Clinicopathological study of salivary gland tumors: an assessment of 303 patients

Salivary gland neoplasms are remarkable for their histological diversity and several studies point to their varied occurrence in the population. Clinical aspects were histologically assessed to determine possible associations and define parameters to differentiate benign and malignant neoplasms. The case files of patients diagnosed with epithelial salivary gland tumors between 1989 and 2005 were reviewed. A majority (71%) of the 303 salivary gland tumors studied were benign and pleomorphic adenoma were found to be most common. Mean ages for patients with benign and malignant tumors were 49.2 and 58.5 years, respectively. A statistically significant difference between these tumors was observed for the following variables: mean age, tumor size and disease duration. A correlation was found between histological diagnosis and tumor consistency. The data presented here corroborate a number of previous studies and are therefore relevant in understanding the diverse characteristics exhibited by these tumors.     

Pleomorphic Adenoma of the Parotid Gland: Report of a Case With Review of Literature

Background

Pleomorphic adenomas are benign salivary gland tumors, which predominantly affect the superficial lobe of the parotid gland. The “pleomorphic” nature of the tumor can be explained on the basis of its epithelial and connective tissue origin. The tumor has a female predilection between 30–50 years of age. Slowly progressing asymptomatic swelling is the usual presentation of the tumor. Surgical excision of the tumor mass forms the mainstay of treatment, with utmost care taken to preserve the facial nerve.

Case Details

This case report aims to throw light on an interesting case of pleomorphic adenoma of the parotid gland in a 50 years old female patient. The patient presented with a slowly progressing asymptomatic swelling on the left side of the face. There is also a special emphasis to a detailed review of literature.

Conclusion

Salivary gland neoplasms can occur at any site where salivary tissue is present. Pleomorphic adenoma is the commonest salivary gland tumor characterized by diverse histomorphological features. Early diagnosis and treatment plan entails thorough history taking, clinical examination, coupled with radiographic and histopathological findings.     

福州市城区2004-2006年居民恶性肿瘤死亡原因分析

[目的]了解福州市城区居民恶性肿瘤死亡的原因分布,为制定恶性肿瘤的防治对策提供依据。[方法]采用入户调查的方法,按ICD-10的标准和方法进行死因分类,对福州市2004～2006年城区居民恶性肿瘤死亡情况进行全面分析。[结果]2004～2006年福州市城区居民恶性肿瘤平均死亡率为104.94/10万,男性高于女性;前五位死因依次为胃癌、肝癌、肺癌、结肠,直肠和肛门癌、食管癌。[结论]恶性肿瘤是威胁福州市居民的主要死亡原因之一,应根据不同人群、不同肿瘤的特点,采取综合性干预措施,预防或减少恶性肿瘤的发生。     

Tumors of the accessory salivary glands of the mouth; a follow-up study of 101 patients

In the period 1970-1987 101 patients were seen with a neoplasm of the intraoral accessory salivary glands. There was no sex preference; mean age of the patients was 51 years. The junction of the hard and soft palates is a site of predilection. Over 50 per cent of these tumours are malignant, the adenoid cystic carcinoma being the most notorious. Treatment consists primarily in surgical removal. In case of malignancy postoperative radiotherapy is often instituted, resulting in local cure in almost all cases. However, the prognosis of the malignant salivary gland tumours, especially of the adenoid cystic carcinoma, is rather unfavourable due to distant metastases.     

Clinical and statistical study of salivary gland adenoma

The authors studied 100 patients with salivary gland adenomas for a period of ten years (from 1989 to 1999). Different types of adenomas regarding their glandular localization, clinical presentation, the age and the sex of the patients were studied. Different diagnostic methods were applied: medical history, clinical examination, sonography, scintigraphy, tomodensitometry, sialography, express morphological diagnosis and permanent histological preparation. All patients were treated surgically: in 61% lateral parotidectomy was performed, in 1.4% - conservative parotidectomy and in 24% - enucleation. The authors report about 7.75% recurrence of pleomorphic adenoma and 6% malignization, mainly in the recurrences of the pleomorphic adenoma. In 22 of the patients a postoperative paresis was observed, in 18 of them it was transitory and gradually disappeared after 8 to 9 months. Auriculotemporal syndrome was observed in 4 of the patients.     

