Features Of Salivary Gland Tumors Research Articles

Salivary Gland Tumors: Limitations of International Guidelines and Status of the planned AWMF-S3-Guideline

Primary salivary gland carcinomas are not among the common head and neck tumors. They are characterized by manifold different histological types. Clinically, malignant tumors often cannot be distinguished from benign tumors, so that in these cases malignancy is only established by histopathological diagnosis. These are all reasons why there are relatively few clinical trials on the diagnosis, therapy and follow-up of these tumors. This in turn has the consequence that often only recommendations with limited evidence can be made in clinical guidelines. The most important international guidelines are the National Comprehensive Cancer Network (NCCN) guideline of 2023, the American Society of Clinical Oncology (ASCO) guideline of 2021, the European Society for Medical Oncology (ESMO) guideline of 2022 and still the British National Multidisciplinary guideline of 2016. These 4 international guidelines with their strengths and limitations are presented and commented here. Against this background, the development of a first German S3 clinical guideline on salivary gland tumors is important and expected to be completed in 2023. For the first time in the German guideline program on oncology, benign and malignant tumors are presented together in order to comprehensively do justice to the special features of salivary gland tumors.

Primary salivary gland tumors from a pathology perspective : Morphomolecular peculiarities and diagnostic and therapeutic challenges

Similar to tumors of other organs, salivary gland neoplasms were historically viewed as asingle neoplastic entity and mostly treated as such. Accordingly, only the clinical tumor stage, and not the histological subtype, was considered to be of significant prognostic impact. However, over the years, several distinct sub-entities have been characterized based on morphological features, such as adenoid cystic carcinoma, mucoepidermoid carcinoma, acinic cell carcinoma, and salivary duct carcinoma. Most importantly, the nosology of salivary gland carcinomas has undergone adynamic "splitting" on the basis of morphological, immunophenotypic, and molecular characteristics, so that 21independent carcinomas are now listed in the current World Health Organization (WHO) classification. Moreover, it has become evident that splitting of these carcinoma subtypes no longer represents a"pathologist's hobby," but carries significant prognostic and therapeutic relevance for optimized cancer surgery and potentially systemic therapy. The current review summarizes the major features of salivary gland tumors, both benign and malignant, and gives an account of their classification systems and genetic profiles.

Epidemiological, Clinical, and Histopathological Features of Salivary Gland Tumors among 150 Sudanese Patients: 10 Years' Experience.

Salivary gland tumors (SGTs) are serious challenges to pathologists. Herein, we aimed to assess epidemiological and histopathological characteristics of SGTs among Sudanese patients. This retrospective descriptive study was undertaken at The pathology department in Khartoum State between 2008 and 2018. Patient records, histopathological reports, and slides were retrieved; and re-examined by two histopathologists. Diagnoses were reclassified according to the 2017 WHO classification of SGTs. Overall, 150 cases of Sudanese patients with SGT were included (90 [60%] males and 60 [40%] females). Among these, 105 were benign (70%) and 45 were malignant (30%). The parotid glands were the most common site for both benign and malignant tumors (77/150; 51%: 59 benign (76.6%) and 18 malignant [23.4%]). The next common site was the submandibular gland (54 [36%]: 38 benign [70.3%] and 16 malignant [29.7%]), followed by minor salivary glands (19 [12.7%]: 8 benign and 11 malignant [57.9%]). Benign gland entities included pleomorphic adenoma (88/105; 83.7%), oncocytoma (5/105; 4.8%), myoepithelioma (4/105; 3.8%), Whartin tumors (3/105; 2.9%), basal cell adenoma (3/105; 2.9%), and sialolipoma (2/105; 1.9%). Malignant gland entities included adenoid cystic carcinoma (12; 26.7%), mucoepidermoid carcinoma (10; 22,2%), acinic cell carcinoma (6; 13.3%), poorly differentiated carcinoma (4; 8.9%), adenocarcinoma NOS (not otherwise specified) (4; 8.9%), basal cell adenocarcinoma (3; 6.7%), carcinoma ex pleomorphic adenoma (3; 6.7%), polymorphous adenocarcinoma (2; 4.4%), salivary duct carcinoma (1; 2.2%), and epithelial-myoepithelial carcinoma (2.2%). SGTs shared several epidemiological and histopathological features, exhibiting high incidence in the parotid and submandibular glands, lower prevalence in minor glands, and greater male predominance.

