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.     

Salivary gland tumors: a single institution experience in India

Between 1991 and 2006, 684 cases of salivary gland tumours were analysed retrospectively, of which 422 (62%) were benign and 262 (38%) malignant. Sixty-one percent of tumours were in the parotid gland, 22% in the minor salivary glands, and 17% in the submandibular glands. The most common benign tumour was pleomorphic adenoma (86%), and the most common malignant tumours were adenoid cystic carcinoma (25%) and mucoepidermoid carcinoma (18%). Among the minor salivary gland tumours, most were seen in the palate (68%).We analyse the incidence and distribution of all types of salivary gland tumours in an Indian series, and provide data for comparison with other epidemiological studies from different geographical sites and races. Demographic data from these studies should help us to a better understanding of the biological and clinical characteristics of the disease.     

Incidence and prevalence of salivary gland tumours in Valparaiso,Chile

Background

To determine the incidence and prevalence of salivary gland tumours in the province of Valparaíso, Chile.

Material and Methods

Retrospective review of salivary gland tumours diagnosed between the years 2000 and 2011 from four local pathology services. Information on demographics and histopathology were retrieved from the medical records.

Results

The study sample consisted of 279 salivary gland tumours. Prevalence and incidence rates per 100.000 persons were 15.4 and 2.51, respectively. Most of the neoplasms corresponded to benign tumours (70.3%). The most affected gland was the parotid gland. Pleomorphic adenoma was the most common benign tumour (53.8%) and mucoepidermoid carcinoma was the most common malignant tumour (7.2%).

Conclusions

Salivary gland tumours are uncommon neoplasms that usually arise in the parotid gland. Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant tumours reported in this series. Key words:Salivary gland tumours, benign tumours, malignant tumours, salivary glands neoplasms, cancer, neoplasia.     

A clinicopathologic study of 196 intraoral minor salivary gland tumours

We present a retrospective study of 196 patients with intraoral minor salivary gland tumours, 128 malignant and 68 benign, diagnosed from 1954 to 1993 in the A.C. Camargo Hospital, São Paulo, Brazil. Sixty-five percent of the cases occurred in the palate, followed by tongue (9.7%) and retromolar area (6.1%). Pleomorphic adenoma was the most common benign tumour, and mucoepidermoid carcinoma was predominant among the malignant tumours. Surgery was the main treatment method and postoperative radiotherapy and radiotherapy alone were used in 40 and 15 patients, respectively. Local recurrence was observed in two patients with pleomorphic adenoma and in eight patients with malignant tumours. Regional lymph node metastases occurred in four cases and distant metastases in five. Forty-six of 47 patients with benigh tumours who were followed up from 1 to 7 years were alive without disease. Twenty-four of 79 patients with malignant tumours who were followed up for at least 5 years died due to the tumour and 47 were alive without disease.     

Intraoral minor salivary gland tumors: a review of 75 cases in a Libyan population

Minor salivary gland carcinomas are uncommon but most often occur in the oral cavity, particularly the hard palate. Dental examination may provide an opportunity for early detection. During the period of 1977-2000 a group of 75 patients (31 males and 44 females, median age 44.2 years and range 15-86 years) with minor salivary gland tumors were diagnosed, based on the 1991 WHO classification. The peak occurrence of the tumors was in the fifth decade for males and sixth decade for females. The frequency of benign tumors was 38.6% (n = 29) and malignant tumors 61.3% (n = 46). Pleomorphic adenoma was the most common histological type of benign tumor identified whereas mucoepidermoid carcinoma and adenoid cystic carcinoma were the most common malignant tumors. The most common primary location of the tumors was the palate followed by the cheek. A benign tumor usually presented as an asymptomatic swelling and ulceration, pain being more frequently associated with the malignant tumors. This study shows that intraoral tumors of minor salivary glands vary widely in presentation, and should be taking into account by medical and dental practitioners in any differential diagnosis when assessing intraoral pathology. Any lesion arising from the hard palate (the most common site in this series) should be considered as a possible minor salivary gland tumor. Referral to a multidisciplinary head and neck clinic following diagnosis is strongly recommended.     

