Sublingual gland neoplasms: clinicopathological study of 8 cases

Background Sublingual gland neoplasms are very rare and the majority of them are malignant. The aim of this study was to evaluate the clinical course, treatment, and outcomes of these uncommon neoplasms based on the authors’ experience and the recent literature.Material and Methods The medical charts of 8 patients with primary epithelial sublingual gland tumors treated between 1994 and 2020 were reviewed.Results Malignant tumors comprised 75% (6/8) of cases. Adenoid cystic carcinoma was the most common (50%, 3/6) and characterized by high risk of local recurrence and lung metastasis. Pleomorphic adenoma was the only representative of benign tumors with no evidence of local recurrence in follow up.Conclusions Treatment of choice of sublingual gland tumors is surgery. However, due to the fact that adenoid cystic carcinoma is the most common malignancy with poor prognosis, surgical treatment should be combined with postoperative radiotherapy. Benign sublingual tumors are less common and treatment of choice in these cases is tumor resection together with sublingual gland. Key words:Salivary gland neoplasms, sublingual gland, pleomorphic adenoma, adenoid cystic carcinoma, mucoepidermoid carcinoma.     

2456例唾液腺肿瘤临床病理分析

目的探讨唾液腺肿瘤的发病、病理类型等临床特点。方法收集中山大学孙逸仙纪念医院口腔颌面外科1973年1月至2018年12月间确诊的唾液腺肿瘤病例2456例患者的相关资料,回顾分析其性别、年龄、病理类型、发病部位、良恶性构成比等特点。结果46年间收治的唾液腺肿瘤患者2456例,女性比例占41.9%,男性占58.1%,40~60岁年龄段为发病高峰,其中良性肿瘤1863例(75.9%),恶性肿瘤593例(24.1%),良恶性之比为3.1∶1。良性肿瘤构成比前2位是多形性腺瘤(58.7%)、Warthin瘤(33.6%),恶性肿瘤构成比前2位是黏液表皮样癌(27.7%)、腺样囊性癌(26.1%)。最常见的良性肿瘤多形性腺瘤的好发部位是腮腺、腭部、颌下腺,而恶性肿瘤中粘液表皮样癌则常见于腮腺和腭部的小唾液腺。本组资料中唾液腺肿瘤发病呈逐年递增的趋势,近10年病例占总病例数的53.3%。结论唾液腺肿瘤病人数量逐年增加;唾液腺肿瘤的总发生率男性高于女性;大唾液腺以良性肿瘤为主,小唾液腺恶性肿瘤多见;多形性腺瘤、Warthin瘤、黏液表皮样癌最常见;40~60岁是唾液腺良、恶性肿瘤高发年龄段。     

Intraoral salivary gland tumors: a retrospective study of 201 cases

Two hundred and one cases of intraoral salivary gland tumors were studied from the files of the School of Pathology, University of the Witwaterstrand and South African Institute for Medical Research. 145 cases (72.5%) were classified as benign, comprising 140 pleomorphic adenomas and 5 monomorphic adenomas. The other 56 cases were classified as malignant or potentially malignant tumors, represented by 21 adenoid cystic carcinomas, 15 adenocarcinomas, 13 mucoepidermoid tumors, 5 carcinoma in pleomorphic adenomas and 2 epidermoid carcinomas. The patients in the malignant/potentially malignant group were significantly older than those in the benign group and a smaller proportion of their tumors were palatal, the difference being statistically significant. The high frequency of pleomorphic adenoma might result from a relatively higher number of black than white patients in this sample.     

Intraoral salivary gland tumors: a retrospective study of 201 cases

Two hundred and one cases of intraoral salivary gland tumors were studied from the files of the School of Pathology, University of the Witwaterstrand and South African Institute for Medical Research. 145 cases (72.5%) were classified as benign, comprising 140 pleomorphic adenomas and 5 monomorphic adenomas. The other 56 cases were classified as malignant or potentially malignant tumors, represented by 21 adenoid cystic carcinomas, 15 adenocarcinomas, 13 mucoepidermoid tumors, 5 carcinoma in pleomorphic adenomas and 2 epidermoid carcinomas. The patients in the malignant/potentially malignant group were significantly older than those in the benign group and a smaller proportion of their tumors were palatal, the difference being statistically significant. The high frequency of pleomorphic adenoma might result from a relatively higher number of black than white patients in this sample.     