A Clinicopathological study of salivary gland neoplasms in a tertiary care hospital: A three year study

Background: The tumors of the salivary glands are uncommon head and neck neoplasms. The aim of this study was to observe the clinical occurrence of salivary gland neoplasms and to study the various histo-morphological features of salivary gland tumours, their frequency, age and sex distribution. Materials and Methods: The cases which have arrived to the Dental OP at Drs Sudha and Nageswara Rao Sidhhartha Institute of Dental Sciences with swellings in the head and neck region were identified and sent to pathology department from June 2013 to May 2016 and cases which were diagnosed as salivary gland neoplasms (96 cases) were taken into consideration and Histopathological examination was done. Results: Out of 96 cases, 51 (53.1 %) were benign and 45(46.9 %) were malignant with M:F ratio of 1.74:1. Age range of patients was from 10 to 80 years. Pleomorphic adenoma was found to be the commonest benign tumor (74.5 %), followed by Warthin’s tumor (19.6%), monomorphic adenoma (3.9 %) and basal cell adenoma (3.9 %). The mucoepidermoid carcinoma was the most common malignant tumor (48.8%) followed by adenoid cystic carcinoma (33.3%), acinic cell carcinoma (13.3%), adenocarcinoma NOS (2.2%) polymorphous adenocarcinoma (2.2%) Conclusion: Males were more affected than females and pleomorphic adenoma was the most frequent lesion followed by warthin’s tumor among benign neoplasms. Mucoepidermoid carcinoma is the most common malignant neoplasm followed by adenoid cystic carcinoma.

Histopathologic Profile of Salivary Gland Tumors among Specimens from a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Salivary gland tumors are rare, comprising about 3% of all head and neck neoplasms. About 80% of the tumors are in parotids, 10% in submandibular glands and the remainders are distributed in sublingual and minor salivary glands. This study was conducted to evaluate the relative frequencies, types, site of distribution and the histopathological features of salivary gland tumors. A descriptive cross-sectional study was conducted in the Department of Pathology, Manipal College of Medical Sciences, Pokhara from January 2011 to December 2019. Ethical approval was taken from the institutional review committee of Manipal College of Medical Sciences (Ref: 314). Convenient sampling was done among specimen. Data were entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 21. Among the 130 specimens, the patients' age ranged from 6 to 78 years with a mean age of 37.26 years for benign tumors and 48.45 years for malignant tumors. There was female predominance with a male to female ratio of 1:1.36. There were 98 cases of benign tumors, commonest being pleomorphic adenoma with 82 (83.67%) cases which was noticed more frequently in fourth decade of life. Among the 32 malignant tumors, mucoepidermoid carcinoma was the commonest tumor 20 (62.5%), followed by adenoid cystic carcinoma 7 (23.33%). Benign salivary gland tumors were more common than malignant tumors and the most common site of location was the parotid for both the benign and malignant tumors. Female outnumbered the male population in benign tumors whereas males were slightly more than females in malignant tumors. This study corroborated well with other previously published studies.

Salivary gland neoplasms: A 10-year review of a major referral center in Ghana

The aim of this study was to describe the clinicopathologic features of salivary gland tumors (SGTs) that were managed at a major referral center in Ghana. This was a retrospective study of all histologically diagnosed and managed Ghanaian patients with SGTs during the period January 2008 to December 2017. Information collected included age, gender, affected gland, presenting symptom, treatment modality, histologic diagnosis, and complications. Descriptive summaries of variables were generated. The χ2 test with Fisher's test was used to compare categorical variables with subsequent testing of association. The study included 116 patients, with 49 males (42.2%) and 67 females (57.8%), representing a ratio of 1:1.4. There were 82 (70.7%) benign SGTs and 34 (29.3%) malignant SGTs. The most common benign SGT was pleomorphic adenoma, which accounted for 62.1% of all SGTs. Malignant SGTs occurred more in older people, and the occurrence of SGTs was significantly at a lower age in males compared with females. Although the general pattern of SGTs did not seem to differ significantly in comparison with the findings of a review performed 10 years earlier, the findings of this study could inform hypotheses generation for future studies to explore the risk factors and associations peculiar to the Ghanaian environment.