Salivary gland tumours: 25 years of experience from a single institution in Croatia

IntroductionThe aim of this study was to determine the types, frequency, distribution, and demographic characteristics of salivary gland tumours in a large representative sample.Patients and methodsWe retrospectively analysed the medical records of 779 patients with tumours of the salivary glands surgically treated from 1985 to 2009 at a single institution.ResultsThere were 500 benign and 279 malignant tumours. The average age of patients with benign tumours was 50 years and of malignant salivary gland tumours 56 years. No differences in age and incidence of tumours existed between males and females. The majority of the tumours occurred in the parotid gland (509), followed by the minor salivary glands (212), the submandibular gland (51) and lastly, the sublingual gland (7). Minor salivary gland tumours occurred most frequently on the palate, the pleomorphic adenoma being the most frequent benign tumour type and the adenoid cystic carcinoma being the commonest malignant tumour. Tumours of the sublingual gland were rare, but all were malignant. Malignant tumours were more common in the minor salivary glands and the submandibular gland.ConclusionThis large study of salivary gland tumours in Croatia could improve our understanding of the significant differences in the global distribution of salivary gland tumours which have been reported.     

Epithelial salivary gland tumors of children and adolescents in southern Portugal. A clinicopathologic study of twenty-four cases.

During a 30-year period 24 epithelial salivary gland tumors were diagnosed in children and adolescents less than 18 years of age. The cases were retrieved from a series of 759 consecutive cases of salivary gland tumors (3.2%) from the area corresponding to southern Portugal during the same period of time. The mean age of the patients was 13.4 years, and one case was congenital. There was a slight female predominance (male/female ratio 1:1.7). The parotid gland was affected in most cases (70.8%). Seventeen neoplasms were benign, and the remaining seven were malignant. As in the adult group, pleomorphic adenoma was the most frequent benign tumor (66.6%), with similar histologic findings and clinical course. Mucoepidermoid carcinoma was the prevalent malignant tumor (20.8%), had a high grade of differentiation, and had a favorable outcome. The histologic pattern of the congenital neoplasm was similar to that of adult epithelial-myoepithelial carcinoma.     

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。     

Salivary duct carcinoma: clinicopathological and immunohistochemical studies

Nine cases of salivary duct carcinoma were reviewed clinically, histologically and immunohistochemically, with special evaluation of biomarkers with prognostic significance (p53, Ki67, c-erbB-2 and DNA content). Eight tumours occurred in the parotid gland and one in the submandibular gland. The average age of the patients (8 males and 1 female) was 62.8 years (range = 47 − 74 years). Tumour size ranged from 1 to 6 cm (mean = 3.46 cm). Recurrences were found in 33.3% (3 patients), regional metastases in 44.4% (4 patients) and systemic metastases in 33.3% (3 patients). Three patients died of their disease (median survival = 12.3 months), one is alive with the disease (follow-up of 222 months) and 5 are alive without evidence of disease (mean follow-up of 75 months). p53 protein nuclear immunostaining was positive in 66.6% and c-erbB-2 overexpression was observed in 100% of the tumours. Ki 67 positivity ranged from 6.75% to 47.5% of tumour cells (mean = 21.3%). DNA aneuploidy was found in 4 tumours (44.4%) and DNA diploidy in 5 (55.5%). Our results seem to indicate that Ki67 immunostaining can be useful in the evaluation of the biological behaviour of these tumours, as well as the presence of a high proliferative index of aneuploid cells and the presence of distant metastases.     

