Epidemiology of non-malignant salivary gland tumours based on 675 cases

Neoplasm of salivary glands constitutes about 3% of all tumours of head and neck. Within the category we can differentiate tumours of a very different histological structure. What lies behind such great differences in the changes within the salivary glands is complex embryogenesis of the glands. About 80% of all tumours of salivary glands is located in parotid gland, from 10 to 20% - in submandibular gland and several percent in sublingual and small salivary gland. This work aims at the assessment of the frequency of occurrence of non-malignant neoplasm in parotid and submandibular gland based on the material collected at the ENT Department of the Medical University in Poznan in the years 1995-2006. In the 12-year period, 778 patients in total suffered from tumours of large salivary glands. The number of non-malignant neoplasm was 675, and the number of malignant neoplasm was 103. With regard to paroid glands, 586 non-malignant tumours and 82 malignant tumours were identified, with regard to submandibular glands the numbers were respectively: 89 and 21. Main aim of this work has been achieved through the execution of partial steps: the analysis of the trends in occurrence of non-malignant neoplasm in the 12-year period, the analysis of the epidemiological differences: sex, age, place of residence - town or country, duration of symptoms, diameter of the tumour at the time the patient reported for treatment, histological structures that were carried on the basis of the comparison of data collected in the two periods of time: period I--the years 1995-2000 and period II--the years 2001-2006. The frequency of operations on non-malignant tumours of salivary glands (as compared to the total number of operations) was 4.11% in the first period and 4.18% in the second. In both periods the most frequent benign tumour was the mixed tumour (54.9% of all tumours) and constituted 60% and 54% of all tumours in the respective periods analyzed. The next most frequently occurring tumour was Warthin's tumour, identified in 31.2% of the patients, in 23% in period I and 35% in period II. Duration of the symptoms, ranged from 1 month to 20 years, 14 months on average, yet in 263 cases the tumour has been developing developed for over a year. The diameter of the non-malignant tumours undergoing operation ranged from 1 cm to 8 cm, with the average being 3 cm. It was 3 cm with regard to the most frequently occurring tumours: adenoma polymorphum, adenoma monomorphum and cystadenolymphoma.     

Histology of submandibular gland tumours, 10 years' experience

Introduction and objectivesThere are few reports focused on neoplasms in the submandibular gland because they are uncommon and are frequently grouped with the other salivary glands tumours. In the classical studies, the proportion of malignancy reported in these cases is around 50%.ObjectivesDetermining the proportion of malignancy, the most frequent histological types, the gender distribution and average age at diagnosis in patients with submandibular gland neoplasms who were treated in our hospital from 2000 year to 2010.MethodsA retrospective review of our department database of the patients who underwent surgery for submandibular gland neoplasm in a ten-year period was performed.ResultsTwenty-two patient records were included, in which 19 (86%) patients presented benign disease and 3 were of a malignant type (adenocarcinoma, well-differentiated epidermoid carcinoma, follicular lymphoma). Two of the 3 cases of malignant neoplasms were in men.ConclusionsA greater proportion of benign neoplasm was found in submandibular tumours. The most frequent benign tumour is the pleomorphic adenoma. Women are more commonly affected (76%). Benign tumours appear in younger patients than do malignant ones.     

Salivary gland neoplasms in the years 1991-2006 in the material of the Department of Otolaryngology, Medical University in Bialystok

Complex structure of salivary glands, histological diversity of malignant salivary gland neoplasms and heterogeneous clinical image make therapeutic strategy difficult and controversial. The aim of this work was an epidemiologic analysis of 86 salivary gland tumour cases (in years 1991-2000) and 82 cases treated at the Otolaryngological Clinic of the Medical University of Bialystok (in years 2001-2006). Epidemiologic researches were conducted retrospectively. Age, sex, histological structure, location and local progression of tumour were analysed. The relationship between histological type, local progression and the presence of metastases to the cervical lymph nodes as well as remote metastases was also examined. The study was based on TNM Tumor Classification: large salivary glands (1977). It was found that malignant epithelial salivary gland tumours affect most commonly the parotid gland in men aged over 50 years. Adenoid cystic carcinoma was the most frequently represented histological type. Remote metastases were observed most commonly in patients with polymorphic adenoma.     

Terminal parotid duct carcinoma.

Terminal duct carcinoma of salivary glands is an uncommon, histologically distinctive, low grade malignant neoplasm arising from the intercalated salivary duct. We present a case arising eight years after removal of a parotid tumour reported as a pleomorphic adenoma. We describe the clinico-pathological features of the present tumour, illustrate the difficulties that may be encountered in differentiating it from other salivary gland tumours, and discuss the possible significance of the previous tumour.     

