malignant salivary gland tumors

8/8/2019 Malignant Salivary Gland Tumors

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MALIGNANT SALIVARY

GLAND TUMORS

MALIGNANT SALIVARY

GLAND TUMORS

MMucoepidermoid carcinomaucoepidermoid carcinomaAAdenoid cystic carcinomadenoid cystic carcinoma

AAcinic cell carcinomacinic cell carcinoma


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Mucoepidermoid CarcinomaMucoepidermoid Carcinoma

CLINIC AL FEATURES:CLINIC AL FEATURES:A dulthood tumor A dulthood tumor Significant female predilectionSignificant female predilection

S ITE:S ITE:50% MEC occur in the parotid gland (arising in50% MEC occur in the parotid gland (arising insuperficial lobe)superficial lobe)

20%

occur on the palate20%

occur on the palateRest of the lesions arising from the minor salivaryRest of the lesions arising from the minor salivaryglands with the buccal mucosa, lips, tongue and retroglands with the buccal mucosa, lips, tongue and retromolar areas to be the favored sites.molar areas to be the favored sites.

C/F.. Cont..dC/F.. Cont..d


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T he tumor may be movable, which is anT he tumor may be movable, which is anuncommon feature for a malignant tumor.uncommon feature for a malignant tumor.High grade lesions are often fixed to theHigh grade lesions are often fixed to theadjacent tissues.adjacent tissues.T heir size is 1T heir size is 1- -4 cm when diagnosed.4 cm when diagnosed.T

here may be facial weakness due to VIIT

here may be facial weakness due to VIInerve involvement.nerve involvement.


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H ISTOPAT H OL OGY:H ISTOPAT H OL OGY:T

hey have three dominant cell typesT

hey have three dominant cell typesMucinous, epidermoid and intermediateMucinous, epidermoid and intermediateT heir cells are arranged in the nests andT heir cells are arranged in the nests anddiffuse sheets that may surround cysticdiffuse sheets that may surround cystic

spacesspacesT here is no capsule, but the edge of theT here is no capsule, but the edge of thetumor is welltumor is well- -demarcateddemarcated


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T here may be focal areas of malignant cellsT here may be focal areas of malignant cellsinfiltrated into the normal salivary tissueinfiltrated into the normal salivary tissueT umors predominant mucous cells and moreT umors predominant mucous cells and morecystic spaces are classified as low gradecystic spaces are classified as low grade(with limited metastatic potential)(with limited metastatic potential)T

hose with solid sheets and fewer mucousT

hose with solid sheets and fewer mucoussecreting cells and high proportion of secreting cells and high proportion of stratified squamous epithelium are classifiedstratified squamous epithelium are classifiedas high grade tumorsas high grade tumors


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Mucoepidermoid CarcinomaLOW GRADE / HIGH GRADE

Mucoepidermoid CarcinomaLOW GRADE / HIGH GRADE


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TREATME N T/PROG N OS IS:TREATME N T/PROG N OS IS:L ow grade tumors follow a benign courseL ow grade tumors follow a benign coursewhereas high grade show distant metastasiswhereas high grade show distant metastasisto the regional lymph nodes as well ( cervicalto the regional lymph nodes as well ( cervicallymph nodes)lymph nodes)T reatment of primary malignancy is managedT reatment of primary malignancy is managedwith surgery followed by radiotherapy to thewith surgery followed by radiotherapy to theprimary site.primary site.Prognosis depends on the histological gradePrognosis depends on the histological gradeof the malignancy.of the malignancy.


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ADENOID CYSTICCARCINOMAADENOID CYSTICCARCINOMA


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMA

It is a malignant salivary gland tumor It is a malignant salivary gland tumor composed of cuboidal cells in a solidcomposed of cuboidal cells in a solidcribriform tubular patterncribriform tubular patternA CC is one of the most deceptive and A CC is one of the most deceptive andfrustrating tumor of the head and neck regionfrustrating tumor of the head and neck region

ORIG

IO

NOR

IG

IO

N :

: A CC arises from intercalated duct reserve A CC arises from intercalated duct reserve

cells or the terminal tube complexcells or the terminal tube complex


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMACLINIC AL FEATURES:CLINIC AL FEATURES:

Peak incidence is in sixth decade of life withPeak incidence is in sixth decade of life withslight female predilectionslight female predilection5050 --70% cases reported are in the minor 70% cases reported are in the minor salivary glands, the major glands that aresalivary glands, the major glands that areaffected are the parotid glandsaffected are the parotid glandsIn major salivary glands, the clinicalIn major salivary glands, the clinicalappearance is that of a unilocular mass,appearance is that of a unilocular mass,which is firm on palpationwhich is firm on palpationT here might be some pain and tendernessT here might be some pain and tenderness


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMAT he lesion has a slow growth rate.T he lesion has a slow growth rate.

Facial nerve paralysis or weakness maybeFacial nerve paralysis or weakness maybethe initial symptomthe initial symptomBone invasion occurs frequently. T here areBone invasion occurs frequently. T here areno radiographic changes initially as there isno radiographic changes initially as there is

infiltration through the marrow spacesinfiltration through the marrow spacesMetastasis is often seen in lungsMetastasis is often seen in lungsT he tumor has tendency to invade theT he tumor has tendency to invade theperinural spacesperinural spaces


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMAT here are no mitotic figuresT here are no mitotic figuresT

here is formation of pseudocystic spacesT

here is formation of pseudocystic spacesthat contain variety of acellular substancesthat contain variety of acellular substancesMyoepithelial cells may represent a minor Myoepithelial cells may represent a minor part of the cellular componentpart of the cellular component


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMA


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMA


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMA


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMA


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ADENOID CYSTIC

CARCINOMA

ADENOID CYSTIC

CARCINOMATREATME N T/PROG N OS IS:TREATME N T/PROG N OS IS:

Primary lesion always requires surgical innervation inPrimary lesion always requires surgical innervation in

the parotid gland with resection in the form of the parotid gland with resection in the form of superficial parotidectomy or deep lobulectomysuperficial parotidectomy or deep lobulectomyPost surgical radiotherapy has shown promisingPost surgical radiotherapy has shown promisingresultsresultsMultiple agent chemotherapy has shown someMultiple agent chemotherapy has shown somepromise in the management of the patients withpromise in the management of the patients withmetastatic diseasemetastatic disease5 years survival rate is approximately 7 0%5 years survival rate is approximately 7 0%A fter 1 5 years, the rate drops to 1 0% only. A fter 1 5 years, the rate drops to 1 0% only.

malignant salivary gland tumors

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