96例老年患者颌下腺肿瘤临床病理分析

目的：了解老年患者颌下腺肿瘤的组织学类型及临床病理特征。方法：对96例老年患者颌下腺肿瘤临床病理资料进行统计学分析。结果：良性上皮性肿瘤71例（73．96％）,恶性上皮性肿瘤25例（26．04％）。多形性腺瘤居良性上皮性肿瘤的首位,腺样囊性癌居恶性上皮性肿瘤的首位。良、恶性上皮性肿瘤的男女性别比为0．92：1和1．5：1：良性肿瘤平均年龄66岁、恶性肿瘤平均年龄69岁。颌下腺肿瘤复发率为4．17％,多形性腺瘤占75％。结论：多形性腺瘤和腺样囊性癌分别是最常见的良、恶性上皮性肿瘤;良性上皮性肿瘤多见于女性,恶性上皮性肿瘤多见于男性;多形性腺瘤易复发。     

CD44V6与部分涎腺肿瘤临床病理的相关性分析

目的:探讨CD44V6在涎腺肿瘤生长、侵袭和转移中的作用。方法:涎腺肿瘤石蜡标本107例,良性50例,恶性57例。用抗CD44V6单克隆抗体作Envision免疫组化二步法,做定量病理分析。结果:良性肿瘤中CD44V6仅在多形性腺瘤和肌上皮瘤的肿瘤性上皮细胞膜中表达。恶性肿瘤中的CD44V6表达不一,但表达阳性率和强度均高于良性瘤,在肿瘤细胞内和胞膜表面都有分布。结论:CD44V6调节着涎腺肿瘤的上皮和淋巴成分的增殖和粘附过程,在涎腺肿瘤发生、发展过程中发挥一定作用。可考虑作为反映涎腺肿瘤恶性度的参考指标。     

副腮腺病变32例临床分析

目的:副腮腺病变在临床上并不多见,本研究旨在探讨副腮腺病变的临床表现、治疗和预后。方法:回顾性分析1999年4月—2008年11月收治的32例副腮腺病变患者的临床资料,包括性别、年龄、病程、症状、体格检查、影像学检查、治疗方案、术后病理检查和随访结果。结果:32例患者中,男8例,女24例,就诊年龄19~69岁,平均45岁。患者通常无明显的症状和体征,病变质地中等或偏硬,活动度良好,界限清楚。所有患者均接受手术治疗,术后病理诊断24例为良性病变(多形性腺瘤19例,良性淋巴上皮瘤3例,基底细胞腺瘤和慢性炎症各1例),8例为恶性病变(腺泡细胞癌和淋巴上皮癌各2例,乳头状囊腺癌、基底细胞癌、上皮-肌上皮癌和黏液表皮样癌各1例),恶性肿瘤患者术后追加放疗。随访12~128个月,平均36个月,预后良好,未见肿瘤复发。结论:副腮腺病变临床少见,其临床表现与良性肿瘤类似,治疗以手术为主,恶性肿瘤可追加术后放疗,预后较好。     

303例颌下腺肿瘤临床病理分析

目的：了解颌下腺肿瘤的组织学类型、构成比及发病性别、年龄、体积、复发等临床病理特征。方法：对303例颌下腺肿瘤临床病理资料进行统计分析。结果：良性上皮性肿瘤216例（71.29%）,恶性上皮性肿瘤79例（26.07%）,软组织肿瘤6例（1.98%）,淋巴造血系统肿瘤2例（0.66%）。多形性腺瘤、肌上皮瘤和Warthin瘤居良性上皮性肿瘤的前3位,腺样囊性癌、癌在多形性腺瘤中、黏液表皮样癌和腺泡细胞癌居恶性上皮性肿瘤的前4位。良、恶性上皮性肿瘤的男女比为0.79∶1和1.82∶1;平均年龄为37.5岁和47.8岁;平均直径为2.55 cm和3.43cm。颌下腺肿瘤复发率为6.93%,复发性多形性腺瘤占76.19%。结论：多形性腺瘤和腺样囊性癌分别是最常见的良、恶性上皮性肿瘤;良性上皮性肿瘤多见于女性,恶性上皮性肿瘤多见于男性;恶性上皮性肿瘤的发病年龄和体积均大于良性;多形性腺瘤易复发。     

Pleomorphic adenoma of the buccal salivary gland: magnetic resonance imaging findings with differential diagnoses

The majority of minor salivary gland tumors are malignant. Of the benign tumors, pleomorphic adenomas are most common. The cheeks, lips, and gingiva are rarely sites of occurrence. A case of pleomorphic adenoma of the buccal salivary gland is presented here with a discussion of the importance of magnetic resonance imaging in demonstrating the extent of the lesion and establishing a differential diagnoses.     