Mobile phone use and risk of parotid gland tumor

Handheld mobile phones were introduced in Denmark and Sweden during the late 1980s. This makes the Danish and Swedish populations suitable for a study aimed at testing the hypothesis that long-term mobile phone use increases the risk of parotid gland tumors. In this population-based case-control study, the authors identified all cases aged 20-69 years diagnosed with parotid gland tumor during 2000-2002 in Denmark and certain parts of Sweden. Controls were randomly selected from the study population base. Detailed information about mobile phone use was collected from 60 cases of malignant parotid gland tumors (85% response rate), 112 benign pleomorphic adenomas (88% response rate), and 681 controls (70% response rate). For regular mobile phone use, regardless of duration, the risk estimates for malignant and benign tumors were 0.7 (95% confidence interval: 0.4, 1.3) and 0.9 (95% confidence interval: 0.5, 1.5), respectively. Similar results were found for more than 10 years' duration of mobile phone use. The risk estimate did not increase, regardless of type of phone and amount of use. The authors conclude that the data do not support the hypothesis that mobile phone use is related to an increased risk of parotid gland tumors.     

Management of malignant salivary gland tumours

Malignant tumours of both major and minor salivary glands are extremely rare: the parotid gland is most frequently affected by malignant change, followed by the submandibular gland. Malignant tumours of minor salivary glands may occur anywhere in the upper aerodigestive tract, but more common sites are the upper lip, junction of hard and soft palate and paranasal sinuses.     

E-钙粘蛋白和β-连环蛋白在涎腺腺癌中的表达及临床意义

目的:探讨E-钙粘蛋白和β-连环蛋白在涎腺腺癌中的表达程度。方法:收集20例原发于涎腺腺癌的石蜡标本,采用免疫组化方法(SP法)检测分析E-钙粘蛋白及β-连环蛋白在肿瘤细胞中的表达。结果:E-钙粘蛋白与β-连环蛋白在正常涎腺组织中有正常表达,而在涎腺腺癌中则是弱表达,甚至不表达,高分化腺癌组与中、低分化腺癌组之间有显著性差异(P<0.05)。结论:E-钙粘蛋白与β-连环蛋白在涎腺腺癌中存在异常表达,并与腺癌的病理分级有关,与肿瘤的侵袭、转移和复发有一定的关系。     

133例卵巢肿瘤临床分析

目的:探讨卵巢肿瘤的临床特点及组织发生学特征。方法:对1998年1月~2004年12月收治的133例卵巢肿瘤的临床资料进行回顾性分析;结果:卵巢肿瘤发生年龄以20~40岁多见,多为良性;与产次关系密切,产次少的发生率明显升高;133例卵巢肿瘤中,上皮性肿瘤45例,占33.83%,生殖细胞肿瘤38例,占28.57%,性索间质肿瘤9例,占6.77%,瘤样病变41例,占30.83%。其中恶性卵巢肿瘤14例,占10.53%,5例发生转移。误诊3例,占2.26%。结论:妊娠对卵巢有一定的保护作用;详细询问病史可减少误诊率;约每8例卵巢肿瘤中1例为恶性,应引起注意;恶性卵巢肿瘤主要转移至大网膜、肠系膜。     

Flexible sigmoidoscopy in colorectal cancer screening: implications of different colonoscopy referral strategies

Flexible sigmoidoscopy (FS) screening reduces colorectal cancer incidence and mortality. Its potential to detect proximal neoplasms depends on colonoscopy referral. We estimated diagnostic performance of sigmoidoscopy using 12 different referral criteria in detecting colorectal cancer and advanced adenomas. Colonoscopy results from 14,947 participants of screening colonoscopy in Germany were used to derive sensitivity of sigmoidoscopy for colorectal cancer, advanced adenomas (AAs), and any advanced neoplasms in the proximal colon. It was assumed that FS detects the same neoplasms as colonoscopy within its reach and that distal neoplasms would be followed by colonoscopy. In addition, numbers of colonoscopies needed (NCN) to detect one proximal advanced neoplasm were calculated. The most advanced findings during colonoscopy were colorectal cancer in 213 subjects (1.4%), AA in 1539 subjects (10.2%) and non-advanced adenomas in 2988 subjects (19.8%). Without colonoscopy referral, overall sensitivities for any colorectal cancer, advanced adenoma and any advanced neoplasm (proximal or distal) would be 79, 65 and 66%, respectively. These sensitivities could be increased to up to 86, 83 and 84% by the referral strategies investigated. Compared to referral due to advanced adenomas, referral due to non-advanced adenomas would substantially increase the NCN at a modest gain in sensitivity. Sensitivities were higher and NCNs were lower in men than in women for every strategy. In conclusion, colonoscopy referral can substantially increase sensitivity of sigmoidoscopy-based screening, but the gain by referral due to non-advanced adenomas substantially increases NCN compared to referral due to advanced neoplasms only. Major sex differences may call for sex-specific referral strategies.     