An analysis of salivary gland neoplasms: a 12-year, single-institution experience in Turkey

The epidemiology of salivary gland tumors worldwide is not very well defined. Although many studies on this subject have been undertaken, the data are generally focused on specific topics such as parotid gland neoplasms or tumors of the major salivary glands. We conducted a study to establish the prevalence and distribution of benign and malignant neoplasms of both the major and minor salivary glands at a single institution. We reviewed 244,204 cases that had come through our pathology department from January 1994 through December 2005 and found 235 cases of a salivary gland neoplasm (0.09%). The female-to-male ratio was 1.04:1, and the mean age of the patients was 47 years. Of the 235 neoplasms, 159 (67.66%) were located in the parotid gland, 34 (14.47%) in the submandibular gland, and 42 (17.87%) in the minor salivary glands. A total of 146 tumors (62.13%) were benign and 89 (37.87%) were malignant. Pleomorphic adenoma was the most common neoplasm, occurring in 98 cases (41.70%). The most common malignancy was mucoepidermoid carcinoma, with 27 cases (11.49%). Our data demonstrate that the characteristics of salivary gland tumors in a Turkish population at a single institution are similar to those reported in the literature worldwide.     

Pleomorphic adenoma of the nose

Mixed parotid tumour of the nose is uncommon, Salivary gland tumours develop near or within the parotid gland nearly twenty times as often as they do in the submandibular gland. About 40% of all minor salivary tumours arise in the hard palate, 20% each in oral cavity and maxillary antrum, 10% in oropharynx and rest 10% are in upper respiratory tract. The average age of the patients with salivary tumours is 45 years, but the age range is wide, extending from childhood to adulthood and even over 80 years. Most series show a preponderance of females, especially if only tumours of the parotid glands are considered.     

Adenocarcinoma of the salivary glands. The pathohistology and subclassification of 77 cases

Seventy-seven adenocarcinomas of the salivary glands recorded in the Salivary Gland Register between 1965 and 1984 were analysed and classified histopathologically. The following results were obtained: 1. 2% of all salivary gland tumours and 10% of all malignant epithelial salivary gland tumours were allotted to the group of adenocarcinomas. The age peak lies in the 7th to 8th decade. 60% occurred in women, 58.5% were localized to the parotid gland, 28.5% to the minor salivary glands (palate, lips, and cheek), 11.5% to the submandibular gland and only 1.5% to the sublingual gland. 2. Solid, tubular and papillary adenocarcinomas can be distinguished. Additional criteria are microcysts, mucus production and grade of differentiation. 3. The solid adenocarcinoma (13%) is predominantly localized in the parotid gland and characterized by a low differentiation, invasive growth and metastases. 4. 62.5% of tubular adenocarcinomas (52%) are localized in the parotid gland, 27.5% to the minor salivary glands and 10% to the submandibular gland. Most of the tumours are highly differentiated. A distinct mucus production is present in 40% of the cases. Microcysts are very frequent. 5. Papillary adenocarcinomas (28.5%) are localized in almost 50% of cases to the minor salivary glands, 45% to the parotid and only 5% to the submandibular gland. Microcysts and mucus production can be observed in 50% of the cases. 6.5% of the cases have a mixed tubular papillary structure. 6. In differential diagnosis, thyroid gland carcinomas and metastases of other adenocarcinomas must be distinguished, the former by negative result of the thyroglobulin reaction, and absent mucus production. 7. Adenocarcinomas arise from the salivary duct system. Solid or tubular adenocarcinomas imitate stages of the embryonal development of the salivary ducts.     

17例涎腺淋巴上皮癌临床病理分析

目的：涎腺淋巴上皮癌是一种罕见的恶性肿瘤,本文主要探讨涎腺淋巴上皮癌的发病情况、病理特点及其诊治措施。方法：回顾性分析2006—2012年间于南方医科大学南方医院就诊的17例涎腺淋巴上皮癌患者,分析其临床特点与治疗方法对预后的影响。结果：17例中,男10例,女7例;Ⅱ、Ⅲ、Ⅳ期患者分别为7（41．2％）、4（23．5％）、6（35．3％）例。术后平均随访时间为2．56年,随访12例患者情况稳定;5例患者分别在术后3年内出现局部复发和（或）远处转移,其中4例已死亡。结论：涎腺淋巴上皮癌是头颈部恶性程度较高的肿瘤之一,好发于腮腺及下颌下腺。治疗应行原发灶扩大切除及根治性颈淋巴清扫术,并结合放化疗以提高疗效。     

