typically more common among adults (such as AIDS, Sjögren syndrome, diabetes mellitus, sarcoidosis, and bulimia) often cause swelling of the major salivary glands.
1. Salivary gland neoplasms are relatively rare, accounting for 6% of head and neck tumors, with parotid gland tumors making up 80% of cases.
2. Clinical presentation depends on whether the tumor is benign or malignant. Benign tumors usually present as asymptomatic swellings while malignant tumors can present with pain, nerve palsies, or nodal metastases.
3. Diagnosis involves investigations like ultrasound, CT, MRI and biopsy to determine the nature and extent of the tumor. However, differentiating between benign and malignant, and identifying the exact histology can still be challenging.
1. The three major salivary glands are the parotid, submandibular, and sublingual glands. The parotid gland is the largest.
2. Pleomorphic adenoma is the most common benign salivary gland tumor, accounting for 80% of parotid tumors.
3. Mucoepidermoid carcinoma is the most common malignant salivary gland tumor. It typically presents as a slow growing swelling in the parotid or submandibular region.
4. Surgery is the primary treatment for salivary gland tumors. For malignant tumors, surgery may be combined with radiation or chemotherapy.
Salivary gland tumors can be benign or malignant. The majority are benign and arise most commonly in the parotid gland. Histologically, tumors are best classified based on their patterns. Treatment depends on the type and severity of the tumor, with more aggressive surgery and radiation used for malignant tumors. Prognosis varies significantly depending on the specific tumor type.
This document discusses treatment modalities for ocular surface squamous neoplasia (OSSN), with an emphasis on mitomycin C (MMC). It describes OSSN classification, risk factors, diagnosis, and various treatment options including surgical excision with cryotherapy, chemotherapy with MMC or 5-fluorouracil, and immunotherapy with interferon alfa-2b. Surgical excision with clear margins followed by cryotherapy provides good tumor control but has a 5-10% recurrence rate. Chemotherapy, especially with MMC, is an effective alternative or adjunctive treatment that can help avoid recurrence by treating microscopic disease. MMC has shown good response rates in multiple case examples presented. Interferon al
Neuroblastoma is the third most common childhood cancer. It arises from neural crest cells that form the adrenal medulla and sympathetic ganglia. Risk factors include genetic mutations and amplification of the MYCN oncogene. Diagnosis involves biopsy and imaging like CT, MRI and MIBG scan. Treatment depends on risk stratification and may include surgery, chemotherapy, radiotherapy, stem cell transplant, retinoids and immunotherapy. Prognosis is best for low risk disease and worst for high risk disease characterized by MYCN amplification and older age.
Retinoblastoma is a rare form of eye cancer that develops from immature retinal cells in children younger than 5 years old. It is caused by mutations in both copies of the RB1 tumor suppressor gene. Symptoms may include a white pupil, crossed eyes, eye inflammation or pain, and vision loss. Diagnosis involves eye examination and imaging tests. Treatment depends on tumor size and spread but may include focal therapies like laser treatment or chemotherapy followed by focal therapies. Outcomes are generally good if caught early, but survivors require long-term monitoring due to risks of secondary cancers from radiation treatment.
This document discusses the treatment of common skin cancers. It describes benign and premalignant skin lesions as well as the three main types of malignant skin cancer - basal cell carcinoma, squamous cell carcinoma, and melanoma. It provides details on risk factors, clinical presentation, diagnosis, staging, and treatment options for each type of skin cancer.
This document discusses malignant tumors of the salivary glands. It covers risk factors like smoking, alcohol consumption and radiation exposure. It also discusses various types of salivary cancers like acinic cell carcinoma, mucoepidermoid carcinoma and adenoid cystic carcinoma. For each cancer, it describes characteristics like prevalence, presentation, histology, treatment options and prognosis. It highlights the importance of surgery and radiation therapy in treating these cancers. Molecular techniques are providing new insights but clinical applications are still limited.
The document provides a review course on ocular oncology covering tumors of the eyelids, conjunctiva, intraocular region, and orbit. It discusses the clinical presentation, classification, examples, investigations, and management including surgical and non-surgical options for various benign and malignant tumor types in these ocular regions. Key tumor types and management approaches are summarized for each anatomical region.
