tumors of the salivary glands
DESCRIPTION
TUMORS OF THE SALIVARY GLANDS. TUMORS OF THE SALIVARY GLANDS MASSES. DIFFERENTIAL DIAGNOSIS OF A SALIVARY GLAND MASS: INFLAMMATION (PAROTIDITIS) MUMPS CALCULI NEOPLASM. TUMORS OF THE SALIVARY GLANDS. INCIDENCE: 3/100,000 3%ALL BODY TUMORS - PowerPoint PPT PresentationTRANSCRIPT
TUMORS OF THE SALIVARY TUMORS OF THE SALIVARY GLANDSGLANDS
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS MASSESMASSES
DIFFERENTIAL DIAGNOSIS OF A SALIVARY GLAND MASS:
–INFLAMMATION (PAROTIDITIS)–MUMPS–CALCULI
–NEOPLASM
TUMORS OF THE SALIVARY GLANDSTUMORS OF THE SALIVARY GLANDSINCIDENCE: 3/100,000INCIDENCE: 3/100,0003%ALL BODY TUMORS3%ALL BODY TUMORS
LOCATION OF SALIVARY GLAND TUMORS: 85% LOCATION OF SALIVARY GLAND TUMORS: 85% PAROTID, 10% SUBMANDIBULAR, 1% SUBLINGUAL, 4-PAROTID, 10% SUBMANDIBULAR, 1% SUBLINGUAL, 4-5% MINOR SALIVARY GLANDS5% MINOR SALIVARY GLANDS
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
80%OF ALL BENIGN LESIONS ARISE IN THE 80%OF ALL BENIGN LESIONS ARISE IN THE LATERAL (TAIL) OF THE PAROTID GLANDLATERAL (TAIL) OF THE PAROTID GLAND..
SUPERFICIAL PAROTIDECTOMY WITH SUPERFICIAL PAROTIDECTOMY WITH PRESERVATION OF THE FACIAL NERVEPRESERVATION OF THE FACIAL NERVE
TOTAL SUBMANDIBULAR AND SUBLINGUAL TOTAL SUBMANDIBULAR AND SUBLINGUAL GLAND RESECTIONGLAND RESECTION
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
PLEOMORPHIC ADENOMAPLEOMORPHIC ADENOMA
BENIGN MIXED TUMORBENIGN MIXED TUMOR
MYOEPITHELIAL AND EPIDERMOID CELL ORIGINMYOEPITHELIAL AND EPIDERMOID CELL ORIGIN
MOST COMMON NEOPLASM IN THE PAROTID MOST COMMON NEOPLASM IN THE PAROTID GLAND ACCOUNTS FOR 65% OF ALL OF THE GLAND ACCOUNTS FOR 65% OF ALL OF THE PAROTID TUMORSPAROTID TUMORS..
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
PLEOMORPHIC ADENOMAPLEOMORPHIC ADENOMA
TREATMENT: WIDE RESECTION OF THE TUMORTREATMENT: WIDE RESECTION OF THE TUMOR
AVOID SHELLING OUT THE LESIONAVOID SHELLING OUT THE LESION
RECURRENCE: PRIMARY DUE TO INADEQUATE RECURRENCE: PRIMARY DUE TO INADEQUATE RESECTIONRESECTION
LESIONS ARE MORE AGGRESSIVE WHEN THEY LESIONS ARE MORE AGGRESSIVE WHEN THEY RECURRECUR..
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
WARTHINWARTHIN’’S TUMOR (ADENOLYMPHOMA)S TUMOR (ADENOLYMPHOMA)SECOND MOST COMMON PAROTID TUMORSECOND MOST COMMON PAROTID TUMOR
MALE : FEMALE 5 : 1MALE : FEMALE 5 : 1
BILATERAL 10%BILATERAL 10%
PRIMARILY LOCATED IN THE LATERAL GLAND HOWEVER PRIMARILY LOCATED IN THE LATERAL GLAND HOWEVER MULTICENTRICITY IS DESCRIBEDMULTICENTRICITY IS DESCRIBED..
PEA SOUP BROWN MUCOID MATERIAL ON SECTIONINGPEA SOUP BROWN MUCOID MATERIAL ON SECTIONING
TREATMENT: LATERAL OR TOTAL GLANDULAR RESECTIONTREATMENT: LATERAL OR TOTAL GLANDULAR RESECTION
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
WARTHINWARTHIN’’S TUMOR (ADENOLYMPHOMA)S TUMOR (ADENOLYMPHOMA)
90%CURED WITH RESECTION90%CURED WITH RESECTION
10%RECUR DUE TO MULTICENTRICITY OR 10%RECUR DUE TO MULTICENTRICITY OR INADEQUATE RESECTIONINADEQUATE RESECTION..
