腮腺区包块诊断分析

目的:提高对腮腺区包块的诊断水平。方法:收集5年间296例腮腺区包块的临床资料,对其一般情况、疾病构成、临床表现、诊断方法等进行分析。结果:男、女之比约1.19∶1,年龄最小1岁,最大83岁;多形性腺瘤80例,占腮腺区包块的27%,占腮腺区良性肿瘤的50%;Warthin瘤50例,占腮腺区包块的16.9%,占腮腺区良性肿瘤的31.3%;炎性包块27例,占腮腺区包块的9.1%。黏液表皮样癌14例,占腮腺区包块的4.7%,占腮腺区恶性肿瘤的29.2%;腺样囊性癌7例,癌在多形性腺瘤中7例,均占腮腺区包块的2.4%、腮腺区恶性肿瘤的14.6%;鳃裂囊肿6例,占腮腺区包块的2.0%;多形性腺瘤以40～49岁年龄组及50～59岁年龄组最多见(χ2检验,P<0.005),Warthin瘤以50～59岁年龄组、60～69岁年龄组、70～79岁年龄组最多见,且40岁以前其发病率为0(χ2检验,P<0.005);炎性包块可见于任一年龄组,且以60～69岁年龄组最多见(χ2检验,P<0.005)。结论:腮腺区包块涵盖的疾病复杂,表现多样,应结合其临床表现、B超、CT、MRI等影像学检查、细针吸细胞学检查、术中快速冰冻病理检查等综合考虑选择合适的治疗或手术方案。     

Salivary gland tumors in a Brazilian population: a retrospective study of 496 cases

Salivary gland tumors are uncommon and the microscopical features can be complex. Epidemiological data of these tumors in the various parts of the world can be helpful for a better understanding of its biology and clinical characteristics. In this study, 496 epithelial and mesenchymal tumors of major and minor salivary glands diagnosed at Londrina Cancer Institute during the period from 1972 to 2001 were reviewed. Out of all cases, 335 (67.5%) were classified as benign and 161 (32.5%) as malignant. The majority of the cases occurred in the parotid gland (67.7%), followed by the minor salivary glands (22.8%) and submandibular gland (9.5%). Among the minor salivary gland tumors, the palate was the most frequent location (67%). The tumors affected more commonly adult patients with peak incidence between 40 and 50 years of age and with a slightly predominance in females. Pleomorphic adenoma was the most frequent tumor representing 54.2% of all cases, followed by mucoepidermoid carcinoma (13.5%), Warthin's tumor (8.5%) and adenoid cystic carcinoma (7.9%).     

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.     

A clinicopathologic study of parotid gland tumors

A review of 121 parotid gland tumors over a 10-year period was carried out. The clinical records were retrieved to analyze treatment modalities, history, pathology reports, and sex and age distribution. Pleomorphic adenoma was the most common benign tumor (88.2%), with adenoid cystic carcinoma being the most common malignant tumor (7.4%). Pleomorphic adenoma was more common in women than in men. Clinical signs and symptoms were of no value in distinguishing between malignant and benign tumors. Malignant tumors tended to be more common in the elderly. Subtotal or total parotidectomy was used as the method of treatment.     

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。     

615例小涎腺上皮性肿瘤的临床病理分析

目的　探讨小涎腺上皮性肿瘤的临床病理特点。方法　对615例小涎腺上皮性肿瘤的部位分布、发病年龄、性别及组织学类型进行回顾性分析。结果　615例小涎腺上皮性肿瘤中腺瘤265例,癌350例,良恶性肿瘤之比为1∶1·3。良性肿瘤中以多形性腺瘤最为常见(81·1%),其次为肌上皮瘤(14·7%)。恶性肿瘤中以腺样囊性癌最常见(32·9%),其次为粘液表皮样癌(21·4%),腺癌(11·7%)。小涎腺上皮性肿瘤以腭部最为好发,分别占良、恶性肿瘤的77·0%和60.0%。腺瘤中女性患者(51·3%)稍多于男性(48·7%);小涎腺癌患者中男性(56·3%)多于女性 (43·7%)。小涎腺腺瘤患者平均发病年龄40·9岁,小涎腺癌平均发病年龄49·1岁,恶性肿瘤的发病年龄显著高于良性肿瘤(P<0·05)。结论　小涎腺上皮性肿瘤在病理类型构成比、部位、年龄、性别分布上具有其独到的特点。     

Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population

There is little information in the English-language literature about the epidemiology of salivary gland neoplasms in the eastern Chinese population. A large retrospective study (6982 primary salivary tumors during 23 years) was carried out to investigate the clinicopathological features (tumor location, patient sex and age) of these tumors in this population. 3593 tumors were in males and 3389 in females. Pleomorphic adenoma (69%) was the most common tumor and 20% were located in minor glands. 92% of Warthin's tumors occurred in males. Malignant tumors were predominantly adenoid cystic carcinoma (30%) and mucoepidermoid carcinoma (30%). Incidences of lymphoepithelial carcinomas (5%) and polymorphous low-grade adenocarcinoma (1%) of malignant tumors were identified. 28% of tumors originated from minor glands. Most findings were similar to those in the literature, with some variations. The salivary tumors slightly predominated in males. Relatively higher incidences of minor gland tumors and specifically of pleomorphic adenoma in minor glands were noted. Adenoid cystic carcinoma and mucoepidermoid carcinoma constituted the most common malignancies. There was a high incidence of lymphoepithelial carcinomas but a low incidence of polymorphous low-grade adenocarcinoma. The historical significant male predominance of Warthin's tumor was confirmed.     