Salivary gland tumours: an epidemiological review of non-neoplastic and neoplastic pathology

Salivary gland tumours (SGT) demonstrate geographical variation. The primary objective of this study was to determine the types, frequency, distribution, and demographics of non-neoplastic and neoplastic salivary gland pathology at Waikato Hospital, New Zealand (NZ) over a 10-year period. Following this we conducted a 10-year retrospective review of SGT epidemiology from international literature. In total 825 patients were identified, 31% (256/825) with non-neoplastic salivary gland pathology, 34% (284/825) with benign neoplastic pathology, 14% (118/825) with primary malignant lesions, 18% (146/825) with metastatic SGTs, and 3% (21/825) with lymphoma. Patients had a mean (range) age of 58 (3–102) years, were predominantly male (58%, 476/825), and NZ European (65%, 536/825). Tumours were most prevalent in the parotid gland (85%, 484/569), of which 44% (211/484) were malignant. Pleomorphic adenoma was the most common benign (71%, 203/284) and overall (36%, 203/569) tumour, while mucoepidermoid carcinoma (25%, 29/118) and squamous cell carcinoma (SCC) (73%, 106/146) were the most common primary malignant and metastatic SGTs, respectively. Our literature review identified 18 studies consisting of 33,933 patients, of whom 71% (24,013/33,933) had benign SGTs. Pleomorphic adenoma (68%, 16404/24013) and mucoepidermoid carcinoma (29%, 2826/9621) were the most common benign and malignant SGTs, respectively. Low numbers of non-neoplastic and metastatic SGTs were reported in the literature. This research provides a greater understanding of differences in their global distribution. Consistent with previous literature, pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant SGTs. In NZ, we found high rates of malignant SCC to the parotid gland, consistent with the epidemiology of non-melanoma skin cancer in the country.     

PCNA, Ki-67 and p53 expressions in submandibular salivary gland tumours

Salivary gland tumours are uncommon with a broad heterogeneity. The most common benign tumour is the pleomorphic adenoma, whereas mucoepidermoid carcinoma and adenoid cystic carcinoma predominate among the malignancies. Most salivary gland tumours occur in the parotid, and consequently clinical and biological data are normally derived from this site. This work describes the expressions of PCNA, Ki-67 and p53 in 15 pleomorphic adenomas, 15 mucoepidermoid carcinomas and 15 adenoid cystic carcinomas of the submandibular gland. Our results showed that all pleomorphic adenomas were negative for p53 and Ki-67 with 66.6% being positive for PCNA. Conversely, p53 was positive in 53% of the mucoepidermoid carcinomas and in 20% of the adenoid cystic carcinomas. Ki-67 was expressed in 47.7% of the mucoepidermoid carcinomas and 40% of the adenoid cystic carcinomas. All malignant tumours were positive for PCNA. These results indicate that the proliferative rate analysed with PCNA and Ki-67 and the expression of p53 in pleomorphic adenoma and adenoid cystic carcinoma of the submandibular gland were similar to those described in the parotid and minor salivary glands. However, mucoepidermoid carcinomas showed higher expression of these markers than those of other salivary glands. This work is the first describing the expression of these immunohistochemical markers exclusively in submandibular salivary gland tumours.     

Incidence and profile of benign epithelial tumors of salivary glands from a single center in Northeast of Brazil

Background Benign tumors of the salivary glands are a group of lesions with varied histopathological and clinical spectrum. The aim was to determine the incidence and clinicopathological characteristics of benign salivary gland neoplasms diagnosed between 2007 and 2016 in a single center located in northeastern Brazil. Material and Methods Records regarding sex, age, anatomical location, histopathological subtype and treatment were retrieved, and data were analyzed using the Stata/IC software (version 12.0). Results There were above 7,100 cases of neoplasms in the head and neck region, of which 403 corresponded to salivary gland neoplasms. Of these, 238 (59%) were benign, being pleomorphic adenoma (PA) the most frequent neoplasm (n=178; 74.8%), followed by Warthin''s tumor (WT) (n=23; 9.7%). Overall, most cases occurred in females (n=136; 57.1%) and age ranged from 11 to 83 years. The parotid gland (n=188; 79%) was the most common anatomical site, and all patients were treated by surgical excision. Of the cases diagnosed as PA, malignant transformation to carcinoma ex-pleomorphic adenoma (CAEXPA) occurred in 7 (3.9%) cases. Conclusions The present study confirmed the clinical and demographic profile of benign salivary gland neoplasms, which contributes to the continuous knowledge of current data about these lesions. Key words:Salivary gland, benign neoplasms, epidemiology.     

