Adenoid cystic carcinoma of the minor salivary glands.

Management of minor salivary gland adenoid cystic carcinoma is a controversial problem. Few clinicians obtain adequate experience in the treatment of this disease, which is often frustrated by early and late distant metastases. Fourteen cases of minor salivary gland adenoid cystic carcinoma recorded in the Delaware Registry over a 20-year period (1968 to 1988) were reviewed retrospectively. These cases were evaluated for their duration of symptoms; size, location, and histologic subtype of the lesion; perineural invasion; lymph node metastases; and treatment to determine the relationship of these factors to survival. Location and histologic subtype of the lesion and duration of symptoms were found to have a more significant impact on survival than size of the lesion, perineural invasion, or lymph node metastases. Surgery is the mainstay of therapy for minor salivary gland adenoid cystic carcinoma, with resection that includes disease-free margins but spares function being advocated. Although adjunctive radiation therapy has not been shown to increase survival, it is reasonable in lesions with perineural invasion and/or lymph node metastases.     

Papillary cystadenocarcinoma arising from minor salivary glands in the anterior portion of the tongue: a case report.

Papillary cystadenocarcinoma is a rare malignant neoplasm of the salivary gland. We report a case of papillary cystadenocarcinoma arising from the minor salivary gland in the anterior portion of the tongue of a 72-year-old male patient with a history of adenocarcinoma of the colon and prostate. Further, we discussed histopathological and clinical features of this lesion, and reviewed the literature.     

Basal cell adenocarcinoma of the minor salivary gland: a case report

Basal cell adenocarcinoma (BCA) is an uncommon salivary gland neoplasm. The majority of salivary gland tumors are located in the parotid gland, while only a few involves the minor salivary gland of the oral cavity. Pathological diagnosis is important to differentiate BCA from other neoplasms, as the prognosis of the diseases is significantly different. In this article, we present a 41-year-old-male with BCA involving the upper labial mucosa.     

Tumors of the minor salivary glands

Ten to 15% of all salivary gland tumors arise from the minor salivary glands, which are distributed throughout the upper aerodigestive tract. Most of these tumors occur in the oral cavity, and there is a much higher incidence of malignancy than is the case with the major salivary glands. The pathologic appearance, clinical features, treatment, and prognosis of minor salivary gland tumors are discussed. Particular reference is made to the role of adjuvant radiotherapy in improving the control rate after surgical excision.     

Tumours of the minor salivary glands

One hundred and forty-five patients were identified with minor salivary gland tumours. General information and tumour-specific information on stage, grade of tumour, resection margins, recurrence and survival were collected. Data was analysed by both univariate and multivariate methods. Indices predicting tumour recurrence and survival were analysed. Forty-two benign lesions, mostly pleomorphic adenomas were identified, one recurred, all survived. One hundred and three malignant lesions were identified, mostly adenoid cystic carcinomas (70%) or mucoepidermoid carcinomas (19%). Late stage disease and the presence of neck node metastases predicted both early recurrence and high eventual mortality. Survival was favoured by the histological type (mucoepidermoid > adenoid cystic), site of primary (oral cavity and oropharynx > nose, sinuses and larynx) and good general condition. Many tumours recurred after 5 years of disease-free survival and late mortality was a feature (80% survival at 5 years, 20% at 20 years). Many patients survive some time with either local recurrence or distant metastases. Long-term follow-up is advocated as local or distant recurrence may be treatable. The value of super radical treatment of the primary is questionable given the likelihood of recurrence at distant sites.     

Pleomorphic adenoma of minor salivary glands

Pleomorphic adenoma, a benign tumor often seen in ENT practice, arises either from minor as well from major salivary glands. 5-14% of tumors occur in minor glands. Sixteen cases of minor salivary gland pleomorphic adenomas are studied. Eight of them originate from the oral cavity: 6 from the palate, one from the lower lip and one from the cheek. Two oral adenomas were malignant. In 4 patients tumors occur in the nasal cavity and in two other patients--in the neck. The clinical and pathological features of these patients are presented. Special attention is given to malignant transformation and the rate of recurrence of the tumors.     

Mucinous cystadenocarcinoma of a minor salivary gland in the upper lip: case report

Mucinous cystadenocarcinoma of the salivary gland is a rare entity that has only recently been described. This lesion was included in the 1991 World Health Organization Classification as "papillary cystadenocarcinoma," and that same year the United States Armed Forces Institute of Pathology classified it as "cystadenocarcinoma with or without a papillary component." Only a small proportion of salivary gland tumors are adenocarcinomas. Most mucinous cystadenocarcinomas affect the major salivary glands, particularly the parotid. These are low-grade malignancies, and most that occur in the minor salivary glands show very little aggressive behavior. These tumors are histologically similar to adenocarcinomas of the gastrointestinal tract. It is often difficult to differentiate them from other neoplasms. The differential diagnosis includes mucoepidermoid carcinoma, acinic cell carcinoma, salivary duct carcinoma, nasal adenocarcinoma, and metastatic carcinoma. This report describes the case of an 80-year-old man who presented with a painless swelling in his right upper lip that had been present for 1 month. Fine-needle aspiration biopsy of the lesion revealed inflammatory cells without an epithelial component. The treatment was wide excision, and there was no recurrence during 6 months of follow-up. The pathological diagnosis was low-grade mucinous cystadenocarcinoma of a minor salivary gland.     

