Intraoral Minor Salivary Gland Research Articles

A clinicopathologic study of 1,047 cases of salivary gland tumors in Thailand.

The objective of this study was to analyze the clinicopathologic data of salivary gland tumors in Bangkok, Thailand. Cases diagnosed with salivary gland tumors were retrieved from a dental school and a medical school in Bangkok, Thailand. Clinicopathologic data were recorded and analyzed with respect to gender, age, site, and histologic type. Of the 411,851 cases, 1,047 salivary gland tumors (0.2%) were found. The male to female ratio was 1:1.2. The age of patients ranged from 1 to 88 years with an average age of 47.1 years. 721 cases were benign tumors (68.8%) while 326 cases (31.2%) were malignant tumors. The parotid gland was the most common site (62.7%), followed by the submandibular gland (18.8%), and the intraoral minor salivary glands (18.0%). Among the intraoral minor salivary glands, palate was the most common site (49.2%). The most common benign and malignant tumors were pleomorphic adenoma and mucoepidermoid carcinoma. Salivary gland tumors are rare. Compared with Western countries, the prevalence of polymorphous low-grade adenocarcinoma (PLGA) in Southeast Asia is low. Data from this study may be helpful for dentists in making differential diagnoses.

Pitfalls in the biopsy diagnosis of intraoral minor salivary gland neoplasms: diagnostic considerations and recommended approach.

Department of Diagnostic Pathology and Laboratory Medicine Beth Israel Medical Center St Luke’s and Roosevelt Hospitals New York, NY The author has no funding or conflicts of interest to disclose.

口腔小唾液腺腫瘍73症例の臨床統計学的検討

口腔小唾液腺腫瘍73症例の臨床統計学的検討

Primary lymphoepithelial carcinoma of the intraoral minor salivary gland: A case report.

Lymphoepithelial carcinoma (LEC) of salivary gland origin is a rare malignant tumor with morphological characteristics identical to those of undifferentiated nasopharyngeal carcinoma. It has a marked racial predilection for Inuit and Southeast Asian populations. An association between LEC and Epstein-Barr virus (EBV) infection has previously been reported. LEC most frequently affects the parotid gland, followed by the submandibular glands. To the best of our knowledge, only three LECs arising from the minor salivary gland have been previously described in the English language literature. The current study reports a case of EBV-associated LEC of the minor salivary gland in the hard palate of a 38-year-old Chinese female, and reviews the clinicopathological characteristics of this uncommon tumor.

Mucoepidermoid carcinoma of the anterior maxilla: A rare entity

Mucoepidermoid carcinoma is the second most common salivary gland tumor primarily involving major salivary glands and intraoral minor salivary glands. Although rare, it can occur in the jaw bones, but it is very rare in the maxillary anterior region. Here, we present a case of mucoepidermoid carcinoma occurring in maxillary anterior region in a 33-year-old male patient presented as painless swelling clinically appearing similar to a periapical or nasopalatine cyst. The final diagnosis of this lesion was made after microscopic examination of biopsy specimen.

Oncocytoma of minor salivary gland involving the retromolar region: A rare entity

Oncocytic neoplasms comprise a group of rare tumors of salivary glands. Histologically, World Health Organization (WHO) (1991) classified them into three distinct types: Oncocytosis, oncocytoma and oncocytic carcinoma. Oncocytoma is also known by the more descriptive and less confusing terms of oxyphilic adenoma and oxyphilic granular cell adenoma. Oncocytoma is a rare benign salivary gland neoplasm composed of large epithelial cells with characteristic bright eosinophilic granular cytoplasm (oncocytic cells). It accounts for approximately 0.4-1% of all salivary gland neoplasms, occurring primarily in parotid glands, with only a small percentage occurring in minor salivary glands of palate, tonsillar fossi, larynx, nasal cavity, maxillary sinus and the lacrimal gland. It occurs primarily in persons older than 50 years of age. According to some authors, the biologic behavior of oncocytomas arising from minor salivary glands is that of an aggressive nature and should be considered as low-grade malignancies. Only 17 cases of histologically verified oncocytoma of an intraoral minor salivary gland are reported in literature, the current case being the 18th. Owing to the lack of large series, assiduous study of the cases reported in the literature may lead to better understanding of this rare entity. We herein describe a rare and probably the first case of minor salivary gland oncocytoma involving retromolar area in a 32-year-old female patient with a brief review of literature.