Histopathological study of gastric polyps. A report of 65 cases

In a retrospective study of the specimens of gastric polypectomy, carried out between January 1992 and December 2002, we analysed the demographic and histological aspects of 65 polyps. This study revealed hyperplastic polyps in 66%, adenomatous lesions in 9.2%, Peutz-Jeghers polyps in 7.7%, inflammatory fibroid polyps in 6.15%, two cases of focal foveolar hyperplasia (3%), two cases of Brunner's gland heterotopia (3%), 1 pancreatic heterotopia (1.5%), 1 fundic gland polyp (1.5%) and 1 carcinoid tumor (1.5%). All adenomas and two Peutz-Jeghers polyps include intraepithelial neoplasia. Moreover, we identified a case of Brunner's gland heterotopia, which contain a focus of plane tubular adenoma with high-grade intraepithelial neoplasia. Other lesions were found within the polyps or into the surrounding gastric mucosa, such as intestinal metaplasia and Helicobacter Pylori gastritis. This work allowed us to recommend complete removal of gastric polyps and the realization of biopsies of the nonpolypoid gastric mucosa in the search of intraepithelial neoplasia or other lesions with malignant potential.     

肾上腺髓质分泌物在皮髓质中分布特点的研究

目的研究肾上腺髓质分泌物嗜铬蛋白A(CgA)、神经特异性烯醇化酶(NSE)和突触素(SYN)在皮、髓质中的分布特点,证明肾上腺髓质可能参与皮质功能的调节,阐明出现临床诊断与病理诊断不一致性的可能原因,为进一步深入研究皮髓质之间的相互作用奠定基础。方法运用免疫组化方法对肾上腺肿瘤病例进行CgA、NSE和SYN染色,观察其在皮髓质中分布特点。结果肾上腺皮质腺瘤、皮质腺癌、嗜铬细胞瘤和嗜铬细胞癌的皮质中均可见CgA染色阳性细胞,皮质增生、髓质增生和正常肾上腺病例皮质CgA染色阴性;肾上腺皮质增生、皮质腺瘤、皮质腺癌、髓质增生和嗜铬细胞癌NSE染色呈阳性,嗜铬细胞瘤和正常肾上腺皮质NSE染色呈阴性;皮质增生、皮质腺瘤、髓质增生、嗜铬细胞瘤和嗜铬细胞癌的皮质中SYN染色呈阳性,皮质腺癌和正常肾上腺皮质SYN染色呈阴性;所有病例髓质CgA、NSE和SYN染色均呈强阳性。结论⑴肾上腺皮质CgA、NSE和SYN分布特点可以帮助鉴别肾上腺肿瘤及增生性疾病。⑵肾上腺皮髓质之间联系紧密,受共同机制所调控,除经典的下丘脑-垂体-肾上腺轴和肾素-血管紧张素-醛固酮系统外,肾上腺皮髓质之间存在相互调节的解剖学和内分泌学基础。     

Retinyl acetate effects on the life span and the incidence of cryptogenic Neoplasms in C3H mice

The effect of feeding 0.02 % retinyl acetate on the development of cryptogenic neoplasms and the life span of C3H/HeJ (⁺) mice of both sexes was studied. The survival at 105 weeks was 58% in untreated males and 28% in untreated females vs. 39% in treated males and 14% in treated females. The average weight in treated groups was also 10–15% lower. The incidence (percent) of neoplasm‐bearing animals and total neoplasms was 87% and 57, respectively, in female controls vs. 93 % and 55 in treated females. In male controls, these values were 57% and 39 compared with 50% and38 in treated males. In treated animals, there was no reduction in the most common neoplasms, that is, neoplasms of the mammary gland and liver. The numbers of ovarian neoplasms and lung adenomas were slightly lower. Therefore, retinyl acetate exerted, at best, only a slight inhibitory effect on development of some types of cryptogenic neoplasms in mice.     

Chest wall resection in general thoracic surgery

To clarify the incidence, indications, and efficacy of chest wall resection, a comprehensive review is needed. Chest wall resection was performed in 23 of 162 operations for thoracic disease over a nine-year period. Eight surgeries requiring chest wall resection for benign disease (8/79) were classified as fenestration or thoracoplasty for empyema, or resection of a benign neoplasm. Fifteen patients who underwent chest wall resections for malignant disease (15/83) were classified as contiguous extension of neoplasms of neighboring organs, primary tumor, or local recurrence. The most common procedure in the malignant disease group was resection for contiguous spread of primary lung cancer (n = 7). The survival rate was 50% at 4 years. There were no serious postoperative complications. In some malignant diseases, complete local control with such a procedure may even lead to a long-term survival. This is a safe and an effective procedure for a variety of diseases.     

