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What is the typical location of a benign salivary neoplasm?
What is the typical location of a benign salivary neoplasm?
What is the consistency of a benign salivary neoplasm?
What is the consistency of a benign salivary neoplasm?
What is a characteristic of a benign salivary neoplasm on palpation?
What is a characteristic of a benign salivary neoplasm on palpation?
What is a possible feature of a carcinoma of the parotid?
What is a possible feature of a carcinoma of the parotid?
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What is a possible complication of a carcinoma of the parotid?
What is a possible complication of a carcinoma of the parotid?
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What is a characteristic of an adenolymphoma?
What is a characteristic of an adenolymphoma?
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What is an important clinical feature of a benign salivary neoplasm?
What is an important clinical feature of a benign salivary neoplasm?
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What is a possible differential diagnosis for a swelling in the oropharynx?
What is a possible differential diagnosis for a swelling in the oropharynx?
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What percentage of parotid gland neoplasms are represented by Pleomorphic adenoma?
What percentage of parotid gland neoplasms are represented by Pleomorphic adenoma?
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What is the characteristic of the capsule of Pleomorphic adenoma?
What is the characteristic of the capsule of Pleomorphic adenoma?
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Which of the following is a feature of Pleomorphic adenoma?
Which of the following is a feature of Pleomorphic adenoma?
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What is the distribution of Pleomorphic adenoma between males and females?
What is the distribution of Pleomorphic adenoma between males and females?
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What is the most common age range for Pleomorphic adenoma to occur?
What is the most common age range for Pleomorphic adenoma to occur?
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What is the risk of Pleomorphic adenoma transforming into carcinoma?
What is the risk of Pleomorphic adenoma transforming into carcinoma?
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What are the components of Pleomorphic adenoma?
What are the components of Pleomorphic adenoma?
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What is the consequence of the incomplete capsule of Pleomorphic adenoma?
What is the consequence of the incomplete capsule of Pleomorphic adenoma?
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What is a characteristic of a pleomorphic adenoma of the parotid?
What is a characteristic of a pleomorphic adenoma of the parotid?
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What is a possible differential diagnosis for a pleomorphic adenoma of the parotid?
What is a possible differential diagnosis for a pleomorphic adenoma of the parotid?
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What is the investigation of choice for a pleomorphic adenoma of the parotid?
What is the investigation of choice for a pleomorphic adenoma of the parotid?
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What is the treatment of choice for a pleomorphic adenoma of the parotid?
What is the treatment of choice for a pleomorphic adenoma of the parotid?
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What is the role of CT Scan in a pleomorphic adenoma of the parotid?
What is the role of CT Scan in a pleomorphic adenoma of the parotid?
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What is the significance of a cold spot in isotope scanning in a pleomorphic adenoma of the parotid?
What is the significance of a cold spot in isotope scanning in a pleomorphic adenoma of the parotid?
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What is a contraindication for biopsy in a pleomorphic adenoma of the parotid?
What is a contraindication for biopsy in a pleomorphic adenoma of the parotid?
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What is a possible cause of bilateral hypertrophy of the masseter?
What is a possible cause of bilateral hypertrophy of the masseter?
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Study Notes
Classification of Salivary Neoplasms
- Benign salivary neoplasms:
- Pleomorphic adenoma (mixed salivary tumor)
- Monomorphic adenoma
- Warthin's tumor (adenolymphoma)
- Oncocytoma (oxyphil adenoma)
- Malignant salivary neoplasms:
- Mucoepidermoid carcinoma
- Adenoid cystic carcinoma (cylindroma)
- Acinic cell carcinoma
- Adenocarcinoma
- Carcinoma ex pleomorphic adenoma
- Epidermoid carcinoma (squamous cell carcinoma)
- Lymphoma
Pathology of Benign Salivary Neoplasms
- Pleomorphic adenoma (mixed parotid tumor):
- Represent 75% of parotid and 50% of submandibular gland neoplasms
- Equal distribution between males and females
- Occurs in the fourth decade of life, but any age and sex may be affected
- Pathology:
- Epithelial, myoepithelial, and stromal components
- Incomplete capsule, allowing extension of neoplastic epithelium into surrounding tissues
- Slow growth, non-infiltrating the facial nerve
- Rarely turns into carcinoma after 10 years
Warthin's Tumor (Adenolymphoma)
- Found in the lower part of the parotid gland
- Loss of superficial temporal pulse
- Typically raises the lobule of the ear and does not affect the facial nerve
Differential Diagnosis
- Extra parotid swellings:
- Lymph nodes, sebaceous cysts, and lipomas may resemble pleomorphic adenomas
- Mandibular, maxillary, and infratemporal fossa tumors may produce false appearance of parotid enlargement
- Hypertrophy of the masseter is bilateral in most cases
Investigations
- Not routine, as clinical diagnosis is reliable enough for most cases
- Biopsy:
- FNAC is allowed, but requires an expert cytopathologist
- Open surgical biopsy of major salivary glands is contraindicated
- Neck US
- CT-scan and MRI: to show the extent of the tumor
- Isotope scanning with technetium: salivary neoplasm shows as a cold spot, adenolymphoma and oncocytoma show as hot spots
Treatment
- Surgery is the only reliable form of treatment for salivary neoplasms
Clinical Picture of Benign Salivary Neoplasms
- Symptoms:
- Painless, slowly growing swelling in the parotid region
- Signs:
- Swelling over the angle of the mandible
- Elevates the lobule of the ear
- Swelling is superficial to the masseter muscle
- Facial nerve is not affected by the tumor
Clinical Picture of Benign Salivary Neoplasms (Palpation)
- Swelling is not hot, not tender, not attached to the skin, masseter, or mandible
- Swelling is well-defined
- Consistency: varies from firm to cystic (but never hard)
- Pulsation of the superficial temporal artery is normal
Clinical Picture of Carcinoma of the Parotid
- Symptoms:
- Steadily enlarging swelling on the side of the face
- Salivary malignancies do not usually grow as fast as other cancers
- Swelling is sometimes painful, with pain radiating to the ear and intensified by mastication
- Signs:
- Mass is usually warm and mildly tender
- Firm or hard and has an irregular surface
- May be adherent to the skin, masseter, or mandible
- If the tumor infiltrates the facial nerve, there is weakness or paralysis of the facial muscles
- Cervical lymph nodes are sometimes involved
- Rarely, these tumors metastasize to the lungs
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Description
This quiz covers the classification of salivary neoplasms, including benign and malignant tumors. Learn about the different types of salivary gland tumors and their characteristics.