A presentation created by Dr. Henry N. Ho, Medical Director, Head and Neck Program, Florida Hospital Cancer Institute, discussing everything you need to know about head and neck melanoma.
Meningioma is a benign tumor that arises from the meninges. It represents 15% of primary brain tumors. Most are benign, but some are atypical or anaplastic. Risk factors include genetic conditions and radiation exposure. Symptoms depend on location but can include headaches, seizures, and neurological deficits. Diagnosis is made through imaging like CT, MRI, and PET scans. Treatment options include observation, radiation therapy, and surgical resection depending on size, location, and patient factors. The document discusses the various surgical approaches used for removing meningiomas in different locations.
This document provides information on pediatric malignant solid tumors, including Wilms tumor (nephroblastoma), neuroblastoma, and rhabdomyosarcoma. It discusses the epidemiology, histology, clinical presentation, risk classification, diagnostic workup, and standard treatment approaches for each of these tumor types. Pediatric cancer is the second leading cause of death in children, though survival rates have improved to over 70% with modern multimodal therapy.
This document summarizes information about breast cancer histopathology types and clinical features presented in a seminar. It discusses various risk factors and genes implicated in breast cancer pathogenesis. The major types covered include ductal carcinoma in situ, lobular carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, medullary carcinoma, mucinous carcinoma, tubular carcinoma, inflammatory carcinoma and metaplastic carcinoma. For each type, the document discusses morphology, clinical features, prognosis and management. The aim is to provide an overview of breast cancer classification and characteristics to inform clinical practice.
Non-melanoma skin cancer is the most common cancer in the US. The two main types are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Risk factors include ultraviolet radiation exposure and fair skin. BCC typically occurs on sun exposed areas and is locally destructive but rarely spreads. SCC also occurs on sun exposed skin and has a greater risk of spreading. Treatment options depend on the type and location of the cancer, and may include surgery, Mohs surgery, radiation, or topical medications.
Tumors of the head and neck region encompass a broad spectrum of diseases, including malignancies of the upper aerodigestive tract, skin, salivary glands, thyroid and parathyroid glands, and soft tissue and bone tumors. Head and neck cancers account for 3% of all new cancers and 2% of cancer deaths in the US annually. Risk factors include smoking, alcohol consumption, HPV infection, and nutritional deficiencies. Diagnosis involves clinical examination, imaging studies, and biopsy. Treatment depends on tumor stage and location, and may involve surgery, radiation therapy, chemotherapy, or a combination.
Nasopharyngeal carcinoma (NPC) is a cancer with a poor prognosis due to its location near vital structures and difficulty of early detection. The majority of NPC tumors are non-keratinizing squamous cell carcinomas that are associated with Epstein-Barr virus. Risk factors include EBV infection, diet, and genetic predisposition. Radiation therapy is the primary treatment, while surgery has a limited role. Prognostic factors like tumor size and lymph node involvement affect survival rates. Angiofibromas are benign nasopharyngeal tumors that mainly affect young males and are treated surgically. Oropharyngeal cancers are usually squamous cell carcinomas associated with alcohol and tobacco use. Treatment involves surgery,
This document provides information about carcinoma of the buccal mucosa, including its anatomy, clinical presentation, diagnostic workup, staging, treatment approaches, and outcomes. Carcinoma of the buccal mucosa commonly presents as an ulcerative or exophytic lesion in the cheek, and risk factors include tobacco and betel nut use. Treatment involves surgery such as wide local excision with or without neck dissection, and postoperative radiotherapy may be used for advanced cases. Radiotherapy alone can also be used for early-stage lesions. The document reviews surgical, radiation, and chemotherapy approaches in detail.
Introduction .
Statics.
Risk factors.
survival rate.
Staging , Grading.
Special investigations.
WHO Classification .
Most common Benign and Malignant salivary gland Tumors
Clinical presentation and prognosis.
Surgical Treatment .
Summary.
Salivary gland tumors account for 2% to 6.5% of all head and neck neoplasms, are more common in female with a peak incidence in their 60s and 70s, but can occur in all age groups.
The majority of neoplasms occur in the parotid, and pleomorphic adenoma is the most common benign tumor and mucoepidermoid carcinoma the most common malignant tumor.
Irregular margins, bony invasions, the presence of metastatic lymph nodes and perineural spread can all be signs of malignancy.