Synchronous association of ileal carcinoid and colorectal carcinoma. A case report

BACKGROUND: Multiple primary malignant neoplasms in a single patient have been well documented in the literature. The lesions can be limited to a single organ or involve multiple organ systems and can be synchronous or metachronous. AiM: Report of a new case. CASE REPORT: We report the case of a 63 year old women with a rectocolonic carcinoma; during surgery an ileal nodule was discovered also as liver metastasis. The final pathologic report on the specimen revealed an adenocarcinoma of the colon and a carcinoid tumor of the small bowel with liver metastasis. Tumoral association is relatively common for patients with small intetinal carcinoids. CONCLUSION: The association carcinoide of hail with primitive tumour not carcinoide is reported primarily with carcinomes of the digestive tract in particulary recto colics carcinoma.     

腮腺肿瘤的CT诊断价值

目的提高对腮腺肿瘤的CT诊断及鉴别诊断水平。方法回顾性分析65例腮腺肿瘤的CT表现和病理结果。结果混合瘤37例,乳头状囊腺瘤15例,管状腺瘤1例,基底细胞腺瘤2例,嗜酸细胞腺瘤1例,淋巴上皮囊肿2例,脂肪瘤2例,癌5例。混合瘤平扫多数为低密度或等密度,增强后轻中度强化或明显强化,行多期增强扫描病例表现为渐进性的强化;乳头状囊腺瘤平扫呈略低密度或等密度,增强后强化较为显著,行多期增强扫描病例无渐进性强化;管状腺瘤平扫可见囊变区,增强后实性部分及囊壁明显强化;基底细胞腺瘤平扫呈等密度不易发现,增强后呈明显不均匀强化;嗜酸性细胞腺瘤平扫为稍高密度,周围脂肪间隙略模糊,增强后呈环形强化;淋巴上皮囊肿平扫成囊样低密度,增强后囊壁强化明显,较为均匀;脂肪瘤平扫呈典型的脂肪密度,增强后无明显强化;腮腺癌平扫呈等密度,增强后明显不均匀强化,3例颈部可见肿大淋巴结。良性肿瘤包膜一般较完整,与正常腮腺组织分界清,恶性肿瘤侵犯周围组织,并可有相应区域淋巴结肿大。结论 CT可清楚显示腮腺区肿瘤的存在及定位,一定程度上可鉴别良恶性肿瘤,增强扫描有助于鉴别诊断。     

A case of osteosarcoma following radiation therapy

A case is presented in whom a new malignant neoplasm developed in fields of prior irradiation. The tumor was histologically diagnosed as osteosarcoma. This case satisfied the criteria of the radiation induced sarcoma proposed by Maehara et al.     

Salivary gland biopsy : experience of La Rabta Hospital's pathology departement

BACKGROUND: The minor salivary glands biopsy is a very common diagnostic procedure in oral medicine rather its efficiency has not been statistically proved. AIM: Assessment of Rabta pathologic department experience METHODS: 297 biopsies have been studied with special attention to the suspected diagnosis before biopsy and the final histologic result. RESULTS: The minor salivary gland biopsy confirmed the initial diagnosis in 78 cases. Although if the minor salivary gland biopsy is in most cases not contributively, it is a very simple procedure which gives the diagnosis of Gougerot-Sjogren disease, amylosis and sarcoidosis.     

A submandibular swelling: the salivary gland?

Four patients, three men aged 32, 51 and 74 years, respectively, and a woman aged 34 years, presented with a submandibular swelling. In all four patients, the swelling was caused by submandibular salivary-gland disease. The first patient appeared to have chronic sialoadenitis due to sialolithiasis, in the second patient the diagnosis was sialoadenosis due to anorexia-boulimia, the third patient had a pleomorphic adenoma and the fourth had a malignant neoplasm of the floor of the mouth causing obstruction of the submandibular gland. A submandibular swelling may have many different causes. It is sometimes difficult to differentiate between enlargement of the submandibular gland and an enlarged lymph node. Intra-oral inspection and palpation may give valuable information about the origin of some submandibular swellings. Using a combination of history, examination and, when necessary, fine-needle aspiration and r?ntgenological examination, the diagnosis of submandibular lumps is usually straightforward.     

原发性附睾肿瘤的诊断和治疗

目的探讨原发性附睾肿瘤的临床特点,提高诊断和治疗水平。方法回顾性总结16例接受手术治疗的原发性附睾肿瘤患者的临床资料,其中13例为附睾良性肿瘤,包括附睾腺瘤样瘤7例,附睾平滑肌瘤3例,附睾纤维假瘤1例,附睾乳头状囊腺瘤1例,附睾硬化性血管瘤1例。13例附睾良性肿瘤患者中8例行肿瘤切除。附睾恶性肿瘤3例,其中腺癌2例,非霍奇金淋巴瘤1例,均行睾丸附切除加腹膜后淋巴结清扫。结果良性肿瘤12例获随访,至今无一例复发;恶性肿瘤均获随访,预后肿瘤大部分是良性肿瘤,手术效果好。附睾恶性肿瘤少见,但预后差。手术是治疗附睾肿瘤的首选方法。