Salivary gland tumors: A 13-year clinicopathologic retrospective study in a Brazilian northeast population.

The present study aimed to evaluate the clinicopathologic features of salivary gland tumors (SGTs) in a Brazillian northeast population. A retrospective descriptive cross-sectional study was performed (1995-2009). All cases of SGTs diagnosed in a private surgical pathology service in Brazil were reviewed, and clinicopathological data were collected. A total of 23.258 histopathological records of biopsies were analyzed, and 174 cases were diagnosed as SGTs (0.7%). Of these, 117 (67.2%) were classified as benign, and 57 (32.8%) were malignant. The series comprised 89 females (51.1%) and 85 males (48.9%), with a mean age of 50.2 years (range: 3-96 years) and a roughly equal female-to-male ratio (1:1). Most tumors occurred in the parotid gland (n = 82, 47.1%), followed by the palate (n = 45, 25.9%), submandibular gland (n = 15, 8.6%). Pleomorphic adenoma (n = 83; 70.9%) and mucoepidermoid carcinoma (n = 19, 33.3%) were the most frequent benign and malignant tumors, respectively. After reevaluation of morphology and immunohistochemical analysis, seven tumors (4.0%) were reclassified following the current WHO Classification of the Head and Neck Tumors. The general features of SGT from the studied Brazilian population were similar to previously published reports in other countries. However, SGTs do not show any sex predilection. Although careful morphological analysis is the key to the correct diagnosis of these tumors, immunohistochemical analysis is essential to establish an accurate diagnosis in the face of challenging cases. Key words:Salivary gland tumors, epidemiology, head and neck pathology.

Histopathological features of salivary gland tumors: A single-center experience

Aim: This study’s goal was to retrospectively evaluate cases who were diagnosed with primary salivary gland tumors in our center, to examine the histopathological features of these tumors, and to reveal difficulties in the differential diagnosis. Material and Methods: Sixty-four patients who applied to our center with complaints of pain and swelling in the salivary gland region between January 2016 and February 2020 and who were diagnosed with salivary gland tumor in our pathology clinic were analyzed retrospectively. The age and sex of the patients, the salivary gland where the tumor was located, and the histopathological examination results were recorded. Results: The age range of the patients was 13-89 years, and 57.8% and 42.2% of 64 patients in total were female and male, respectively. While 86% of the patients had tumors located in the parotid gland, 14% of them had tumors located in the submandibular gland. According to the histopathological examination results, 89% and 11% of the patients had benign and malignant tumors, respectively. While the most common tumor among benign tumors was a pleomorphic adenoma at a rate of 57.8%, the most common tumor among malignant tumors was a mucoepidermoid carcinoma at a rate of 4.7%. Conclusion: In the present study, salivary gland tumors were more common in females. The majority of salivary gland tumors were located in the parotid gland, and the majority of them were benign. The majority of tumors located in the submandibular gland were malignant.

The demographic and clinicopathological features of salivary gland tumors in Turkey

Aim: Salivary gland tumors (SGTs) are rare neoplasms thus, the local records are valuable to obtain the epidemiological overview. This study aimed to determine the demographic and clinicopathological features of SGTs in our clinic and compare the findings with the studies from Turkey and all over the world.Material and methods: The data of 185 patients who underwent surgery for SGT in The Department of Otorhinolaryngology-Head and Neck Surgery of a tertiary referral center between 2012 and 2017 were studied retrospectively. The demographic and clinicopathological features of the patients were recorded.Results: Among all patients with primary and secondary SGTs, the median age was 53 years, 54.6% of the patients were men. Patients with primary tumor constituted 96.8% of all cases. Malignancy rate was 14. Parotid gland was the most common location (90%). Nearly half of all primary tumors were diagnosed as pleomorphic adenoma (n=84, 46.9%). Mucoepidermoid carcinoma was the most common malign neoplasm of the parotid gland. There were only six patients (3.2%) that had secondary SGT.Conclusion: Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malign pathologies, respectively. The lowest malignancy rate and the highest rate of warthin tumor of the existing literature were the most conspicuous findings of our study. Although the frequency of the secondary SGTs is low, the possibility of metastasis should be considered especially for the patients above 65 years of age.