Necrosis can also characterize malignancy.
Benign tumors were more common than malignant ones.
The prevalent benign tumor was PA, and the prevalent malignant tumors were ACC and MEC.
The smaller the gland more likely that a mass is malignant.
This document discusses neoplasms of the nose and paranasal sinuses. It begins by stating that these neoplasms are rare, comprising 3% of cases, and are often misdiagnosed as benign conditions due to similar symptoms. The nose has an approximately equal distribution of benign and malignant tumors, while paranasal sinus tumors are usually malignant. Various benign, intermediate, and malignant tumor types are then classified and discussed in further detail over multiple pages, along with symptoms, diagnosis, and treatment approaches.
The document summarizes various tumors that can occur on the eyelid. It divides tumors into benign, pre-malignant, and malignant categories and lists examples of tumors that fall into each category. Some of the more common tumor types discussed include squamous cell papilloma, basal cell carcinoma, sebaceous gland adenoma and carcinoma, capillary hemangioma, and non-Hodgkin lymphoma. For each tumor, the summary provides details on clinical presentation and recommended treatment approaches.
The document discusses the anatomy and pathology of the buccal mucosa and related structures. It provides details on:
- The anatomy of the buccal mucosa, muscles, nerves, blood supply, and related structures.
- Common tumors that can arise in the buccal mucosa, including carcinomas which are often associated with pre-existing leukoplakia or tobacco/betel nut use.
- Evaluation, staging, and treatment options for buccal mucosa tumors, which may involve surgery, radiation therapy, chemotherapy, or a combination depending on the size, extent, and staging of the cancer.
malignant skin lesions /BASIC MEDICAL KNWOLEDGE .pptMUJEEB REHMAN
This document provides information about three types of malignant skin diseases: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). BCC is the most common type of skin cancer, usually appearing as a pearly nodule on sun-exposed areas. SCC is the second most common, associated with cumulative sun exposure and chronic inflammation. MM is less common but more deadly, with risk factors including past skin cancers, dysplastic nevi, red hair, and sunburn history. Surgical excision is the main treatment for all three, with Mohs surgery used for minimizing recurrence of BCC. Prognosis depends on factors like tumor depth, location, and presence of immunosuppression.
Similar to Malignant Salivary gland neoplasm - Dr. Mudit Gupta (20)
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Malignant Salivary gland neoplasm - Dr. Mudit Gupta
1.
2. 2
Introduction Epidemiology
Clinical pictures
of different
glands
Risk factors
Histogenetic
theories of
tumorigenesis
TNM Staging
Histopathological
classification
Treatment
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG
3.
4. Salivary carcinoma is uncommon
pathology .
Unique from other head and neck
cancer :-
1. Multiplicity of tumour types
2. Pleomorphic adenoma has pre malignant
potential.
3. Indolent growth pattern but still reoccur
and metastasize
Broad pathological classification:-
1. Epithelial tumours->80%
2. Mesenchymal tumours-<20%
3. Hemolymphoid tumours
Watkinson and Gilbert, Stell & Maran’s
Textbook of Head and Neck Surgery and
Oncology.
Watkinson, Clarke, and Clarke, Scott-
Brown’s Otorhinolaryngology and Head
and Neck Surgery.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 4
8. Epithelial tumours account
for 95%
USA – 10 per million per
year
Europe - slightly less
(Belgium, Netherlands, the
UK and Finland having
about 6–7 new cases per
million per year)
Indian subcontinent- 0.6
per million per year in
males and females each. Mishra, et al. “Head and Neck Cancer : Global Burden
and Regional Trends in.” (2014).
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 8
10. Parotid Gland : 64–80% of all tumours ,of which 15–32% are malignant.
Submandibular glands : 7 to 11% of all tumours ,of which 41–45% being
malignant.
Sublingual gland : <1% of all tumours ,of which 70–90% are malignant.
Minor salivary gland tumours :9 to 23% of all tumours ,of which 80% being
malignant.
7/18/2021 10
Watkinson, Clarke, and Clarke, Scott-Brown’s
Otorhinolarnygology and Head and Neck Surgery.
SALIVARY GLAND MALIGNANCY/ DR. MG
11.