Cystadenocarcinoma (papillary cystadenocarcinoma) of the submandibular gland

Cystadenocarcinoma (papillary cystadenocarcinoma) of the salivary gland is a rare malignant neoplasm. Major locations of this neoplasm are the parotid gland, the sublingual gland, and minor salivary glands, while occurrence in the submandibular gland is extremely rare. As far as we know, only one report, written in the French language, has been published concerning cystadenocarcinoma of the submandibular gland, but no report is available in the English language. In this report, we describe a case of cystadenocarcinoma arising from the submandibular gland of a 54-year-old male patient. The neoplasm is a low-grade carcinoma, and pre-operative examination may not show typical characteristics of malignant neoplasms. Therefore, as was true in this case, the differential diagnosis from benign lesions is sometimes difficult. This is the first report on cystadenocarcinoma of the submandibular gland in the English language and the first to show a computed tomography (CT) scan and magnetic resonance imaging (MRI) of this neoplasm in the submandibular gland.     

Correlation between ultrastructural changes and the presence of metastases in adenoid cystic carcinoma of salivary glands

Adenoid-cystic carcinoma is a malignant epithelial neoplasm which has different histological types. Still, an open question is, whether adenoid-cystic carcinoma of the salivary glands with metastases to lympho nodes and specific micro- and macroscopic features, allows us to define their progression. A group of 46 patients with adenoid-cystic cancer of the salivary glands was studied and was subjected to histological and ultrastructural assessment. In analysed group in 12 patient metastases to lympho nodes were confirmed. In 10 cases it was solid type of tumour and in 2 canaliculars type. In tumours with metastases to lympho nodes solid types prevailed and there was no a typical cribriform type. In all cases they were found fields of mixted texture of the tumours structure.     

Epidemiological study of salivary gland tumours

Tumours located in the salivary glands form the most heterogeneous group in all human oncological pathology. They show various epidemiological, clinical and evolutionary characteristics which separate them from other neoplasms of the head and neck. In this paper, we have carried out a study on their epidemiological aspects, collecting 80 cases diagnosed in the ENT Service of the University Hospital Complex of Santiago over 17 years. The incidence was 1.22 cases per 100,000 inhabitants per year. The frequency was higher in males (58.75%) and in the 7th decade of age. A predominance was noticed in females under 40 years of age and in males over this age, but the differences were not statistically significant. The most frequent site was the parotid gland, and we could not find any case in the sublingual gland. In 52.5% of cases the tumour was benign, pleomorphic adenoma being the most prevalent. Among malignant tumours, the epidermoid carcinoma stood out in our series. The prevalence of benign tumours in females and of malignant tumours in males was clear, with significant differences. We compare our results with the data published in the literature.     

Plattenepithelkarzinom in einer Gangzyste der Glandula submandibularis

Squamous cell carcinomas are rare malignant tumors of the major and minor salivary glands in the head region. This is the report of a squamous cell carcinoma within a cyst of the submandibular gland. Clinical, histological and immunohistochemical findings are presented, and the importance as well as the therapeutic strategy of this very rare malignant tumor of the salivary glands are discussed.     

Neoplasias de glándulas salivales menores: estudio de 10 años

Salivary gland tumours represent between 2 % and 6.5 %, approximately, of all head and neck tumours. The aim of this paper was to identify the frequency of minor salivary gland tumours among patients in the Oral Medicine Clinic of the Federal University of Paraná during the period from 1997 to 2007. A retrospective study was conducted on 1,923 histopathological analyses of oral lesions. Fourteen cases of salivary gland tumours were found, of which 7 were benign and 7 malignant. The lesions were localized mainly in the palate (71.5 %). By histological type, 50 % of the lesions were characterized as pleomorphic adenoma, 28.6 % mucoepidermoid carcinoma, 14.3 % cystic adenoid carcinoma and 7.1 % as polymorphous adenocarcinoma. These findings suggest that salivary gland tumours have a low incidence in the population and that the pleomorphic adenoma is the most common type of tumour, followed by mucoepidermoid carcinoma.     

The incidence of neoplastic versus inflammatory disease in major salivary gland masses diagnosed by surgery

What is the incidence of non-neoplastic disease when dealing with masses of the major salivary glands? A knowledge of this information would aid the physician in making decisions relative to the management of the masses. Furthermore, the expected malignancy rate may need to be adjusted according to the findings of this study. Many reported series of salivary gland neoplasms show the relative incidence of benign vs. malignant neoplasms; however, not every patient with a mass of the salivary gland who comes to surgery is finally diagnosed as having had a neoplasm. Knowing the relative incidence of neoplastic vs. non-neoplastic salivary gland diseases has important diagnostic, therapeutic, and prognostic implications. Records of all patients who underwent either a parotidectomy or submandibular gland excision from 1975 to the present at the Eye and Ear Hospital of Pittsburgh were reviewed; 73% of the parotidectomies performed were done for neoplastic disease. A patient with a parotid mass has a likelihood of 1:10 of having a malignancy. Similarly, on a population basis, 1 submandibular mass in 12 will be malignant.     