Pitfalls in the Biopsy Diagnosis of Intraoral Minor Salivary Gland Neoplasms

Among the more common types of intraoral minor salivary gland neoplasms are pleomorphic adenoma, basal cell adenoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma. These minor salivary gland neoplasms share similar morphologic features and to a large extent immunohistochemical findings. Differentiation between these benign and malignant neoplasms is often predicated on the presence or absence of invasion. As such, in the presence of limited tissue sampling that typifies the initial testing modalities, including fine needle aspiration biopsy and/or incisional biopsy, it often is not possible to differentiate a benign from malignant minor salivary gland neoplasm. The diagnostic difficulties arise from the absence in needle or incisional biopsy of the tumor's periphery to determine whether infiltrative growth is or is not present. In this manuscript we discuss limitations and considerations associated with evaluation of incisional biopsies of intraoral minor salivary gland tumors. We offer a diagnostic approach to evaluating these biopsies, and suggest diagnostic terminology for biopsy specimens in which distinction between benignancy and malignancy is not feasible. The pathologist's approach to this distinction is critical, as treatment of benign neoplasms is generally conservative, whereas malignant lesions may warrant more aggressive management.

Intraoral minor salivary gland tumours: a retrospective study from a dental and maxillofacial surgery centre in salem, Tamil Nadu.

Minor salivary gland tumors (MSGTs) constitute a heterogeneous group of neoplasms with variation in histopathology. These are rare neoplasms usually occurring in the palate. Dental examination may provide an opportunity for early detection. This study was undertaken to do an epidemiological survey of minor salivary gland tumours reporting to a single dental and maxillofacial surgery centre and to determine the correlation of the histopathologic characteristics with the clinical features. A retrospective survey of the histopathological findings of 1,020 consecutive biopsy reports in a single dental and maxillofacial surgery centre was done to identify cases of MSGT. The results were tabulated based on various criteria. In our study, only 8 tumors were benign (26.67%), and 22 tumors were malignant (73.33%). Mucoepidermoid carcinoma (MEC) was the most common tumor (15 of 30). Pleomorphic adenoma was most common benign MSGT in our series (7 of 30). This was followed by adenoid cystic carcinoma (6 of 30). Palate was the most common site (13 of 30) followed by buccal mucosa (5 of 30) and lip (4 of 30). Unlike many previous studies, malignant salivary gland tumours were predominant. MEC was the most common malignant tumour in our study similar to many other studies. The palate was the most common site for minor salivary gland neoplasms.

Myoepithelial carcinoma of the retromolar area with extensive mandibular involvement

Myoepithelial tumors were first described in 1943, and account for less than 1% of all salivary gland neoplasms. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al. in 1975 and represents a very rare entity, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. However, there have been few reports on myoepithelial carcinoma affecting intra-oral minor salivary glands, and its immunohistochemical features have been poorly illustrated. We herein describe a rare case of myoepithelial carcinoma affecting the retromolar region of a 52-year-old woman that caused extensive mandibular bone destruction. We also reviewed the English literature concerning the involvement of intra-oral minor salivary glands by myoepithelial carcinoma.

Adenoid cystic carcinoma of the buccal mucosa: A case report and review of the literature

Adenoid cystic carcinomas are deceptive malignancies that show slow growth and local invasion with recurrences seen many years after diagnosis. Upto 50% of these tumors occur in the intraoral minor salivary glands usually in the hard palate. Buccal mucosal tumors are relatively rare. We determined the incidence of buccal mucosal adenoid cystic carcinoma by reviewing the number of reported cases in the literature. This is the first article to analyze the occurrence of adenoid cystic carcinomas in the buccal mucosa through a review of 41 articles. Our review revealed 178 buccal mucosal adenoid cystic carcinomas among a total of 2,280 reported cases. We present a case of adenoid cystic carcinoma occurring in the left buccal mucosa of a 45-year-old female.

A clinical study on 45 cases of intraoral minor salivary gland carcinoma

2001年4月から2011年3月までに当科で加療した口腔内小唾液腺癌45例の臨床的検討を行った。原発部位は，頬粘膜が13例と最も多く，次いで8例の口底であった。病期は，stage I 16例，stage II 13例，stage III 3例，stage IVA 12例，stage IVB 1例であった。病理組織学的には，粘表皮癌が最も多く22例で，次いで腺様嚢胞癌13例，多型低悪性度腺癌4例の順に多かった。初回治療として，放射線療法を施行した1例を除く44例に手術療法を施行した。原発巣再発は粘表皮癌4例，腺様嚢胞癌1例，腺癌NOS 1例に認めた。原発巣再発を認めた粘表皮癌4例のうち，高悪性度は2例（40.0%），中悪性度は1例（20.0%），低悪性度は1例（9.1%）で，追加手術により中悪性度・低悪性度の2例は救済された。頸部郭清術は16例に施行し，頸部再発は高悪性度および中悪性度粘表皮癌に1例ずつ認め，追加手術により中悪性度症例は救済された。原発腫瘍・頸部が制御された上で肺転移を認めた症例は腺様嚢胞癌の3例で，いずれも原病死した。小唾液腺癌45例の5年および10年疾患特異的生存率は90.1%および66.9%であった。以上より，原発巣再発の多い高悪性度粘表皮癌では十分な安全域の設定が必要であり，腺様嚢胞癌においては肺転移に対する新規治療法の確立が必要と考えられた。