12. Radiation exposure
Smoking, Alcohol
Aflatoxin B1 (Canadian livestock)
Nitrosamines, Silica dust
Cytomegalovirus
Diet – lack of PUFA
C-erbB-2 over expression - high grade tumour
Ki-67 : adverse prognostic effect in adenoid cystic
carcinoma
EBV -undifferentiated carcinoma.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 12
15. BICELLULAR THEORY
Proximal secretory duct cell -
intercalated duct and
myoepithelial cells.
Intercalated duct stem cell:
Acinic cell carcinoma, Adenoid
cystic carcinoma, Pleomorphic
adenoma, Oncocytoma.
Excretory duct stem cell:
Squamous cell carcinoma &
Mucoepidermoid carcinoma.
RESERVE CELL THEORY
Tumor arise from the adult
differentiated counter part of
salivary gland unit.
Acinar cell: Acinic tumor
Striated duct cell: Warthin’s
tumor & Oncocytoma
Intercalated duct &
Myoepithelial cells: Mixed
tumor
Excretory duct cells:
Mucoepidermoid carcinoma &
Squamous cell carcinoma
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 15
16.
17. TX Primary tumour cannot be assessed
T0 No evidence of primary tumour
T1 Tumour 2 cm or less, without extra parenchymal extension*
T2 Tumour more than 2 but less than 4 cm, without extra parenchymal extension
T3 Tumour more than 4 cm, and/or has extra parenchymal extension
T4a Tumour invades skin, mandible, ear canal and/or Facial nerve involvement (moderately
advanced disease)
T4b Tumour invades base of skull, and/or pterygoid plates and/ or encases carotid artery (very
advanced disease)
7/18/2021 SALIVARY GLAND MALIGNANCY/ DR. MG 17
18. N1 Metastasis in a single ipsilateral node, 3 cm or less in greatest dimension, without extra nodal
extension
N2a Single ipsilateral node > 3–6 cm, without extra nodal extension
N2b Multiple ipsilateral nodes < 6 cm
N2c Bilateral or contralateral nodes < 6 cm
N3a Node(s) > 6 cm, without extra nodal extension
N3b Single or multiple nodes, with extra nodal extension
7/18/2021 SALIVARY GLAND MALIGNANCY/ DR. MG 18
19. MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis
7/18/2021 SALIVARY GLAND MALIGNANCY/ DR. MG 19
20. Stage 0 TIS N0 M0
Stage I T1 N0 M0
Stage II T2 N0 M0
Stage III T3 N0 M0
T1 T2 T3 N1 M0
Stage IVA T4a N0 M0
T4a N1 M0
T1 T2 T3 N2 M0
T4a N2 M0
Stage IVB T4b Any N M0
Any T N3 M0
Stage IVC Any T Any N M1
7/18/2021 SALIVARY GLAND MALIGNANCY/ DR. MG 20
22. 1. Short duration history
2. Rapid growth
3. Fixation to skin
4. Induration
5. Ulceration of the skin
6. Pain
7. Facial nerve palsy
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 22
Pre-auricular lump
23. Asymptomatic ,discrete pre-auricular or infra-auricular lumps.
A small percentage present only as a swelling of the soft palate or
lateral oropharynx and 1% arise in the accessory parotid gland
(along the Stensen duct).
Post styloid region: CN IX,X,XI,XII involvement.
Cervical lymphadenopathy.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 23
Skin involvement
Intra oral lump arising
from deep lobe
Klotz DA, et al.
Laryngoscope
2000
Flint et al., Cummings Otolaryngology -
Head and Neck Surgery E-Book.
24. Painless mass or swelling under the jaw
Distortion of the floor of the mouth
Skin invasion or ulceration
Nerve paresis or paralysis
1. Hypoglossal N- weakness of tongue
2. Lingual nerve of Trigeminal nerve(V3)-Numbness of
tongue
3. Mandibular branch of the VII nerve- weakness of lower
lip
28% regional lymph node metastasis.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 24
Skin involvement
lump in the
submandibular triangle
Flint et al., Cummings Otolaryngology
- Head and Neck Surgery E-Book.
25. Fixation of gland
Nerve paresis or paralysis
1. Lingual nerve of Trigeminal nerve(V3)-
2. Mandibular branch of the VII nerve.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 25
Mass in the floor of the mouth. A case of
adenoid cystic carcinoma of the sublingual
gland.