Salivary Gland Neoplasms in Indian Paediatric Population Visiting a Dental Institution

INTRODUCTION: With a probability of 50% malignancy, salivary gland tumors are not too commonly noticed in children and adolescents. Most of these have idiopathic etiology but a few pre-disposing factors have been reported in literature. We hereby report eighteen cases of paediatric salivary gland tumors in a study conducted from September 2013 to August 2018 at department of Oral and maxillofacial surgery at Tatyasaheb Kore Dental college and Research Centre, Kohlapur, Maharashtra, India..AIM & OBJECTIVES: This study aimed to inspect the distribution, clinical and histopathological features of salivary gland tumours in children and adolescents.MATERIAL AND METHODS: A total of 18 cases of salivary gland tumors encountered in paediatric age group were studied and explored for age, gender, site proneness and for histopathological nature.RESULTS: Female gender had a predominance over males. Parotid tumors were more common (77.78%) as compared to tumors of submandibular glands. Six cases were diagnosed with benign tumors (pleomorphic adenoma) and rest had malignant tumors (mucoepidermoid in nature). Majority of the cases did not report undergoing any prior treatment.CONCLUSION Present study revealed that salivary gland tumors in paediatric age group are quite rare with female gender being more prone. With majority of cases being mucoepidermoid in nature, parotid gland is most commonly affected.

Salivary gland tumors in a Brazilian population: A 20-year retrospective and multicentric study of 2292 cases

PurposeNeoplasms of the salivary glands comprise more than thirty subtypes of lesions with various clinical behaviors. The present study aimed to describe the incidence and main features of salivary gland tumors in Brazil. Material and methodsA retrospective descriptive cross-sectional study was performed (1997–2017). A total of 88,430 biopsy records of oral and maxillofacial lesions from 5 pathology referral centers were analyzed. All cases of salivary gland tumors were reviewed and data such as gender, age, skin color, anatomical location, symptomatology, tumor size and histopathological diagnosis were collected. ResultsAmong all lesions, there were 2,292 (2.6%) cases of salivary gland tumors. The most frequent benign and malignant neoplasm was pleomorphic adenoma (n = 1,086; 47.4%) and mucoepidermoid carcinoma (n = 322; 14.0%), respectively. The majority of the patients were white (n = 757; 33%) and female (n = 1,391; 60.7%), and most cases involved the parotid gland (n = 933; 40.7%; p < 0.001). Age ranged from 1 to 101 years, occurring more in the fourth decade of life. Tumor size varied from 0.3 to 15 cm and the presence of symptomatology (pain/swelling) occurred more in patients with malignant tumors (p < 0.001). ConclusionThe incidence profile and clinical findings of salivary gland tumors were similar to those described worldwide; nevertheless, multicenter studies are valuable to better characterize these neoplasms.

Clinicopathological study of Salivary Gland Tumors

Background: The tumors of the salivary glands are uncommon head and neck neoplasms. The aim of this study was to evaluate the relative frequencies, types, site distribution and the histopathological features of salivary gland tumors. Materials and Methods: This was a cross-sectional study of 50 patients of salivary gland tumors in the department of General Surgery in Victoria hospital attached to Bangalore Medical College and Research Institute, Bangalore . Tumors were analyzed based on demographics, anatomic location and histopathological type. Results: Out of 50 cases, 39 (78 %) were benign and 11 (22 %) were malignant with M:F ratio of 1.5:1. Highest incidence of tumors were found in 3 rd decade of life and next common age incidence have been noted in 2 nd decade. Male were more prone to develop both benign and malignant parotid tumor than that of female. Pleomorphic adenoma was found to be the commonest benign tumor (52 %). The mucoepidermoid carcinoma was the most common malignant tumor (10 %). Parotid was the most common site for the location of tumors (70%) followed by submandibular (26%) and sublingual salivary glands (4 %). Conclusion: Pleomorphic adenoma was the commonest salivary gland tumor observed in both sexes. Mucoepidermoid carcinoma was the most common malignant salivary gland tumor. The parotid gland was the most common site of origin in both benign and malignant tumors.