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSESONCOCYTOMAONCOCYTOMA
PRINCIPALLY A PAROTID GLAND TUMORPRINCIPALLY A PAROTID GLAND TUMOR
5TH DECADE5TH DECADE
PROBABLY DUE TO HYPERPLASIA FROM AGINGPROBABLY DUE TO HYPERPLASIA FROM AGING
>>1%SALIVARY GLAND TUMORS1%SALIVARY GLAND TUMORS
CYSTIC COMPONENT HAS BEEN IDENTIFIEDCYSTIC COMPONENT HAS BEEN IDENTIFIED..
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
BASAL CELL ADENOMABASAL CELL ADENOMA
COMMON IN THE LATERAL PAROTID AND THE COMMON IN THE LATERAL PAROTID AND THE SUBMUCOSAL GLANDS IN THE UPPER LIPSUBMUCOSAL GLANDS IN THE UPPER LIP..
TREATMENT: LATERAL OR TOTAL GLANDULAR TREATMENT: LATERAL OR TOTAL GLANDULAR RESECTIONRESECTION..
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSESHEMANGIOMAHEMANGIOMA
50%OF ALL PAROTID TUMORS IN CHILDREN50%OF ALL PAROTID TUMORS IN CHILDREN
TREATMENT: ENVOLUTION BY THE AGE OF 5 IS TREATMENT: ENVOLUTION BY THE AGE OF 5 IS COMMONCOMMON
CN VII: SUPERFICIAL LOCATION IN CHILDREN CN VII: SUPERFICIAL LOCATION IN CHILDREN THUS OPERATIVE INTERVENTION SHOULD BE THUS OPERATIVE INTERVENTION SHOULD BE AVOIDED AND LET ENVOLUTION PROCEED AVOIDED AND LET ENVOLUTION PROCEED UNLESS THERE IS UNCONTROLLED BLEEDINGUNLESS THERE IS UNCONTROLLED BLEEDING..
STEROID THERAPYSTEROID THERAPY
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
LIPOMALIPOMA4%OF ALL PAROTID TUMORS4%OF ALL PAROTID TUMORS
MALE PREDOMINANCEMALE PREDOMINANCE4-5%TH DECADE4-5%TH DECADE
TREATMENT: LATERAL OR TOTAL GLANDULAR TREATMENT: LATERAL OR TOTAL GLANDULAR RESECTIONRESECTION
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS BENIGN MASSESBENIGN MASSES
MYXOMAMYXOMA
SLOW GROWINGSLOW GROWING
INFILTRATIVEINFILTRATIVE
TREATMENT: WIDE RESECTION OR TOTAL TREATMENT: WIDE RESECTION OR TOTAL GLANDULAR REMOVALGLANDULAR REMOVAL
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESMALIGNANT MASSES
PROGNOSIS: PALATE > PAROTID > SUBMANDIBULAR / PROGNOSIS: PALATE > PAROTID > SUBMANDIBULAR / SUBLINGUAL GLANDSUBLINGUAL GLAND
5TH-6TH DECADE5TH-6TH DECADE
RATE OF GROWTH DOES NOT CORRELATE WITH THE RATE OF GROWTH DOES NOT CORRELATE WITH THE DEGREE OF MALIGNANCYDEGREE OF MALIGNANCY
LUNG/BONE: PRIMARY METASTATIC SITESLUNG/BONE: PRIMARY METASTATIC SITES
PRIOR RADIOTHERAPY INCREASES THE RISK OF A PRIOR RADIOTHERAPY INCREASES THE RISK OF A SALIVARY GLAND MALIGNANCYSALIVARY GLAND MALIGNANCY..