An audit of oral diseases at a Nairobi centre, 2000-2004

OBJECTIVES: To describe oral diseases diagnosed in an urban referral centre in Kenya in terms of age, gender and anatomical distribution and to compare this with reports in the literature. METHODOLOGY: A retrospective histopathological audit. SETTING: Oral Pathology Laboratory at the University of Nairobi Dental Hospital, a tertiary referral centre in Kenya. RESULTS: 548 (53.83%) patients were diagnosed with oral and maxillofacial tumours. Benign tumours (mean age +/- SD = 29.93 +/- 18.27 years) peaked in the third decade and tended to affect men at a younger age (p = 0.001). The most common benign tumour was the ameloblastoma (50.23%: n = 109), which predominantly affected the mandible, and also occurred in male patients at a younger age (p = 0.023). Peak incidences for malignant disease were observed in the sixth decade (mean age +/- SD = 46.94 +/- 18.99 years). Oral squamous cell carcinoma (OSCC) was the most common malignant tumour (59.55%; n = 187); occurring in the tongue, floor of the mouth, buccal mucosa and palate. 10.30% of OSCC occurred in patients under 40 years of age. 147 patients presented with cysts, which were mainly (68.10%) of odontogenic origin. Reactive lesions, infections, salivary gland diseases and autoimmune conditions constituted 26.60% of the case load. CONCLUSION: The tendency of oral squamous cell carcinoma to occur in younger age groups may be an indication of carcinogenic factors that could be peculiar to this population. There is an urgent need for the expansion of reporting systems for oral diseases as an integral part of development of appropriate strategies in the improvement of general health in Kenya.     

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。     

Diagnosis and treatment of epithelial salivary gland tumours in children and adolescents

In a series of 2,871 epithelial salivary gland neoplasms managed in the Peking University School of Stomatology between 1974 and 1999, 86 arose in children <16 years of age (52 parotid, 12 submandibular gland, 2 sublingual gland, and 20 minor salivary gland). Considerable delay was encountered in diagnosis (benign 24 months and malignant 16 months). In this group of children, 46 tumours (53%) proved to be malignant, with an incidence in the parotid, submandibular, sublingual, and minor salivary glands of 31/52 (60%), 2/12, 0/2, and 13/20 (65%), respectively. Sixty-six of 86 neoplasms (77%) occurred in children between 10 and 16 years of age. Only six neoplasms were encountered in children of 5 years or younger, four of which were high-grade malignant tumours. Benign tumours were successfully treated by local excision with only one recurrence. Of 46 malignant neoplasms, 8 were treated palliatively; of the remainder 8 were lost to follow-up and 2 patients died of their disease.     

Salivary gland tumours in Congo (Zaire).

From the files of the Department of Pathology of Kinshasa University Hospital, a retrospective study on salivary gland tumours in Congo (Zaire) had been carried out in order to determine their histological and epidemiological profile. Salivary gland tumours are rare in Congo, with a relative frequency of 1.8%. Pleomorphic adenoma (55.1%) and adenoid cystic carcinoma (15.9%) are the most common tumours. Parotid gland (36.6%) is the most frequent location of salivary gland tumours in this country. People aged between 30 and 39 years (19.9%) (Mean: 37.4 +/- 16.2 years) and females (M/F = 0.8/1) are most affected. No case of adenolymphoma is recorded in this series.     

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.     