Sclerosing Polycystic Adenosis of the Nasal Septum: The Risk of Misdiagnosis

Sclerosing polycyctic adenosis (SPA) is a rare lesion of unknown etiology morphologically resembling fibrocystic changes of the breast. To date, approximately 41 cases of SPA have been reported. Most cases of SPA have originated in the parotid and submandibular glands, with a few cases of intra-oral minor salivary gland origin. This is the first reported case of sclerosing polycystic adenosis of nasal minor salivary gland origin. The differential diagnosis of SPA includes polycystic disease, sclerosing sialadenitis, and benign and malignant glandular neoplasias. Although atypia ranging from mild dysplasia to carcinoma in situ can occur in some cases, SPA has a favorable outcome. It is important to be familiar with SPA to avoid aggresive treatment that results from a misdiagnosis. We present a case of a 49-year-old man who had 1-year history of right nasal obstruction.

P106. A retrospective analysis of salivary gland neoplasms: Our experience

Introduction: Salivary gland neoplasms represent less than 1% of all tumours and 3.5% of all head and neck neoplasms. They constitute a heterogeneous group of neoplasms characterized by a broad range of histological types. The purpose of this study was to analyze the relative frequency and distribution of salivary gland tumours and to provide data with reference to age, sex and the distribution of these tumours reported in the Department of Oral Pathology, V.S. Dental College and Hospital, Bangalore, South India from 1997 to 2010. Methods: Salivary gland tumours were retrieved from the pool of oral biopsy specimens submitted to the Department of Oral Pathology, V.S. Dental College and Hospital, Bangalore. The data pertaining to age, sex, location and histopathological types of these tumours was collected. Results: Of the total biopsies retrieved during the 13-year period (1997–2010), there were 33 cases of salivary gland tumours. Of these, only 2 cases (6.06%) presented in the submandibular gland and the remaining 31 cases occurred in the intra-oral minor salivary glands. The demographic distribution of these tumours is illustrated in the table given below. Histopathological analysis showed that of the 33 cases, 11 cases (34.4%) were Mucoepidermoid carcinoma, and 2 of these were high grade tumours. There were 9 cases of adenoid cystic carcinoma (28.1%), 8 cases of pleomorphic adenoma (25%) and 1 case each of Polymorphous low grade adenocarcinoma, salivary duct carcinoma and canalicular adenoma. The distribution of the above cases is illustrated in the following pie chart (Table 2). Discussion and conclusion: This retrospective study, over a period of 13 years, evaluates the clinical and histopathological characteristics of salivary gland tumours retrieved from the archives of our department with respect to age, sex and site distribution of tumours. Each neoplasm showed variation in age, sex, and site distribution. The majority of the neoplasms were intra-oral in location. Moreover, rare variants were also encountered. Of the 33 tumours, 17 cases were treated by wide surgical excision, some in combination with adjuvant therapy.

A Clinicopathologic Study of 82 Intraoral Minor Salivary Gland Tumors

Intraoral minor salivary glands tumors (MSGT) are uncommon, with geographic variations in frequency and distribution. This study analyzed the clinic-pathologic features of these tumors in Shiraz, southern Iran. All of cases histopathologically recorded as epithelial MSGT in Pathology Department of Khalili Hospital from 2002 to 2009 were evaluated with regard to patient's age and gender, tumor location and type, retrospectively. Out of 82 cases of MSGT, 53.7% were benign and 46.3% were malignant. Pleomorphic adenoma and adenoid cystic carcinoma were the most common benign and malignant tumors, respectively. The palate was the most common site of involvement (64.6%). Male to female ratio was 1:1.27. The mean age of the patients was 35.0±17.2 years for benign and 48.8±18.2 years for malignant tumors. MSGTs in the present study represent many characteristics of other studies. However, our patients who were affected by benign tumors were young.