Salivary Gland Fine-Needle Aspiration Cytology: A Single Institution Experience

Introduction 208 FNA cytology diagnoses between 2008-2014 Materials and Methods • Computer search was used to identify salivary gland FNA performed in the 2008-2014 period. • Cytologic diagnostic categories for the analysis were malignant neoplasm, suspicious for malignancy, benign neoplasm, neoplasm NOS, non-neoplastic, atypical cells and nondiagnostic. • Cyto-histologic correlation was performed on patients who underwent surgical excision post FNA. Conclusion • Salivary gland FNAC is a valuable tool for distinguishing between benign and malignant neoplasms, and between neoplastic and nonneoplastic lesions. Introduction: Fine needle aspiration cytology (FNAC) is considered an important tool in the diagnosis of salivary gland lesions. However, the great variety and overlapping features of salivary gland tumors can make a precise diagnosis difficult. At our institution, FNAs are performed from salivary gland lesions to discriminate between neoplastic and non-neoplastic lesions and to guide clinical management. This study reviews FNAC of salivary gland lesions performed at our institution during the past 7 years. Materials and Methods: Computer search was used to identify salivary gland FNA performed in the 2008-2014 period. Palpable lesion FNAs were performed by cytopathologists and deep-seated lesions by radiologists with cytopathologistperformed onsite evaluation in most cases. Cytologic diagnostic categories for the analysis were malignant, suspicious for malignancy, benign neoplasm, neoplasm NOS, non-neoplastic, atypical cells and nondiagnostic lesions. Cyto-histologic correlation was performed on patients who underwent surgical excision post FNA. Results: 208 salivary gland FNAs were reviewed. FNAC diagnoses included 79 benign neoplasms, 21 malignant, 9 suspicious for malignancy, 16 neoplasms NOS, 74 non-neoplastic, 4 atypical and 5 nondiagnostic lesions. Eighty-five (41%) of 208 FNAs had histological correlation; 43/44 (97.7%) benign neoplasms, 8/9 (89%) malignant and 6/8 (75%) non-neoplastic lesions were correctly categorized. Concordant histologic subtype was found in 39/43 (90.7%) benign and in 5/8 (62.5%) malignant neoplasms. There was one false positive: 1 atypical pleomorphic adenoma (PA) diagnosed as metastatic carcinoma favor prostate primary; and one false negative, a myoepithelial carcinoma ex-PA diagnosed as salivary gland adenoma. Conclusions: Salivary gland FNAC is a valuable tool for distinguishing between benign and malignant neoplasms, and between non-neoplastic and neoplastic lesions. FNAC is highly accurate for specific histologic subtype of benign neoplasms, and less for malignant. Molecular markers may help overcome diagnostic pitfalls of cytomorphology. • Fine needle aspiration cytology (FNAC) is considered an important tool in the diagnosis of salivary gland lesions. • However, the great variety and overlapping features of salivary gland tumors can make a precise diagnosis difficult. • At our institution, FNAs are performed from salivary gland lesions to discriminate between neoplastic and nonneoplastic lesions and to guide clinical management. • This study reviews FNAC of salivary gland lesions performed at our institution during the past 7 years. Diagnoses No. (%)

Documentation of the Salivary Gland Tumors: An Institutional Data From Turkey

Objective: World-wide series show some differences in the incidence and clinicopathologic features of salivary gland tumors. Methods: A total of 248 cases of SGTs diagnosed in our hospital between 1998 and2013 were reviewed with respect to their clinicopathologic features. Results: There were 128 male and 116 female patients with a mean age of 49.2. Of these 248 tumors 214 were benign and 34 were malignant. The mean age of the patients with benign tumors was 48.6 years and with malignancies was 55.3 years. The most common site was the parotid gland (83.5%) followed by submandibular and minor ones. Pleomorphic adenoma (50.4%) was the most common benign tumor and affected female patients more frequently. It is followed by Warthin’s tumor that favored parotid gland. Adenoid cystic carcinoma was the most frequent malignant tumor followed by mucoepidemid carcinoma and carcinoma ex pleomorphic adenoma and the majorities were located in the submandibular gland. Conclusion: In the present study, epidemiological data was compared with other worldwide series. Our retrospective study revealed that; benign tumors were more frequent, major salivary glands were more affected by both benign and malignant tumors than minor salivary glands and the parotid gland was the most affected site. Epidemiological data in the various parts of the world can be helpful for a better understanding of SGT's biology and characteristics. Key words: Salivary gland, benign, malignant, tumors, epidemiology