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.     

A clinico-pathologic study of 311 intra-oral salivary gland tumors in Thais

Background:  There have been several epidemiologic studies on intra-oral salivary gland tumors in several countries, but little is known of these tumors in Thailand.
Objectives:  To determine the relative frequency and distribution of various types of intra-oral salivary gland tumors in the Thai population.
Methods:  The files of the Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, from 1969 to 2007 were searched for intra-oral salivary gland tumors. Histopathologic slides were reviewed and reclassified according to the 2005 WHO Classification of Head and Neck Tumors. The age, gender, race, and anatomical distribution of the tumors were collected from the patients' records.
Results:  Of the 16,358 accessioned cases, 311 cases (1.90%) were diagnosed as intra-oral salivary gland tumors. One hundred and forty-seven cases (47.27%) were benign tumors, while 164 cases (52.73%) were malignant tumors. The mean age of the patient ± SD = 41.57 ± 16.65 years. Females outnumbered male patients by a ratio of M:F = 1:1.38. Almost all except one patient were Thais. Pleomorphic adenoma was the most common intra-oral salivary gland tumor. The majority of cases occurred at the palate.
Conclusions:  Pleomorphic adenoma is the most common intra-oral salivary gland tumor and the most common benign intra-oral salivary gland tumor, while mucoepidermoid carcinoma is the most common malignant intra-oral salivary gland tumor. Intra-oral salivary gland tumors in Thailand elicit similar trend as in previous studies, with only minor differences such as the ranking of some tumors, the higher incidence of intra-bony location, and the lower incidence of polymorphous low-grade adenocarcinoma.     

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.     

Tumors of the intraoral minor salivary glands: a demographic and histologic study of 426 cases

In a demographic and histologic study of 426 oral minor salivary gland tumors, 57.5% were classified as benign and 42.5% were classified as malignant or potentially malignant. There was an overall female preponderance (1.59/1). The mean age for females was 53.1 years and for males was 50.6 years. The mean age for patients with malignant tumors was 5.4 years greater than for patients with benign tumors and was statistically significant. The palate was the most common site for oral minor salivary gland tumors followed by the upper lip and the buccal mucosa. These three sites accounted for 76.1% of all cases. Pleomorphic adenoma was the most common benign tumor (41% of all cases and 71% of benign tumors) followed by monomorphic adenoma of the canalicular and basal cell subtypes (10% of all tumors and 18.9% of benign lesions). Mucoepidermoid carcinoma was the most commonly encountered malignant tumor, accounting for 15.2% of all tumors and 35.9% of malignant lesions. Low-grade (terminal duct, lobular, polymorphous) adenocarcinoma was the most second most common type, making up 11% of all tumors and 26.4% of all malignant tumors. The results of this study are compared with other recent studies.     

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.     

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.     

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.     

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.     

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。     

A retrospective study of 60 cases of salivary gland tumors in a Thai population.

Sixty cases of salivary gland tumors were diagnosed in the Oral Pathology Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand, from 1973 to 2002. Fifty-two cases (86.7%) involved the intraoral minor salivary glands, six cases (10%) were found in the major glands, and two cases (3.3%) were intrabony. The predominance of malignant over benign tumors was evident with 68.3% being malignant and 31.7% benign. Patients ranged in age from 9 to 75 years. The female to male ratio of benign intraoral salivary gland tumors was 1.4 to 1 and of malignant types was 1.1 to 1. The principle site of occurrence was the palate (65.4%), followed by buccal mucosa (13.5%). Pleomorphic adenoma (30%) was the most common benign tumor, and mucoepidermoid carcinoma (44.3%) was the most common malignant tumor. Comparing the data from the present study with other series, some discrepancies exist.     

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。     

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.     

The pathology of salivary glands. Tumors of the salivary glands

The management of benign and malignant neoplasms of the salivary glands requires precise knowledge of tumor histogenesis and classification as well as surgical skills. Pleomorphic adenoma and Whartin's tumor are the most frequent tumors in parotid glands while the probability for malignant tumors is higher in other glands, especially in sublingual and minor salivary glands. Those malignant salivary glands tumors are rare and necessitate multidisciplinar staging and management in close collaboration with the pathologist and the radiation oncologist.