Myoepithelial carcinoma of intraoral minor salivary glands: a clinicopathological study of 7 cases and review of the literature

Myoepithelial carcinoma (MC), also known as malignant myoepithelioma, is a rare malignant salivary gland neoplasm with a predilection for the parotid gland. We present the clinicopathological and immunohistochemical features of 7 cases of intraoral MC in attempt to better understanding this entity. Seven intraoral MCs were retrieved from the files of the Department of Oral Pathology, School of Stomatology, Wuhan University, during a 10-year period. Immunohistochemical markers, including cytokeratin (CK) AE1/AE3, S100, vimentin, smooth muscle actin (SMA), p63, and maspin, were used to further characterize these lesions. A review of contemporary relevant literature is also provided. The patients were 5 women and 2 men, and the age range was 37 to 75 years (mean 57.9 years). Three cases arose in the hard palate, 2 in the retromolar region, and 1 each in the tongue and the floor of the mouth. Histologically, the tumors exhibited a solid architecture with cells arranged in nodules, nests, trabeculae, or cords. The epithelioid cell type is the most frequently encountered, followed by clear cells. The tumor-associated matrix is more prevalent hyalinized than myxoid. Immunohistochemically, CK AE1/AE3, S100, vimentin, p63, and maspin were expressed in all cases. Positivity for SMA was seen in 3 tumors. Five patients with follow-up information showed no evidence of disease after a mean follow-up of 69.6 months (range 22-108 months). Combining the current series with 21 additional cases in the literature indicated that myoepithelial carcinoma of intraoral minor salivary glands is generally a low-grade malignant tumor with little propensity for regional or distant metastasis and low recurrence. Awareness of the clinicopathological and immunohistochemical features of intraoral MC is necessary for accurate diagnosis. Wide local excision with tumor-free margins is the treatment of choice.

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

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.

Low-Grade Mucoepidermoid Carcinoma of the Intraoral Minor Salivary Glands With Cervical Metastasis: Report of 2 Cases and Review of the Literature

Low-Grade Mucoepidermoid Carcinoma of the Intraoral Minor Salivary Glands With Cervical Metastasis: Report of 2 Cases and Review of the Literature

P1.26. Intraoral and oropharyngeal minor salivary gland malignant neoplasms: Review of 315 patients treated in a single institution

P1.26. Intraoral and oropharyngeal minor salivary gland malignant neoplasms: Review of 315 patients treated in a single institution

Pleomorphic Adenoma of the Cheek: A Case Report and Review

Pleomorphic adenoma comprises the majority of both major and minor salivary gland tumors. Intraorally, the palatal glands are most commonly affected, at a frequency ranging from 43% 1 Chaudiary A.P. Vickers R.A. Gorlin R.J. Intraoral minor salivary gland tumours An analysis of 1414 cases. Oral Surg. 1961; 14: 1194 Abstract Full Text PDF Scopus (214) Google Scholar to 70%. 2 Fine G. Marshall R.B. Horn Jr, R.C. Tumours of the minor salivary glands. Cancer. 1960; 13: 653 Crossref PubMed Scopus (61) Google Scholar The cheeks, lips, and gingiva are rarely sites of occurrence. 3 Spiro R.H. Koss L.G. Hadju S.I. et al. Tumours of salivary gland origin A clinicopathological study of 492 cases. Cancer. 1973; 31: 117 Crossref PubMed Scopus (333) Google Scholar It is well-known that pleomorphic adenoma of the major salivary glands may grow to a huge size without significantly affecting the patient. Intraoral tumors, however, are usually treated before reaching large enough dimensions to interfere with speech and deglutition. We treated a case of a fairly large pleomorphic adenoma of the cheek, and we describe this case and review the features of pleomorphic adenoma occurring at this site.

Advanced malignant minor salivary glands tumors of the oral cavity

Intraoral minor salivary gland carcinomas (MSGC) are rare tumors with different frequency, distribution, and prognostic factors relating to overall survival. From 1992 to 2006, a total of 95 patients with MSGC originating in the oral cavity were analyzed by univariate and multivariate analysis using the log-rank test and Cox-regression. Fifty-four percent of all patients had a low-grade disease and 46% had a high grade disease. The 2-, 5-, and 10-year overall survivals were 82%, 73%, and 58%, respectively. The T (P = .007), N category (P = .010), UICC stage (P = .021), and resection margin status (P < .0001) statistically influenced survival, whereas the M status did not (P = .16). Salvage treatment influenced the patients' overall survival significantly (P < .0001). This study confirms that in MSGC salvage surgery and tumor stage correlates well with prognosis. More studies are necessary to confirm prognostic factors and determine the true frequency of MSGC in the oral cavity.