Submandibular Gland Tumours: A South African Perspective

Abstract

ABSTRACT Background: Reports relating to submandibular gland neoplasms are sparse in the literature and the epidemiology of these neoplasms is variable in different parts of the world. Some studies suggest different patterns of tumour types in Black/Negroid patients, as compared to White Caucasian patients. There is no clarity about the origins of these tumours nor its distribution. Aim: This research paper audits the histopathological types of tumours and their clinical presentations at two central referral academic hospitals in South Africa. Method: A cross-sectional study was undertaken, using retrospective clinical data from two large academic public hospitals over a 7-year period from January 2005 to December 2011. All patients who had a submandibular gland resection at the two hospitals were included. A total of 61 patient records were examined, of which 26 met the inclusion criteria, being that of true neoplasms of the submandibular triangle. Results: Of the 26 patients 54% were males. The ages ranged from 22 to 65 years, with a mean of 42.5 years. Benign disease was found in 65.4% of patients, while 34.6% had malignancy. Black patients had a higher ratio of benign disease than White patients, and Black males were more likely to have benign disease (83.33%) than Black females (50%). On histopathology, pleomorphic adenoma was the most common benign tumour (82%), while adenoid cystic carcinoma was the most common epithelial or glandular malignancy (22%). There was also a high rate of lymphoma (56% of patients) in the malignant group. Clinically, local pain (p=0.03) and peripheral nerve involvement (p=0.05) were found to be significantly associated with malignant infiltrating epithelial disease. Conclusion: The rate of malignancy and age at presentation for Black patients was found to be lower than that reported in the Western literature. Pain and local/peripheral nerve involvement were clear clinical markers of malignant infiltrative disease.