Flint et al., Cummings
Otolaryngology - Head and Neck
Surgery E-Book.
26. Found throughout the entire upper aero digestive
tract
Signs & symptoms depend upon the anatomical
site involved.
1. Hard palate – ulceration
2. Nose & nasopharynx- obstructive symptoms
Local invasion of tumours into surrounding tissue
common
1. ET dysfunction
2. Hoarseness
SALIVARY GLAND MALIGNANCY/ DR. MG
Mucoepidermoid carcinoma (low grade) of
palate.
Watkinson, Clarke, and Clarke, Scott-Brown’s
Otorhinolaryngology and Head and Neck Surgery.
Flint et al., Cummings Otolaryngology -
Head and Neck Surgery E-Book.
Patient with salivary duct carcinoma extending
into maxillary sinus and nasal cavity.
26
30. MUCOEPIDERMOID
CARCINOMA
Most common (45%) salivary
malignancy
Parotid : 50-70%
Minor salivary glands : 15-35%
Submandibular glands: 6-11%
All ages, children.
F>M
Low, intermediate and high grade
Watkinson and Gilbert, Stell
& Maran’s Textbook of Head
and Neck Surgery and
Oncology.
Mucoepidermoid carcinoma (low grade) of
palate.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 30
31. Presentation
o Low-grade: Slow growing, painless
mass
o High-grade: Rapidly enlarging, +/-
pain, +/- metastasis to lymph nodes,
+/- facial palsy
Gross pathology
o Well-circumscribed to partially
encapsulated to unencapsulated
o Solid tumor with cystic spaces
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 31
32. Patients with tumors of equal
HPE grade - better prognosis in
the parotid gland than
submandibular gland
HISTOPATHOLOGY
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 32
Low-grade
Mucus cell > epidermoid
cells
Prominent cysts
Mature cellular elements
Intermediate-grade
Mucus = epidermoid
Fewer and smaller cysts
Increasing
pleomorphism and
mitotic figures
High-grade
Epidermoid > mucus
Solid tumor cell
proliferation
Mistaken for SCCA,
Mucin staining
33. Treatment
Influenced by site, stage, grade.
Stage I & II - Wide local excision
Stage III & IV- Radical excision +/- neck dissection +/- postoperative
radiation therapy
5 yr.
survival
15 yr.
survival
Low Grade 70% 50%
High Grade 47% 25%
Survival rates:
Mucoepidermoid carcinoma treated by partial
maxillectomy.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 33
34. ADENOID CYSTIC
CARCINOMA
Overall 2nd most common malignancy
(30%)
More common in submandibular,
sublingual and minor salivary glands
60% minor salivary glands
25-33% parotid
Most common malignancy of the
submandibular gland
M = F
5th decade
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 34
35. Presentation
Asymptomatic enlarging mass
Insidious growth over many years
Pain due to peripheral nerve
invasion
Facial nerve palsy may be evident
Gross pathology
Well-circumscribed
Solid, rarely with cystic spaces
Infiltrative
Adenoid Cystic Carcinoma of right hard palate
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 35
36. PERI-NEURAL SPREAD
Spread into, and along, peripheral nerves occurs
in 80 percent of cases (well established
prognostic factor)
Two mechanisms:
- Direct spread
- Embolic mechanism
50% cases
More likely if tumour is large
Skip lesions of facial nerve
Bad prognosis – nerve palsy
Recurrence : 30-50%
7/18/2021 36
37. DISTANCE
METASTASIS
Lung metastasis – Characteristic
Metastasis : Lungs, bone, liver
Lymph node metastases are rare
Local recurrences are common (30–50% of cases)
Calculated cumulative Mets
70% at 5 years
100% at 10 years
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SALIVARY GLAND MALIGNANCY/ DR. MG 37
38. HISTOLOGY
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 38
Cribriform pattern
• Most common, best prognosis
• “swiss cheese” appearance
Tubular pattern
Layered cells forming duct-like structures
