타액선 종양의 임상적 고찰

Abstract

The salivary glands are divided into major salivary glands, consisting of the paired parotid, submandibular, and sublingual glands, and the minor salivary glands, composed of the 600 to 1000 glands distributed throughout the upper aerodigestive tract. Because of the diversity of tumor types and the relative rarity of salivary gland neoplasm, exact diagnosis and treatment decision have been difficult. Treatment was surgical and the resection was conservative when possible, depending upon the extent of the tumor. Seventy cases of salivary gland tumors which were diagnosed at our hospital from January 1987 to December were reviewed according to age, sex, site, presenting symptoms, staging, histology, and outcome, retrospectively. The following results were obtained; There were 27 males(38% ) and 43 females(62% ). The male to female ratio was 1 : 1.5 in benign tumors, and 1 : 2 in malignant tumors. Of all salivary gland tumors, 35 cases(50%) arose in the parotid gland, 16 cases(23%) in the submandibular gland, and 19 cases(27%) in the minor salivary glands. Among the benign tumors, size of 1 ∼3cm was 31 cases(56% ). There were 55(79%) benign tumors, and 15(21%) malignant tumors. The most frequent benign tumor was pleomorphic adenoma(89% ), and malignant tumor was adenoid cystic carcinoma(400. The incidence of malignancy was 11% in parotid gland, 31% in submandibular gland, and 32% in minor glands. The symptoms varied in duration from several weeks to 26 years. 29 cases(41%), had symptoms for one to five years. The most common presenting symptom was asymptomatic slowly growing mass(54%) followed by pain, rapidly growing mass, rhinorrhea, nasal obstruction, and facial nerve paralysis. The incidence of neck node involvement was 27% (4 cases). According to TNM system of AJC, 3, 5, 2, and 5 cases had stages I through IV. Superficial parotidectomy was performed 21 cases(60%) of parotid tumor. Among the submandibular and minor salivary glands, wide excision was performed 13 cases(81%) and 14 cases(74%). Among the parotid and submandibular glands, postoperative facial nerve paralysis was occurred 9 cases(18%). Recurrence was seen in 4 cases(6%).