Nonsquamous cell tumors of the minor salivary glands

Tumors may develop from minor salivary glands present in the submucosa of the upper aerodigestive tract and from other glands of similar structure in the head and neck area. By far, the most common location for minor salivary glands is the oral cavity.     

Adenoid cystic carcinomas of minor salivary glands

Objectives

Adenoid cystic carcinoma (ACC) is a very rare epithelioid tumor with different prognostic factors relating to overall survival. This study aims to analyze the prognostic factors, outcome and the value of surgical therapy on recurrent disease.

Materials and methods

From 1992 to 2006, a total of 33 patients with ACC originating in minor salivary glands of the oral cavity were clinicopathologically reviewed. Clinical and histological data was analyzed by univariate analysis using the log-rank test.

Results

64% of patients had a low-grade and 36% had a high grade disease. The 2-, 5- and 10-year survivals were 89.7%, 62.1% and 54.2%. The T category (p = 0.001), N category (p = 0.027), UICC stage (p < 0.0001), and resection margins (p = 0.024) influenced survival. Salvage treatment influenced patient's overall survival (p = 0.002).

Conclusion

This study confirms that in ACC T category, N category, UICC stage, and resection margin status correlates well with prognosis. Salvage surgery of patients with recurrent ACC should be performed if possible as the survival is significantly increased.     

Tumours of the minor salivary glands: a clinicopathologic study of 243 cases

243 patients with tumours of the minor salivary glands were analysed clinicopathologically. The palate was the most common location for the lesions. Mixed tumours (pleomorphic adenomas) were the most common benign tumour type. Muco-epidermoid carcinoma and adenoid cystic carcinoma were the dominant types of malignant tumours. For malignant tumours, the overall 3-year survival rate was 84.0%, 5-year 80.2%, 10-year 66.7% and 15-year 53.6%. The overall recurrency rate was 38.9%. The rate of cervical lymph node metastases and distant metastases rate were both 9.2%.     

Management of parapharyngeal minor salivary neoplasms in children: a case report and review

Parapharyngeal neoplasms are rare entities in children. Benign minor salivary gland neoplasms of the parapharyngeal space have been described in the adult literature, but there is little guidance in the pediatric literature. We present the case of an adolescent male with a primary minor salivary gland pleomorphic adenoma presenting as an enlarging, asymptomatic parapharyngeal mass. We discuss the clinical presentation, radiologic findings, differential diagnosis and our surgical management with a summary of the current literature on the topic.     

Pleomorphic adenoma of minor salivary gland with therapeutic misadventure: a rare case report

Background

Acute mastoiditis is a serious complication of acute otitis media especially in the pediatric age group. This study reports the authors' experience in the treatment of children admitted with acute mastoiditis to the Pediatric Hospital of Cairo University throughout the year 2007, also we aimed to evaluate our current management of this serious disease.

Methods

Nineteen children were included in this study, 11 females and 8 males, their ages ranged from 9 months to 11 years. All children were treated with intravenous antibiotic on initial admission, myringotomy was considered for cases that did not respond to medical treatment for 48 hours, while cortical mastoidectomy (with myringotomy) was reserved for cases that presented initially with subperiosteal abscess with or without post-auricular fistula, cases with intracranial complications and for cases that showed no response to myringotomy (after 48 hours). Follow up of the patients was carried out for at least 1 year.

Results

Medical management alone was enough in 5 cases (26%); all of them had erythematous tender mastoid on first presentation. Seven cases (37%) needed myringotomy; 2 of them showed no response and they needed cortical mastoidectomy and the other 5 cases responded well except for 1 case that developed post-auricular subperiosteal abscess 2 months later necessitating cortical mastoidectomy with no evidence of recurrence till the end of the follow-up period. Seven cases (37%) presented with subperiosteal abscess and they needed cortical mastoidectomy with myringotomy; they showed no recurrence till the end of the study.

Conclusion

Conservative management is an effective method in the treatment of non-complicated acute mastoiditis, but myringotomy should be considered if there is no response within 48 hours. Cortical mastoidectomy should be used in conjunction with the medical management in the treatment of complicated cases.     

头颈部上皮-肌上皮癌的诊治分析

目的　探讨头颈部上皮-肌上皮癌的诊治。方法  对1999～2013年收治于中国医学科学院肿瘤医院的23例头颈部上皮-肌上皮癌患者进行回顾性分析。23例患者中,13 例行单纯手术治疗,9例行术后放疗,1例行术后化疗,应用Kaplan-Meier法计算患者的生存率。结果　患者5年累计生存率及累计无复发生存率分别为81.0%和67.3%,总体复发率为39.1%（9/23）,单纯手术组及手术加放疗组5年累计无复发生存率分别为55.6%和80.0%,但无统计学显著差异（χ2=2.232,P =0.135）。结论　头颈部上皮-肌上皮癌有较高的复发率,广泛手术切除并保证足够的安全界是头颈部上皮-肌上皮癌的主要治疗方式,对于病变广泛或姑息手术的患者,可以考虑辅助放化疗,但疗效有待进一步研究证实。