TUMORS OF THE SALIVARY GLANDS MALIGNANT TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESMASSES
MUCOEPIDERMOID CARCINOMAMUCOEPIDERMOID CARCINOMA
MUCOUS AND EPIDERMOID CELL ORIGINMUCOUS AND EPIDERMOID CELL ORIGIN6%OF ALL PAROTID TUMORS - MOST COMMON 6%OF ALL PAROTID TUMORS - MOST COMMON
MALIGNANCYMALIGNANCY65%FOUND IN THE PAROTID GLAND65%FOUND IN THE PAROTID GLAND
18%OF ALL MALIGNANT TUMORS OF THE 18%OF ALL MALIGNANT TUMORS OF THE SALIVARY GLANDSSALIVARY GLANDS
TUMORS OF THE SALIVARY GLANDS MALIGNANT TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESMASSES
MUCOEPIDERMOID CARCINOMAMUCOEPIDERMOID CARCINOMA
LOW, INTERMEDIATE AND HIGH GRADESLOW, INTERMEDIATE AND HIGH GRADES
4-6TH DECADE4-6TH DECADE
8%CN VII INVOLVEMENT AT THE TIME OF 8%CN VII INVOLVEMENT AT THE TIME OF PRESENTATIONPRESENTATION
10%LYMPH NODE METASTASIS10%LYMPH NODE METASTASIS
TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESTUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESMUCOEPIDERMOID CARCINOMAMUCOEPIDERMOID CARCINOMA
TREATMENT: TOTAL GLANDULAR RESECTION +/- TREATMENT: TOTAL GLANDULAR RESECTION +/- NECK NODE DISSECTIONNECK NODE DISSECTION
CN VII: SPARE NERVE UNLESS INVOLVED WITH CN VII: SPARE NERVE UNLESS INVOLVED WITH TUMORTUMOR..
POSTOPERATIVE RADIOTHERAPY DEPENDING ON POSTOPERATIVE RADIOTHERAPY DEPENDING ON MARGINS, EXTRACAPSULAR EXTENSION FROM MARGINS, EXTRACAPSULAR EXTENSION FROM LYMPH NODES, PERINEURAL INVOLVEMENT, OR LYMPH NODES, PERINEURAL INVOLVEMENT, OR INVOLVEMENT OF SURROUNDING STRUCTURESINVOLVEMENT OF SURROUNDING STRUCTURES
TUMORS OF THE SALIVARY GLANDS MALIGNANT TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESMASSES
MUCOEPIDERMOID CARCINOMAMUCOEPIDERMOID CARCINOMA
RECURRENCE RATE 15-25%, USUALLY DUE TO RECURRENCE RATE 15-25%, USUALLY DUE TO INADEQUATE RESECTIONINADEQUATE RESECTION..
WHEN MUCUOEPIDERMOID CARCINOMA IS WHEN MUCUOEPIDERMOID CARCINOMA IS LOCATED IN THE SUBMANDIBULAR GLAND, THE LOCATED IN THE SUBMANDIBULAR GLAND, THE TUMOR IS MORE AGGRESSIVETUMOR IS MORE AGGRESSIVE..
RARELY INVOLVES THE SUBLINGUAL GLANDRARELY INVOLVES THE SUBLINGUAL GLAND
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESMALIGNANT MASSES
ADENOID CYSTIC CARCINOMA (CYLINDROMA)ADENOID CYSTIC CARCINOMA (CYLINDROMA)MOST COMMON MALIGNANT TUMOR OF THE MOST COMMON MALIGNANT TUMOR OF THE
SUBMANDIBULAR GLANDS AND THE SECOND SUBMANDIBULAR GLANDS AND THE SECOND MOST COMMON PAROTID MALIGNANCYMOST COMMON PAROTID MALIGNANCY
25-30%CN VII PARALYSIS/PARESIS ON 25-30%CN VII PARALYSIS/PARESIS ON PRESENTATIONPRESENTATION
PERINEURAL INVASION IS COMMONPERINEURAL INVASION IS COMMON
GRAY PINK WITH CRIBRIFORM HISTOLOGYGRAY PINK WITH CRIBRIFORM HISTOLOGY
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSES MALIGNANT MASSES
ADENOID CYSTIC CARCINOMA (CYLINDROMA)ADENOID CYSTIC CARCINOMA (CYLINDROMA)
UNPREDICTABLE TUMORUNPREDICTABLE TUMOR
SLOW GROWING, HOWEVER, RELENTLESS SLOW GROWING, HOWEVER, RELENTLESS DISEASEDISEASE
LUNG METASTASIS COMMONLUNG METASTASIS COMMON
LYMPH NODE INVOLVEMENT NOT COMMONLYMPH NODE INVOLVEMENT NOT COMMON
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSESMALIGNANT MASSES