基质金属蛋白酶及其组织抑制剂表达失衡与涎腺恶性肿瘤浸润生长的关系

目的　探讨基质金属蛋白酶2、9(MMP-2、9),膜型基质金属蛋白酶1(MT1-MMP)及基质金属蛋白酶组织抑 制剂1、2(TIMP-1、2)与涎腺恶性肿瘤浸润生长的关系。方法　应用免疫组化SP法和明胶酶谱法检测28例涎腺良 性肿瘤、26例涎腺恶性肿瘤中MMP-2、9,MT1-MMP及TIMP-1、2的表达及细胞定位,分析其中酶原与活性酶的含量 比例。结果　涎腺恶性肿瘤中MMP-2、9的表达强于良性肿瘤(P<0·05),TIMP-1、2的表达低于良性肿瘤 (P<0·05)。MMP-2、MT1-MMP、TIMP-2的表达有相关性。MMP-9酶原及活性MMP-9在恶性肿瘤中的表达均高于良 性肿瘤(P<0·05)。结论　MMP-2、9在涎腺恶性肿瘤浸润性生长中扮演了重要角色。涎腺恶性肿瘤中,TIMP-1、2 抑制作用的降低导致了MMP-2、9合成、激活的增多,令MMP-2、9与其天然组织抑制剂TIMP-1、2之间的平衡失调, 从而基底膜加速降解。     

Salivary gland tumors in an Iranian population: a retrospective study of 130 cases.

PURPOSE: Tumors of the salivary glands are uncommon, comprising 3% to 10% of head and neck neoplasia. In the absence of epidemiologic studies of these neoplasms in an Iranian population, we conducted a preliminary survey of 130 cases over the last 20 years in Hamedan, Iran. PATIENTS AND METHODS: The medical records and case notes of all patients with histologically confirmed salivary gland tumors were reviewed retrospectively from February 1984 to March 2003. This review found 89 patients with benign tumors and 41 patients with malignant tumors. The collection of data included gender, age, location, and histopathology of the tumor. Other recorded data included diagnostic procedures, operative reports, complications, additional treatment, and follow-up. RESULTS: We studied 78 females and 52 males with a mean age of 44.9 years. Patients with benign and malignant tumors presented with a mean age of 41.3 and 47 years, respectively. The frequency of benign tumors was 68.4% (n = 89) and 31.6% for malignant tumors (n = 41). Tumors were localized in the parotid gland (63%; n = 82), the submandibular gland (23%; n = 30), and in the minor salivary glands (14%; n = 18). The most common benign tumor was pleomorphic adenoma (65.4%; n = 85). Among malignant tumors, mucoepidermoid carcinoma was the most frequent (11.5%; n = 15), followed by adenocarcinoma (10%; n = 13). Greater than 63% of malignant tumors were treated surgically, and the remaining with combined therapy. Seven patients died over the follow-up period (6 with persistent disease), 5 were lost to follow-up, and 23 remained cancer-free. CONCLUSION: Between benign and malignant salivary gland tumors, frequency of pleomorphic adenoma and mucoepidermoid carcinoma was in keeping with studies reported previously. In other salivary gland tumors, however, diversity was obvious and showed significant difference, requiring further studies.     

Immunohistochemical characterization of functional markers in human minor salivary gland tumors

The distribution of carcinoembryonic antigen (CEA), secretory component (SC), immunoglobulin A (IgA), immunoglobulin M (IgM), J-chain, and lysozyme in tumors of minor salivary glands was investigated using an immunoperoxidase method. Although CEA was demonstrated in both benign and malignant tumors, its distribution was relatively more common and with increased staining intensity in malignant tissues. In pleomorphic adenomas, the distribution of SC was similar to that of IgA and J-chain, suggesting the presence of secretory IgA in the epithelial cells. However, some neoplastic epithelial cells contained SC but not IgA and J-chain. No IgM was detected in such cells. Lysozyme could be demonstrated only in pleomorphic adenomas. Mucoepidermoid tumors and adenoidcystic carcinomas were negative for lysozyme. These findings suggest that some neoplastic ductal epithelial cells of pleomorphic adenomas retain functional characteristics of normal epithelial cells.     