Basophilic mucinous substance
Solid pattern
Solid nests of cells without cystic or tubular spaces
Worst prognosis
39. Treatment
Complete local excision
Tendency for perineural invasion: facial nerve sacrifice
Postoperative RT
Prognosis
Local recurrence: 30-50%
Distant metastasis: Lungs
Indolent course: 5-year survival 72%, 15-year survival
34%
(Ross et al., 2001)
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 39
40. ACINIC CELL CARCINOMA
Third most common parotid
malignancy
5th decade
F>M
Bilateral parotid disease in 3%
Presentation
Solitary, slow-growing, often
painless mass
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 40
41. Gross pathology
Well-demarcated
Most often homogeneous
Histology
Solid and microcystic patterns
Most common
Solid sheets
Numerous small cysts
Polyhedral cells
Small, dark, eccentric nuclei
Basophilic granular cytoplasm
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 41
42. Treatment
Complete local excision
Total parotidectomy with neck
dissection
+/- postoperative RT
Late recurrence
Prognosis
5-year survival: 76-96%
15-year survival: 50-55%
(Luukkaa et al., 2005)
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 42
43. ADENOCARCINOMA
Rare
6th to 7th decades
F > M
Parotid and minor salivary glands
Presentation:
Enlarging mass
25% with pain or facial weakness
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 43
44. Histology
Heterogeneity
Presence of glandular structures and absence of
epidermoid component
Low grade : Papillary, Mucinous
High grade : Trabecular, Clear cell, Sebaceous
Treatment ( All regarded high grade )
Complete local excision
Neck dissection
Postoperative RT
Prognosis
Local recurrence: 51%
Regional metastasis: 27%
Distant metastasis: 26%
15-year cure rate:
Stage I = 67%
Stage II = 35%
Stage III = 8% 7/18/2021 44
45. POLYMORPHOUS LOW-GRADE
ADENOCARCINOMA
• 2nd most common malignancy in minor salivary glands
• 60% palate, 20% cheek, 12% lips
• 7th decade , F > M
• Painless, submucosal mass
• Morphologic diversity
• Solid, glandular, cribriform, ductular, tubular, trabecular, cystic
Propensity for perineural spread
15% cervical metastasis
Local recurrence – 15 years after treatment
Treatment
Complete yet conservative excision
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SALIVARY GLAND MALIGNANCY/ DR. MG 45
46. MALIGNANT MIXED TUMORS
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 46
1.Carcinoma ex-
pleomorphic
adenoma
•Carcinoma
developing in the
epithelial
component of
preexisting
pleomorphic
adenoma
1.Carcinosarcoma
•True malignant
mixed tumor—
carcinomatous
and sarcomatous
components
1.Metastasizing
pleomorphic
adenoma
•Metastatic
deposits of
otherwise typical
pleomorphic
adenoma
47. CARCINOMA EX-PLEOMORPHIC
ADENOMA
2-4% of all salivary gland neoplasms
6th-8th decades
Parotid > submandibular > palate
2nd most common parotid malignancy
Presentation - Longstanding painless mass with
sudden enlargement, facial palsy (parotid gland
involvement)
Risk Factors :
Men > 40 years
Tumour in deep lobe
Solitary nodules > 2 cm
H/o surgery (recurrence)
H/o Radiotherapy
Risk: 5 - 6% in 20 years
Clinical photograph of the patient with
left submandibular mass
7/18/2021 47
48. Gross pathology
Poorly circumscribed
Infiltrative
Hemorrhage and necrosis
Histology
Malignant cellular change
adjacent to typical pleomorphic
adenoma
Carcinomatous component
Adenocarcinoma
Undifferentiated
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 48
49. Treatment
Radical excision
Neck dissection (25% with lymph node involvement
at presentation)
Postoperative RT
Prognosis: poor
Dependent upon tumor size, invasion, cervical
metastasis, high grade, carcinoma making > half of
tumor mass, origin – major gland.
