The Clinical Characteristics and CT Findings of Parotid and Submandibular Gland Tumours.

Houdong Zuo

doi:10.1155/2021/8874100

Abstract

Objective To investigate the clinical characteristics and CT findings of parotid and submandibular gland tumours. Materials and methods. From May 2017 to April 2020, all patients with clinically proven parotid and submandibular gland enlargement and palpable masses underwent CT examinations. All patients were confirmed by pathology after surgery. The clinical characteristics and CT features were observed and evaluated. The mean density values before and after enhancement were measured and analyzed. The chi-square test, one-way ANOVA, and Student's t-test were used. Results Ninety-four patients with a total of 94 unilateral tumours in the parotid and submandibular glands were enrolled, including 38 pleomorphic adenomas (PAs), 27 Warthin's tumours (WTs), and 29 malignant tumours (MTs). The majority of the PAs (28/38) and MTs (23/29) were located in the parotid gland; the others were located in the submandibular gland. All the WTs were in the parotid gland. The most common benign tumours of the parotid gland were PAs (28/38, 73.7%) and WTs (27/27, 100%), and the most common MTs were mucoepidermoid carcinoma, acinic cell carcinoma, and squamous cell carcinoma (4/29, 13.8%). The most common benign and malignant tumours in the submandibular gland were PAs (10/38, 26.3%) and ductal adenocarcinomas (3/4, 75%). The majority of PA patients (28/38) were female, compared with WT (2/27) (P < 0.001) and malignant tumour patients (10/29) (P < 0.01). A significant difference was also found between WTs and MTs in female patients (P < 0.05). The mean age of PA patients was 43.4 ± 12.1 years, which was lower than that of WTs (62.1 ± 11.7) and MTs (58 ± 14.18) (P < 0.001, P < 0.001, and P=0.244, respectively). On CT imaging, the mean diameter of the PAs and WTs was significantly smaller than that of the MTs (P=0.001 and P < 0.001), and no difference was observed between the PAs and WTs (P=0.275). In the parotid gland, the superficial lobe was more frequently involved than the deep lobe (PAs, 22 : 6; WTs, 17 : 10; and MTs, 15 : 8). The majority of PAs and WTs demonstrated round shapes (25/38, 19/27) and were well defined (30/38, 24/27); by contrast, most MTs were lobulated, irregular shapes (24/29), and ill defined (25/29). On plain CT, the PAs were usually homogeneous, while MTs were frequently heterogeneous, with more necrosis, larger cystic areas, and more haemorrhage or calcification. The mean CT values of PAs, WTs, and MTs were 39.2 ± 3.9 HU, 39.1 ± 3.0 HU, and 37.6 ± 3.1 HU (P > 0.05), respectively. On contrast CT, the WTs were significantly enhanced compared with MTs and PAs, with mean CT values of 53.5 ± 4.0 HU, 84.4 ± 6.0 HU, and 65.2 ± 3.8 HU, respectively (all P < 0.001). The mean CT value changes for PAs, WTs, and MTs (∆) were 14.4 ± 3.0 HU, 45.3 ± 4.5 HU, and 27.7 ± 2.5 HU, respectively. Significant differences were observed between ∆PAs and ∆WTs, ∆PAs and ∆MTs, and ∆WTs and ∆MTs (all P < 0.001). Conclusion Parotid and submandibular gland tumours have some typical clinical characteristics and CT findings, and plain and early contrast-phase CT combined with clinical parameters may be helpful for diagnosis.

Highlights

Salivary glands are important exocrine organs in humans that can produce and release saliva and a variety of digestive enzymes into the oral cavity. ree pairs of large salivary glands—the parotid, submandibular, and sublingual glands—are distributed in the lining of the mouth
Twenty-eight pleomorphic adenomas (PAs), 27 Warthin’s tumours (WTs), and 23 malignant tumours (MTs) originated from the parotid gland, and 10 PAs and 6 MTs were in the submandibular gland
We found that the most common benign tumours in the parotid and submandibular glands were pleomorphic adenomas (PAs) and Warthin’s tumours (WTs), and the common malignant tumours were mucoepidermoid carcinomas, acinic cell carcinoma, squamous cell carcinoma, and ductal adenocarcinoma. e majority of PA patients were females, while most WT and MT patients were male

Summary

Introduction

Salivary glands are important exocrine organs in humans that can produce and release saliva and a variety of digestive enzymes into the oral cavity. ree pairs of large salivary glands—the parotid, submandibular, and sublingual glands—are distributed in the lining of the mouth. In 2017, the World Health Organization (WHO) classified salivary gland tumours into more than 30 malignant and benign histological subtypes and used cytology as a preliminary. E morphology of salivary gland tumours is diverse due to their originating from different glandular cell types [3], which demonstrate significant pathologic, biological, and clinical diversity. Chemotherapy has limited treatment effects and only brings some relief to patients with malignant and advanced disease. Patients with salivary tumours who undergo RT may experience some negative effects and harm, including xerostomia and salivary hypofunction due to damage caused to the salivary glands [4]. The therapeutic effect varies greatly depending on the tumour histology and stage [5]

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Conclusion