Immunohistochemical characterization of functional markers in human minor salivary gland tumors

The distribution of carcinoembryonic antigen (CEA), secretory component (SC), immunoglobulin A (IgA), immunoglobulin M (IgM), J-chain, and lysozyme in tumors of minor salivary glands was investigated using an immunoperoxidase method. Although CEA was demonstrated in both benign and malignant tumors, its distribution was relatively more common and with increased staining intensity in malignant tissues. In pleomorphic adenomas, the distribution of SC was similar to that of IgA and J-chain, suggesting the presence of secretory IgA in the epithelial cells. However, some neoplastic epithelial cells contained SC but not IgA and J-chain. No IgM was detected in such cells. Lysozyme could be demonstrated only in pleomorphic adenomas. Mucocpidermoid tumors and adenoidcystic carcinomas were negative for lysozyme. These findings suggest that some neoplastic ductal epithelial cells of pleomorphic adenomas retain functional characteristics of normal epithelial cells.     

Surgical treatment of pleomorphic adenoma of the parotid gland: report of 110 cases

One hundred benign and ten malignant pleomorphic adenomas of the parotid gland were analyzed. Follow up ranged from two to 20 years. Of 54 cases of benign pleomorphic adenoma of the parotid gland, recurrence was noted in five cases (9.2%). The five-year recurrence rate was 17.2%. Of the six malignant pleomorphic adenoma, recurrence within the first ten years took place in four patients (66.6%).     

Epithelial salivary gland tumors of children and adolescents in west China population: a clinicopathologic study of 79 cases

Objective:  Determine the clinical and histopathologic features of epithelial salivary gland tumors of children and adolescents.
Methods:  A total of 79 cases of epithelial salivary gland tumors of children and adolescents were retrieved from the files. Information about demographic, clinical, histopathologic characteristics, and follow-up status were analyzed.
Results:  Sixty tumors (75.9%) were benign and 19 (24.1%) malignant. The most common tumor overall was pleomorphic adenoma (PA). The parotid was the most frequently involved site (43.0%). PA was the most common type of benign tumor. The most common malignant tumor was mucoepidermoid carcinoma. Five patients with parotid PA and two cases with palate myoepithelioma showed local recurrences. One patient with mucoepidermoid carcinoma showed local recurrences and died from the tumor 3 years after the initial treatment. One patient with adenocarcinoma presented local and neck recurrences, and died 4 years after initial treatment.
Conclusions:  Our data showed that the salivary gland tumors in children and adolescents may be the higher incidence of benign tumors, especially of PA; the slightly higher tendency for female predominance; the higher incidence of parotid glands. Mucoepidermoid carcinoma was the most common malignant tumor, with majority of low grade. Initial treatment should be planned to excise the tumor completely with satisfactory margins. The neck dissections or postoperative radiotherapy were performed in patients with low differentiation malignancies, or patients who present nodal metastasis or with clinically suspicious regional metastasis.     

2489例涎腺上皮性肿瘤临床病理分析

目的:了解涎腺上皮性肿瘤的临床病理特点。方法:对2489例涎腺上皮性肿瘤临床病理资料进行统计分析。结果:涎腺恶性上皮性肿瘤840例,腺样囊性癌、黏液表皮样癌、癌在多形性腺瘤中居其前3位;涎腺良性上皮性肿瘤1649例,多形性腺瘤、Warthin瘤、基底细胞腺瘤居其前3位。涎腺恶性、良性上皮性肿瘤男女之比为1.13∶1和0.99∶1;平均发病年龄47.86岁和44.86岁;腮腺和腭部为好发部位。结论:腺样囊性癌和多形性腺瘤是最常见的涎腺恶性、良性上皮性肿瘤。     