Primary squamous cell carcinoma of the submandibular salivary gland

Malignant tumors of the submandibular salivary glands are rare in occurrence, among which primary squamous cell carcinoma of the submandibular salivary gland is unusual and the documented evidence is 2 to 5% among malignant tumors A case of primary squamous cell carcinoma of submandibular salivary gland is being presented for its rarity     

Salivary gland neoplasia in childhood

Salivary gland tumours, benign or malignant, are rare in childhood and as a result may be misdiagnosed and treated inappropriately. Ten children with salivary gland tumours have been treated by the author over a period of 18 years. Four tumours were benign and six malignant. Treatment in all cases was by surgical excision. There has been one recurrence, treated by further surgery, in an acinic cell carcinoma. Three cases had inadequate surgery or biopsy before referral. These findings reflect other series, which demonstrate that a solid tumour in a salivary gland in childhood is more likely to be malignant than to be benign.     

Intraductal papilloma of the submandibular gland

Salivary tissue intraductal papillomas are rare, benign tumours that predominantly affect minor salivary glands. We report a case of an intraductal papilloma arising in the unusual site of the submandibular gland. The tumour was completely excised and recurrence is not expected. A brief review of this histologically distinct lesion is presented.     

Manifestation of malignant lymphoma of the head and neck with special reference to the salivary glands

We found that thirteen per cent of all head and neck malignomas are malignant lymphomas. In 75% of these cases the Non-Hodgkin type could be found. The major salivary glands were involved by the lymphoma in 55% out of 104 patients. Paraglandular lymph nodes of the parotid gland were affected as well as intraglandular lymph nodes and the lymphoid tissue within the gland proper. The submandibular gland normally shows an involvement only with its paraglandular lymph nodes. Two thirds of the Non-Hodgkin lymphomas located in the salivary glands were low-grade. In case of clinical suspicion of a malignant lymphoma, fine needle biopsy is required for cytological diagnosis. However, surgery is mandatory for histological diagnosis, not as a therapeutic measure.     

Tratamiento quirúrgico de los tumores de glándulas salivales

Introduction and objectivesSalivary gland tumours account for 3% of head and neck tumours. The aim of this study is to analyze our series of tumours of the salivary glands requiring surgical treatment at our centre from 2004 to 2007.Material and methodsThis study is a retrospective review of 49 patients diagnosed as having tumours of the major and minor salivary glands or ectopic salivary tumours, and surgically treated at our hospital between 2004 and 2007. We reviewed their clinical characteristics, imaging findings, fine-needle cytology results, surgical charts (sub-maxillectomies, parotidectomies, palatal tumour excisions and cervicotomies), final pathology findings, and course with at least one year follow-up.ResultsForty-nine salivary tumours were treated, including 43 parotid tumours (87%), 3 sub-mandibular tumours (6%), 1 palatal tumour (2%) and 2 ectopic tumours (4%). Sixteen percent of the tumours were malignant. Fine-needle cytology sensitivity was 40%, whereas specificity was 100%. Out of 43 parotidectomies, 40 (93%) were primary parotidectomies, and 3 were revision parotidectomies. Most parotidectomies (81%) were superficial or partial and 8 (19%) were total. Parotidectomy complications are similar to those described previously in the literature: permanent facial palsy in superficial or partial parotidectomy (5%), wound dehiscence or necrosis (13%), post-operative bleeding (4%), fever or wound infection (7%), sialoceles (44%) and Frey's syndrome (2%).ConclusionsParotid tumours are the most common salivary gland tumours. Most of them are benign, but Warthin's tumour is more frequent than usual in our series. Early and late complications from parotidectomy are uncommon, although sialocele is a common transitory complication in our series.     

Inflammatory diseases of the salivary glands in infants and adolescents

OBJECTIVE: To determine retrospectively the localization, etiology and treatment of inflammatory diseases of the salivary glands in infants and children and to evaluate treatment outcome. PATIENTS AND METHODS: Forty-five patients were treated in our institution in the period 1966-2000. The patients' records were evaluated and the results and side-effects of therapy were documented by a controlled follow-up study. RESULTS: Twenty-five of our patients were females (55.6%) and 20 males (44.4%). Inflammatory disorders figured most prominently in the group of patients between 12 and 16 years (n=14). Inflammation of the submandibular glands was the most common disease with 53.3% (n=24). The most frequent underlying cause in this subgroup of acute and chronic sialadenitis was sialolithiasis of the submandibular gland (40%). All patients were symptom-free in the long-term follow-up and all were symptom-free after surgical intervention. CONCLUSIONS: The present study shows that diseases of the salivary glands are rare among infants and children. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach.