Parotid Gland Tumor Characteristics

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Questions and Answers

Which salivary gland disease is caused by the spread of infection?

Pleomorphic adenoma

Adenolymphoma

Salivary calculi

Acute bacterial sialoadenitis (correct)

What is a possible complication of untreated acute bacterial sialoadenitis?

Chronic sialoadenitis

Pleomorphic adenoma

Adenolymphoma

Septicaemia (correct)

What is a characteristic of pleomorphic adenoma?

It is a type of salivary calculus

It is an acute bacterial infection

It is a malignant tumor

It rarely transforms into a malignant tumor (correct)

What is the main cause of salivary calculi?

Obstruction Signup and view all the answers

What is a possible route of metastasis for parotid carcinoma?

Lymphatic spread to submandibular LNs Signup and view all the answers

What is a characteristic of adenolymphoma?

It is also known as Warthin's tumor Signup and view all the answers

What is a possible complication of untreated salivary calculi?

Sialoadenitis Signup and view all the answers

What is the most common type of salivary gland tumor?

Pleomorphic adenoma Signup and view all the answers

What is the typical appearance of the tumor in the given pathology?

Greyish formation with whitish areas and multiple cystic spaces Signup and view all the answers

What is the primary reason for early decompression in the treatment of this pathology?

To alleviate severe pain due to pressure Signup and view all the answers

What is the characteristic of the stroma in this pathology?

It is pale blue and full of lymph follicles Signup and view all the answers

What is the most common type of carcinoma in this pathology?

Mucoepidermoid carcinoma Signup and view all the answers

What is the composition of the stones in this pathology?

Ca and Mg carbonate Signup and view all the answers

What is the consequence of not performing early decompression?

Severe pain and rapid necrosis Signup and view all the answers

What is the characteristic of the epithelial cells in this pathology?

They are columnar and squamous in shape Signup and view all the answers

What is the outcome of the tumor's growth in the parotid gland?

Major destruction of the parotid gland Signup and view all the answers

What is the characteristic of the opening of the duct in the oropharynx?

It is red, raised, and oedematous Signup and view all the answers

How is the bulge in the oropharynx better felt?

From inside the mouth Signup and view all the answers

What is a possible manifestation of malignant transformation in the patient?

Loss of hypoglossal and lingual nerve function Signup and view all the answers

What is a possible finding in the draining lymph nodes?

They are enlarged and soft Signup and view all the answers

What is a possible cause of the swelling in the oropharynx?

A stone in the duct Signup and view all the answers

What is the significance of the unequal superficial shift of the tonsil medially?

It is a sign of a malignant transformation Signup and view all the answers

What is the primary method of assessment for pleomorphic adenoma?

CT scan and MRI Signup and view all the answers

What is the primary purpose of sialendoscopy in salivary gland diseases?

Diagnostic and therapeutic Signup and view all the answers

What is the characteristic of adenolymphoma on a technetium 99 scan?

Hot areas Signup and view all the answers

What is the primary method of diagnosis for clinically benign tumors?

FNAC Signup and view all the answers

What is the primary purpose of prophylactic measures in salivary gland diseases?

To prevent stone formation Signup and view all the answers

What is the characteristic of salivary stones on a plain X-ray?

80% are radio-opaque Signup and view all the answers

What is the primary method of diagnosis for acute bacterial sialoadenitis?

Culture and sensitivity of the pus Signup and view all the answers

What is the significance of leukocytosis in acute bacterial sialoadenitis?

It is a sign of infection Signup and view all the answers

What is the primary purpose of a preauricular skin incision in parotidectomy?

To avoid injury of superficial temporal vessels and auriculotemporal nerve Signup and view all the answers

What is the benefit of making a 2 cm incision parallel to the lower border of the mandible in submandibular sialadenectomy?

To preserve the mandibular branch of the facial nerve Signup and view all the answers

What is the primary indication for palliative excision and radiotherapy in salivary gland tumors?

Inoperable cases Signup and view all the answers

What is the purpose of Hilton's method in parotidectomy?

To split the parotid fascia in a transverse direction Signup and view all the answers

What is the benefit of sialendoscopy in the management of salivary gland stones?

To remove duct stones Signup and view all the answers

What is the primary indication for total radical sialadenectomy?

Highly malignant tumors Signup and view all the answers

What is the primary structure to be preserved during submandibular sialadenectomy?

Mandibular branch of the facial nerve Signup and view all the answers

What is the purpose of ESWL in the management of salivary gland stones?

To treat salivary stones Signup and view all the answers

Study Notes

Capsulated Tumor (Mucoepidermoid Carcinoma)

Contains non-capsulated greyish formation with whitish areas (epithelial) and multiple cystic spaces lined by epithelial cells and filled with mucoid material
Stroma is pale blue with mucinous and myxomatous tissues
Can cause severe pain and rapid necrosis, followed by recurrence

Adenoid Cystic Carcinoma

Commonest malignancy in minor salivary glands
Composed of multiple cystic spaces lined by epithelial cells and filled with mucoid material
Stroma is pale blue with mucinous and myxomatous tissues

Pleomorphic Adenoma

Rarely malignant transformation after 10-20 years
Recurrence possible after removal due to defect in the capsule

Adenolymphoma (Warthin's Disease)

Never turns malignant

Acute Bacterial Sialoadenitis

Spread of infection can cause septicaemia, toxaemia, and pyaemia
Locally causes cellulitis and acute abscess
The opening of the duct is red, raised, and discharging pus or blood
Investigation: blood picture shows leucocytosis, culture and sensitivity for pus coming from duct

Salivary Calculi

Obstruction can cause sialectasis
Investigation: ultrasound shows all salivary stones, plain X-ray shows 80% of stones are radio-opaque, sialendoscopy is diagnostic and therapeutic

Investigations

C.T scan and MRI are most useful methods for assessment and show the extent of the tumor
FNAC is a reliable method for diagnosis
Excision biopsy and frozen section during operation are essential for clinically malignant tumors
Technetium 99 scan: adenolymphoma shows hot areas, while other salivary tumors give cold areas
Sialography shows sialectasis or filling defect in radiolucent stones

Treatment

Prophylactic: proper hydration and oral hygiene
Clinically benign tumors: conservative parotidectomy
Clinically malignant tumors: total radical sialadenectomy, ESWL is used nowadays to treat submandibular salivary stones
Inoperable cases: palliative excision, radiotherapy

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Description

This quiz covers the characteristics of a capsulated tumor in the parotid gland, including its appearance and composition. It also touches on the parotid fascia and possible necrosis.