谷胱甘肽过氧化物酶-3在腮腺多形性腺瘤中的表达及意义

目的 :研究谷胱甘肽过氧化物酶-3(glutathione peroxidase-3,GPX-3)基因及蛋白在腮腺良、恶性多形性腺瘤中的表达,以明确GPX-3与腮腺多形性腺瘤发生、发展的相关性,为临床预测腮腺多形性腺瘤的发生及恶变提供理论依据。方法:采用荧光定量PCR和蛋白免疫印迹法检测30例腮腺多形性腺瘤,30例腮腺多形性腺瘤的瘤旁2 cm腺体组织,以及10例恶性腮腺多形性腺瘤中的GPX-3 mRNA及蛋白的表达,对其相对表达量进行统计学分析。结果:GPX-3 mRNA和蛋白在腮腺良、恶性多形性腺瘤中的表达明显低于瘤旁腺体组织,且在腮腺恶性多形性腺瘤中的表达最低,差异有统计学意义(P<0.01)。GPX-3在腮腺多形性腺瘤中的表达与患者的年龄、性别及肿瘤大小无关,差异无统计学意义(P>0.05),且GPX-3在腮腺多形性腺瘤中的表达与肿瘤TNM分期及恶性成分比例有关,其差异有统计学意义(P<0.05)。结论:GPX-3在腮腺良性多形性腺瘤中低表达,且在腮腺恶性多形性腺瘤中的表达最低,提示GPX-3的低表达与腮腺多形性腺瘤的发生及恶变密切相关。     

Basal cell adenocarcinomas of the major salivary glands

Basal cell adenoma of salivary gland has become an established variant of monomorphic adenoma since its segregation from pleomorphic adenoma in 1967. Although there have been many comprehensive reports about benign basal cell adenomas, only rare case reports of malignant basal cell type neoplasms have appeared in the literature. Described in this report are the clinicopathologic features of 29 cases labeled basal cell adenocarcinomas that had morphologic characteristics of basal cell adenomas but infiltrative, perineural, and intravascular growth features that indicated a malignant potential. With limited follow-up, seven tumors are known to have recurred, and three of these metastasized to lymph nodes and lung. One patient died with extensive local spread of the tumor. All patients were adults. The peak incidence was in the sixth decade of life, and there was no gender predilection. The parotid gland was the predominant site. A solid type growth configuration was most frequent; membranous, trabecular, and tubular types were less frequent, in that order. Three patients also had dermal cylindromas, perhaps indicative of a salivary gland-skin adnexal diathesis that has been previously reported.     

Intraoral minor salivary gland neoplasms: review of 213 cases.

PURPOSE: Minor salivary gland tumors (MSGTs) constitute a heterogeneous group of neoplasms with great histomorphologic variation. This study reviews a large series of benign and malignant salivary gland tumors of the oral region and determines the incidence and the correlation of the histopathologic features with the clinical characteristics. MATERIALS AND METHODS: Two hundred thirteen cases of MSGT were retrospectively studied. Hematoxylin-eosin-stained slides were examined in all cases. Special stains and immunohistochemical stains were used in selected cases. Clinical characteristics of the neoplasms were also noted. RESULTS: One hundred nineteen tumors were benign (56%), and 94 tumors were malignant (44%). Pleomorphic adenoma was the most common benign tumor (93 of 119). Canalicular adenoma was the second most common benign MSGT in our series (25 of 119). Of the 94 malignant MSGTs, mucoepidermoid carcinoma (MEC) (45 of 94), adenoid cystic carcinoma (22 of 94), and polymorphous low-grade adenocarcinoma (18 of 94) were the most common. Most MECs (34 of 45) were low-grade lesions. Of 5 central MECs, 3 cases occurred in the maxilla and 2 cases arose in the mandible. CONCLUSIONS: Benign intraoral MSGTs are slightly more common than malignant MSGTs. Pleomorphic adenoma is the most common MSGT, and MEC is the most common malignant variety. The palate is the most common site for minor gland neoplasms. Benign labial salivary gland neoplasms are more common in the upper lip, and malignant labial tumors are more common in the lower lip.     

Quantitative study on nucleolar organizer regions in salivary gland tumours]

The argyrophil staining technique for nucleolar organizer regions (NOR) had been applied to a series of benign and malignant salivary gland tumours. We have studied 38 salivary gland tumours, 16 benign and 22 malignant. In all specimens clearly defined silver-stained intranuclear AgNOR dots were visible. The differences between the numbers of AgNORs in the benign and malignant groups, notably pleomorphic adenomas, adenoid cystic carcinoma, mucoepidermoid carcinoma and adenocarcinoma, were highly significant. This result suggested that the AgNOR technique is of diagnostic help in distinguishing between these salivary gland tumours.