Histopathological Pattern of Salivary Gland Tumors

Background: The tumors of the salivary glands are uncommon head and neck neoplasms. The aim of this study was to evaluate the relative frequencies, types, site distribution and the histopathological features of salivary gland tumors. Materials and Methods: This was a retrospective study of 176 cases of salivary gland tumors collected from medical record section and department of pathology at B.P.Koirala Memorial Cancer Hospital from Jan. 2005 to Dec. 2010. Tumors were analyzed based on demographics, anatomic location and histopathological type. Results: Out of 176 cases, 66 (37.5 %) were benign and 110 (62.5 %) were malignant with M:F ratio of 1.7:1. The mean age observed was 44.76 years with age range of 12 to 75 years. Pleomorphic adenoma was found to be the commonest benign tumor (72.7 %), followed by Warthin tumor (15.1%), monomorphic adenoma (3.0 %) and basal cell adenoma (3.0 %). The mucoepidermoid carcinoma was the most common malignant tumor (38.1 %), followed by adenoid cystic carcinoma (25.4%), acinic cell carcinoma (10.9%), adenocarcinoma NOS (6.3%), carcinoma ex pleomorphic adenoma (5.4%) and unclassified malignant tumor (4.5 %). Parotid was the most common site for the location of tumors (70.4%) followed by submandibular (19.3%) and minor salivary glands (10.2 %). Conclusion: Pleomorphic adenoma was the commonest salivary gland tumor observed in both sexes. Mucoepidermoid carcinoma was the most common malignant salivary gland tumor. The parotid gland was the most common site of origin in both benign and malignant tumors. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10291 Journal of Pathology of Nepal (2014) Vol. 4, 520-524

Imaging of the Salivary Glands

Imaging of the salivary glands is a diagnostic challenge because of the variety of disease processes that may show similar imaging findings. This article provides an overview of anatomy, epidemiology, clinical presentation, and imaging features of salivary gland tumors as well as inflammatory and systemic processes involving these glands. The imaging features with differential diagnoses are discussed with emphasis on computed tomography (CT) and magnetic resonance imaging (MRI). A variety of disease processes, including inflammatory, infectious, obstructive, systemic, and neoplastic processes can inflict the salivary glands. The diversity of benign and malignant salivary neoplasms is probably greater than that of any other organ system.1 Salivary tumors gland comprise 3% of all head and neck tumors and cause 0.1% of all cancer deaths. 2 As part of understanding the role of imaging in diagnosis of salivary gland disorders, normal anatomy of the glands is describedfirst in this review followed by discussion of individual disease entities.

Clinicopathologic analysis of 493 cases of salivary gland tumors in a Southern Brazilian population

The aim of this study was to determine the distribution and demographic features of salivary gland tumors (SGTs) in a large Brazilian population. A total of 493 cases of SGTs diagnosed between 2001 and 2011 from a general pathology laboratory and an oral pathology service were reviewed with respect to their clinicopathologic features. A total of 369 tumors were benign and 124 were malignant. The mean age of patients with benign tumors was 46.3 years and that of patients with malignancies was 54.0 years. The parotid gland was the most common location (42.3%). Pleomorphic adenoma (PA) and Warthin's tumor were the most common benign neoplasias, whereas mucoepidermoid carcinoma (MEC) and adenocarcinoma, not otherwise specified, were the most frequent malignancies. The present data confirm that PA and MEC are the most common benign and malignant SGTs. However, it is important to consider that differences in tumor types may be influenced by whether a tumor derives from a medical or a dental service.

Clear Cell Entities of the Head and Neck: A Selective Review of Clear Cell Tumors of the Salivary Glands

Clear cell changes may be observed in virtually any benign or malignant tumor of epithelial, mesenchymal, melanocytic and hematopoietic derivation not be attributed to variable etiologies. In general, benign and malignant clear cell neoplasms of the head and neck are rare. They may involve various regions and may be of diverse derivations, with only 1-2% of tumors of the salivary glands, jaws and oral mucosa are primarily or almost exclusively composed of clear cells (Maiorano et al., Semin Diagn Pathol 14:203-212, 1997). This review will selectively discuss the clinicopathological features of salivary gland tumors with clear cell changes, which, at times, may pose a diagnostic challenge and dilemma.

