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?

<p>Obstruction (A)</p> Signup and view all the answers

What is a possible route of metastasis for parotid carcinoma?

<p>Lymphatic spread to submandibular LNs (A)</p> Signup and view all the answers

What is a characteristic of adenolymphoma?

<p>It is also known as Warthin's tumor (D)</p> Signup and view all the answers

What is a possible complication of untreated salivary calculi?

<p>Sialoadenitis (C)</p> Signup and view all the answers

What is the most common type of salivary gland tumor?

<p>Pleomorphic adenoma (A)</p> Signup and view all the answers

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

<p>Greyish formation with whitish areas and multiple cystic spaces (B)</p> Signup and view all the answers

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

<p>To alleviate severe pain due to pressure (D)</p> Signup and view all the answers

What is the characteristic of the stroma in this pathology?

<p>It is pale blue and full of lymph follicles (A)</p> Signup and view all the answers

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

<p>Mucoepidermoid carcinoma (A)</p> Signup and view all the answers

What is the composition of the stones in this pathology?

<p>Ca and Mg carbonate (A)</p> Signup and view all the answers

What is the consequence of not performing early decompression?

<p>Severe pain and rapid necrosis (B)</p> Signup and view all the answers

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

<p>They are columnar and squamous in shape (D)</p> Signup and view all the answers

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

<p>Major destruction of the parotid gland (D)</p> Signup and view all the answers

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

<p>It is red, raised, and oedematous (A)</p> Signup and view all the answers

How is the bulge in the oropharynx better felt?

<p>From inside the mouth (C)</p> Signup and view all the answers

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

<p>Loss of hypoglossal and lingual nerve function (B)</p> Signup and view all the answers

What is a possible finding in the draining lymph nodes?

<p>They are enlarged and soft (A)</p> Signup and view all the answers

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

<p>A stone in the duct (D)</p> Signup and view all the answers

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

<p>It is a sign of a malignant transformation (C)</p> Signup and view all the answers

What is the primary method of assessment for pleomorphic adenoma?

<p>CT scan and MRI (D)</p> Signup and view all the answers

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

<p>Diagnostic and therapeutic (D)</p> Signup and view all the answers

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

<p>Hot areas (A)</p> Signup and view all the answers

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

<p>FNAC (D)</p> Signup and view all the answers

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

<p>To prevent stone formation (D)</p> Signup and view all the answers

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

<p>80% are radio-opaque (A)</p> Signup and view all the answers

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

<p>Culture and sensitivity of the pus (D)</p> Signup and view all the answers

What is the significance of leukocytosis in acute bacterial sialoadenitis?

<p>It is a sign of infection (B)</p> Signup and view all the answers

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

<p>To avoid injury of superficial temporal vessels and auriculotemporal nerve (C)</p> 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?

<p>To preserve the mandibular branch of the facial nerve (C)</p> Signup and view all the answers

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

<p>Inoperable cases (D)</p> Signup and view all the answers

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

<p>To split the parotid fascia in a transverse direction (B)</p> Signup and view all the answers

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

<p>To remove duct stones (B)</p> Signup and view all the answers

What is the primary indication for total radical sialadenectomy?

<p>Highly malignant tumors (D)</p> Signup and view all the answers

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

<p>Mandibular branch of the facial nerve (D)</p> Signup and view all the answers

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

<p>To treat salivary stones (D)</p> 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.

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