Malignant minor salivary gland tumors: a retrospective study of 27 cases

Abstract

Malignant tumors of the intra-oral minor salivary glands are uncommon. The aim of this study was to give information concerning the clinical features of these tumors, the distribution of location, treatment opportunities, and outcome. Twenty-seven patients with malignant salivary gland tumors that were treated between January 1999 and December 2008 were evaluated retrospectively. Of the 27 minor salivary gland carcinomas, 48.1% were adenoid cystic carcinomas (ACC), 29.7% mucoepidermoid carcinomas (MEC), 22.2% adenocarcinomas (ADCA). The most common first symptom was a painless swelling in 60% of the cases, with the second most common symptom being ulcers (28%). Four recurrences and two metastases were found. No recurrence was observed in ADCA. All four patients experiencing a recurrence developed it in the first 3years after treatment. Wide excision with a clinical margin of 1cm and in large tumors, positive surgical margins or perineural infiltration and postoperative radiotherapy (RT) can be recommended; but in order to give exact information concerning the possible benefit from postoperative RT, it needs large prospective multicenter studies. Long-term follow-up controls and in particularly longer than 5years in ACC including yearly chest X-rays should be offered to these patients because of late metastasis and recurrences.