Cause-specific survivals
40 percent at 5 years,
24 percent at 10 years,
19 percent at 15 years
Computed tomography scan
neck axial view showing
cervical lymph nodes
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 49
51. SQUAMOUS CELL
CARCINOMA
1.6% of salivary gland neoplasms
7th-8th decades
M:F = 2:1
Criteria :
1. Tumour must arise from the
gland itself and not from
lymph nodes within the gland
2. There must be no regional or
adjacent tumour
3. High-grade mucoepidermoid
carcinoma must be excluded 7/18/2021 51
55. Batsakis and Rugezi criteria
Extra-glandular lymphoma must
not be present
There is histological proof that the
lymphoma involves the gland
parenchyma and not the
intraglandular lymph nodes
Immunohistochemical screening
must confirm the presence of
lymphoma markers
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 55
• Primary lymphoma : 5% of extra-
nodal lymphomas
• 2% of all salivary gland tumors
• Almost all primary lymphomas of
the salivary glands affect the
parotid
• Sjogren's syndrome: Risk of
developing a Lymphoma in this
syndrome is said to be 40 times
that of the normal
56. Hodgkin’s lymphoma
Most cases occur in the parotid gland
Represent disease involvement of intra-parotid
lymph nodes
Primary non-Hodgkin’s lymphoma
De novo
Secondary (lymphoepithelial sialadenitis)
50-70 years
Solitary, painless mass in de novo cases
History of waxing and waning enlargement of
several glands in the secondary forms
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 56
57. True extra nodal involvement only happens with NHL
Low-grade non-Hodgkin's lymphoma (NHL) is either not treated at
all or, if it is, conservative monomodal management (eg.
Chlorambucil)
High-grade lesions treated aggressively eg.VAPEC-B.
Both groups have a median survival of approximately eight years
Low grade lymphoma solely involving a salivary gland: Local
excision or radiotherapy
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 57
58. Metastases to the salivary glands arise from the skin of the head
and neck ( Pinna and eyelid), lung, breast and kidney
Happen in little over 1 percent of head and neck skin squamous
carcinomas
Malignant cutaneous melanoma can involve the parotid lymph
nodes than 2 percent.
Skin tumours posterior to the facial artery and vein 50 % of parotid
nodal metastasis
Skin cancer anterior to these involve the parotid in only 3 percent of
cases
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 58
59. Cure rates are dismal
Parotidectomy en bloc with a neck dissection in continuity with the
primary lesion is indicated
Five-year survival rates are little more than 10 percent
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 59
66. 66
Total conservative parotidectomy
• Tumour extension into deep parotid lobe
• Tumour primarily arises in deep lobe
• Recurrent pleomorphic adenoma
• Malignant tumours
• Performed with preservation of facial nerve (
No gross nerve invasion / Function +)
Total radical parotidectomy
• Total parotidectomy + Facial nerve sacrifice
• Macroscopic nerve invasion
• Frozen section
• Nerve grafting
Extended radical parotidectomy
• Resection of:-
• Masseter
• Temporalis muscle
• Ascending ramus of mandible,
• TM joint, EAC, Zygomatic arch or mastoid
process.
67. POST-OPERATIVE
COMPLICATIONS
1. Skin flap necrosis
2. Hematoma
3. Wound infection / gape
4. Salivary fistula – Pressure bandage
5. Facial nerve paralysis – which could be:
a. Temporarily: 10 – 50%
b. Permanent: 5% (O’Brien et al.,
2003)
6. Numbness of the ear due to injury of great
auricular nerve
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SALIVARY GLAND MALIGNANCY/ DR. MG 67
68. 7. Frey’s syndrome (Gustatory sweating syndrome)
Incidence : 50% of the patients.
7/18/2021
SALIVARY GLAND MALIGNANCY/ DR. MG 68
73. Radiotherapy without surgery – limited role
Results of Surgery + RT better than Surgery alone.
Recommended postop RT for:
1. High-grade histology
2. Tumours > 4cm size
3. Recurrent disease
4. Inadequate surgical margins / Positive margin
5. Perineural invasion
6. Extension of disease beyond the gland (Capsule)
7. Nodal disease
Neutron RT : Superior locoregional control than Conventional RT but
same survival
High complication with Neutron RT
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74.
75. No studies to date have shown these agents to be
effective
Palliative treatment
1. Locally advanced unresectable disease
2. Recurrent
3. Metastatic disease
c-KIT and ERBB2 gene expression has been over expressed in
ADCC Trastuzumab and imatinib
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77. Malignancies of the major salivary glands represent a rare and
diverse group of cancers
Knowledge about tumor staging and histologic grading is necessary
for prognostic predictions, patient counseling, and treatment
planning
10 year disease specific survival for Stage I, II, II/IV tumours was
96,61 & 17% respectively
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