ADENOID CYSTIC CARCINOMA (CYLINDROMA)ADENOID CYSTIC CARCINOMA (CYLINDROMA)
TREATMENT: SURGICAL RESECTION OF THE TREATMENT: SURGICAL RESECTION OF THE GLAND WITH POSSIBLE NERVE RESECTION IF GLAND WITH POSSIBLE NERVE RESECTION IF INVOLVEDINVOLVED
POSTOPERATIVE RADIOTHERAPYPOSTOPERATIVE RADIOTHERAPY
MALIGNANT PLEOMORPHIC ADENOMA MALIGNANT PLEOMORPHIC ADENOMA (MALIGNANT MIXED TUMOR (MALIGNANT MIXED TUMOR
OR CARCINOMA EX PLEOMORPHIC ADENOMA)OR CARCINOMA EX PLEOMORPHIC ADENOMA)ETIOLOGY: MALIGNANT TRANSFORMATION OF A ETIOLOGY: MALIGNANT TRANSFORMATION OF A
PLEOMORPHIC ADENOMAPLEOMORPHIC ADENOMA5-6TH DECADE5-6TH DECADE
AVERAGE DURATION OF THE LESION IS AVERAGE DURATION OF THE LESION IS PRESENT 10 YEARS BEFORE BEING PRESENT 10 YEARS BEFORE BEING DIAGNOSEDDIAGNOSED
TREATMENT: GLANDULAR RESECTION WITH TREATMENT: GLANDULAR RESECTION WITH NERVE RESECTION IF INVOLVED WITH TUMORNERVE RESECTION IF INVOLVED WITH TUMOR
ACINOUS (ACINIC) CELL CARCINOMAACINOUS (ACINIC) CELL CARCINOMA
LOW, INTERMEDIATE AND HIGH GRADELOW, INTERMEDIATE AND HIGH GRADEINTRAVASCULAR EXTENSIONINTRAVASCULAR EXTENSION
3RD-6TH DECADE3RD-6TH DECADEMETASTASIS TO THE LUNG AND BONE (VERTEBRAE)METASTASIS TO THE LUNG AND BONE (VERTEBRAE)
TREATMENT: GLANDULAR RESECTIONTREATMENT: GLANDULAR RESECTIONRADIOTHERAPY IS RADIOTHERAPY IS NOT NOT EFFECTIVE EFFECTIVE
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSES MALIGNANT MASSES
SQUAMOUS CELL CARCINOMASQUAMOUS CELL CARCINOMA
IS IT A METASTATIC LESIONIS IT A METASTATIC LESION??1/3HAVE FACIAL NERVE INVOLVEMENT AT THE 1/3HAVE FACIAL NERVE INVOLVEMENT AT THE
TIME OF PRESENTATIONTIME OF PRESENTATION
MALE > FEMALEMALE > FEMALE
6TH DECADE6TH DECADETOTAL GLANDULAR RESECTIONTOTAL GLANDULAR RESECTION
10YEAR SURVIVAL: 45%10YEAR SURVIVAL: 45%
ADENOCARCINOMAADENOCARCINOMA
USUALLY FIXED TO THE SURROUNDING STRUCTURESUSUALLY FIXED TO THE SURROUNDING STRUCTURESMALE > FEMALEMALE > FEMALE
3RD - 6TH DECADE3RD - 6TH DECADE22%FACIAL NERVE INVOLVEMENT AT THE TIME OF PRESENTATION22%FACIAL NERVE INVOLVEMENT AT THE TIME OF PRESENTATION
25%METASTASIS AT THE TIME OF PRESENTATION25%METASTASIS AT THE TIME OF PRESENTATIONGLANDULAR RESECTION WITH NERVE RESECTION IF INVOLVED GLANDULAR RESECTION WITH NERVE RESECTION IF INVOLVED
WITH TUMORWITH TUMORNECK DISSECTIONNECK DISSECTION
POSTOPERATIVE RADIOTHERAPYPOSTOPERATIVE RADIOTHERAPY
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS MALIGNANT MASSES MALIGNANT MASSES
UNDIFFERENTIATED CARCINOMAUNDIFFERENTIATED CARCINOMA7TH-8TH DECADE7TH-8TH DECADE
33%FACIAL NERVE INVOLVEMENT AT THE TIME 33%FACIAL NERVE INVOLVEMENT AT THE TIME OF PRESENTATIONOF PRESENTATION
HIGHLY MALIGNANTHIGHLY MALIGNANT
TREATMENT: GLANDULAR RESECTION, NECK TREATMENT: GLANDULAR RESECTION, NECK DISSECTION, POSTOPERATIVE RADIOTHERAPYDISSECTION, POSTOPERATIVE RADIOTHERAPY
NERVE RESECTION IF INVOLVEDNERVE RESECTION IF INVOLVED
TUMORS OF THE SALIVARY GLANDS TUMORS OF THE SALIVARY GLANDS COMPLICATIONS OF SURGICAL INTERVENTIONCOMPLICATIONS OF SURGICAL INTERVENTION
ORAL FISTULASORAL FISTULASFACIAL NERVE INJURYFACIAL NERVE INJURY
LOSS OF EAR SENSATIONLOSS OF EAR SENSATIONFREY’S SYNDROME (GUSTATORY SWEATING)FREY’S SYNDROME (GUSTATORY SWEATING)
SKIN NECROSISSKIN NECROSIS