Salivary gland tumors in Uganda: clinical pathological study.

The incidence of salivary gland tumors is claimed to be influenced by geographical and racial factors. The pathological classification and nomenclature of salivary gland tumors as defined by WHO classification (1991), is accepted world-wide but little is available in the literature regarding the spectrum of salivary gland tumors in Africa in the basis of this classification. Such efforts would allow comparison and justify any differences between the black African population and the rest of the world. To outline the clinicopathological features of salivary gland tumors in Uganda. Makerere University, Faculty of Medicine, Department of Pathology. All epithelial tumors from major and minor salivary glands accessioned from 1979 to 1988 were analyzed in respect to sex and age of patients, anatomical location of the tumor and histological type. The histological diagnosis of each individual tumor was based on the 1991 WHO classification of salivary gland tumors. During the span of 10 years, 268 cases of salivary gland tumors were diagnosed. Of these, 113 (42.2%) were males, 148 (55.2%) females and in the remaining seven (2.6%) cases, the sex was not specified. The age range of the 247 patients with recorded ages was from 0.5 to 80 years. The mean age at diagnosis was 38.1 (SD =17.03) with the median of 38.0 years. Thirty four percent of tumors originated from the parotid, 33.2% from the submandibular and 32.8% from minor salivary glands. No tumor was implicated from the sublingual gland. There were a total of 125 (46.6%) malignant tumors and 143 (53.4%) benign tumors. The mean age of patients with malignant lesions (43.1 years; SD=16.75; median=44.00 years) was 9.6 years older than those with benign tumors (mean=33.5 years; SD=16.0; median=30.00 years). Pleomorphic adenoma was the most common benign tumor (74.8%), followed by myoepithelioma (9.8%). No Whartin's tumor was encountered. The malignant tumors were dominated by adenoid cystic carcinoma (28.8%) followed by mucoepidermoid carcinoma (21.6%). The pattern of distribution of salivary gland tumors in black African population seems to differ from that of Western series in that; i) females are more affected than males, ii) there is a low proportion of tumors from the parotid gland and high proportion of tumors from the submandibular and minor salivary glands, iii) the parotid and minor salivary gland tumors have more probability of being malignant than those tumors from the submandibular gland iv) the newly categorized pathological entities are common and v) Whartin's tumor is extremely rare in black African population.

大唾液腺ならびにその周辺領域の疾患に対するＭＲＩ診断の臨床的研究

The diagnostic value of magnetic resonance imaging (MRI) for lesions situated in the major salivary glands was clinically discussed in this study. A total of 46 patients with salivary gland disorders treated in our department over the past five years were assessed by mean of MRI, and in 11 patients the findings were compared with the histopathological features of lesions sectioned at the same level postoperatively. In addition, preliminary investigations to introduce a new qualitative diagnostic procedure for estimation of salivary gland function in geriatric patients were attempted. In this investigation, T1 and T2 values, and signal intensity ratios of the submandibular gland were measured in elderly patients complaining of dry mouth and in healthy controls. Likewise, salivary gland function was examined by taste stimulation induced by applying citric acid to the tongue surface just before starting MRI. The results of these trials were as follows:1 MRI clearly demonstrated lesions in the salivary glands.2. The histopathological diagnosis could not be accurately predicted by signal intensity. However, benign tumors showed higher intensity signals than did malignant tumors in T2-weighted images.3. Cystic lesions could be differentiated from tumors by signal intensity.4 Histopathological features of salivary gland tumors corresponded to the MRI signal intensity.5. Relaxation times of T1 and T2, values and signal intensity in each major salivary gland were diminished in elderly patients in a resting condition.6. Only T1 values in healthy subjectives remarkably responded to taste stimulation.These results suggest that MRI is useful and beneficial not only in the qualitative diagnosis of tumors arising from salivary glands but also in the estimation of salivary gland function. MRI should therefore be included in routine diagnostic examinations for salivary gland disorders.