Salivary gland neoplasms in Maiduguri, north-eastern Nigeria

OBJECTIVE: To document the pattern of salivary gland neoplasia in Maiduguri, Nigeria. DESIGN AND SETTING: A retrospective clinical and histopathological review (January 1987-December 2002) of cases diagnosed at a tertiary care hospital. MATERIALS AND METHODS: Information on demographics, diagnosis and cancer management in the hospital were retrieved from biopsy reports and case notes of patients. RESULTS: The palatal (71.9%) and parotid (78.3%) glands were the most common minor and major salivary glands involved, with a benign-malignant ratio of 1:1 and 1.4:1, respectively. Pleomorphic adenoma (44.3%) was the most common salivary gland neoplasm recorded. It was commonly reported in the third decade (mean 30.4 years) and among males (M:F, 1.4:1). Ectopic lesions (17.1%) were reported in the neck, nose and cervical nodes. Mucoepidermoid carcinoma (10.1%) was the most common salivary gland malignancy, occurring in the second and sixth decades; of equal gender distribution and predominantly in the palate (50%). The squamous cell carcinoma (10.9%) and adenoidcystic carcinoma (21.9%) were the most common malignancies in the major and minor glands respectively. There was a higher prevalence of malignancies of the parotid than previously reported for northern Nigeria (P = 0.036). CONCLUSION: Pleomorphic adenoma and mucoepidermoid carcinoma were the most commonly reported benign and malignant neoplasia in this series. The prevalence of mucoepidermoid carcinoma contrasts with reported findings in other African studies.     

Intraoral minor salivary gland tumors: a clinicopathological study of 82 cases

We present a retrospective study of 82 patients with intraoral minor salivary gland tumors which were diagnosed from 1979 to 2003 in Gifu University Hospital. The histological diagnoses were reevaluated according to the 1991 WHO classification. A total of 82 tumors, consisting of 55 benign and 27 malignant tumors, were found in 28 male and 54 female Japanese patients; the male-to-female ratio was 1:1.9. The mean age of the patients was 51.4+/-18.1 years. The tumors affected the palate (n = 64), the buccal region (n = 10), the upper lip (n = 6), the floor of the mouth (n = 1), and the retromolar region (n = 1). Histologically, the tumors were classified as pleomorphic adenoma (n = 54), papillary cystadenoma (n = 1), adenoid cystic carcinoma (n = 10), mucoepidermoid carcinoma (n = 8), acinic cell carcinoma (n = 3), adenocarcinoma (n = 2), basal cell adenocarcinoma (n = 1), papillary cystadenocarcinoma (n = 1), and carcinoma in pleomorphic adenoma (n = 2). From the results of the present study and review of the literature, it is suggested that the minor salivary gland tumors in Japan may be characterized by a higher incidence of benign tumors, especially of pleomorphic adenoma; a more marked tendency for female predominance; a higher incidence of palatal involvement; and a rarer occurrence of polymorphous low grade adenocarcinoma, in comparison with those reported in the literature from outside of Japan.     

Extracapsular dissection (ECD) and extended ECD: description of the technique and outcome of treatment

Over the last two decades the senior author has exclusively applied the technique of extracapsular dissection (ECD) and extended ECD to treat discrete, apparently benign parotid tumours. This article describes both techniques and evaluates their application. Simple principles are described to anticipate unexpected malignant tumours and manage lumps safely by wide excision. A retrospective analysis of 97 consecutive patients with discrete, apparently benign parotid lumps is presented. The tumours were classified using the European Salivary Gland Society (ESGS) classification for benign tumours of the parotid gland. The ECD or extended ECD technique was employed irrespective of tumour site or size. A review of patients was carried out after a minimum of six months post surgery by two independent clinicians. The mean (range) hospital stay was one (0-4) night (median 1). Complications were both modest and transient. The temporary facial nerve injury rate was 5/97 (6%). Other complications included haematoma (n=2), sialocele (n=2), and first-bite syndrome (n=2). Independent review post surgery demonstrated a mean Sunnybrook facial grading system score of 98/100 and a mean Stony Brook scar assessment score of 4.5/5. In this series 5/97 (5%) of discreet mobile lumps concealed a low-grade salivary cancer. Experience with the application of ECD in conjunction with its extended form in 97 consecutive patients with discrete parotid lumps is described. The technique is amenable to all parotid lumps, is not restricted by site or size, and has shown minimal morbidity. The risk of recurrent disease could not be addressed.