Malignant Minor Salivary Gland Tumors Research Articles

Perplexing Intraoral Swellings: A Cross-Sectional Study On Minor Malignant Salivary Gland Tumors

Background: This study aims to assess the prevalence and correlation between age, gender, and site of malignant minor salivary gland tumors among patients attending a tertiary healthcare centre in Trivandrum from 2015 to 2022. A total of 26 cases were reviewed, with mucoepidermoid carcinoma (MEC) being the most prevalent, followed by adenoid cystic carcinoma (ACC) and polymorphous adenocarcinoma (PAC). Our findings suggest a slight female predilection overall, though certain tumor types showed gender-specific trends. The study highlights important epidemiological insights that can help future research and clinical practice inmanaging malignant minor salivary gland tumors.

Malignant Minor Salivary gland neoplasms ofLarynx: Our Experience.

<br><b>Introduction:</b> Malignant minor salivary gland tumors are rare, accounting for fewer than 1% of all laryngeal cancers.</br> <br><b>Aim:</b> This study aims to share our experiences regarding clinical, radiological, pathological profiles and their management.</br> <br><b>Materials and methods:</b> The current study reviews 11 cases of malignant minor salivary gland tumors of the larynx treated surgically at our Institute between 2005 and 2019.</br> <br><b>Results:</b> The mean age of the patients was 54 years (range 38-75 years) with six females and five males in the series (1.2:1). Subglottis and trachea were the sites of origin in 54% of the cases, and hoarseness with dyspnea were the most common presenting symptoms. There were nine Adenoid cystic and two Mucoepidermoid carcinoma patients. Surgery was the primary mode of treatment.</br> <br><b>Conclusions:</b> Most of the larynx's malignant minor salivary gland tumors are submucosal in origin. The outcome and prognosis vary considerably based on the tumor's histology, grade, and stage.</br&gt.

Clinicopathological Analysis of 907 Major and Minor Salivary Gland Tumors.

The frequency and types of salivary gland tumors show significant geographical variations. The most common are primary epithelial tumors, with pleomorphic adenoma and mucoepidermoid carcinoma being the most frequent. This study aims to analyze the clinicopathological data of patients with major and minor salivary gland (MiSG) tumors. The retrospective study included all patients with major and MiSG tumors diagnosed and treated between January 2000 and January 2019. Files of 907 patients were reviewed and investigated for clinicopathologic features of major and MiSG tumors in Serbia. The majority of tumors were of epithelial origin. Pleomorphic adenoma was the predominant type of tumor, with 35.1% among all tumors on all sites. Adenoid cystic carcinoma and mucoepider-moid carcinoma (with 7.1% and 2.7%, respectively) were the most common malignant ones. The most common localization was the parotid gland. Minor salivary gland tumors comprised 16.43% of all salivary gland tumors in our series, the most common localization being the oral cavity. The results of our study are mostly consistent with the results of other previously published studies. The most important finding, worth emphasizing, is that the most common malignant major and MiSG tumor in our population is adenoid cystic carcinoma, rather than mucoepidermoid carcinoma, in all investigated localizations. In addition, the nasal cavity is the most common localization among malignant MiSG tumors.

UNUSUAL LIP TUMORS: A CASE SERIES

<h3>Background</h3> The majority of isolated persistent lip swellings are attributed to mucoceles. However, minor salivary gland neoplasm must be included in the differential diagnosis, particularly with upper lip swellings. Benign pleomorphic adenomas are the most frequent labial mucosa neoplasm; however, other benign and malignant tumors may also develop in the lips. <h3>Objective</h3> To demonstrate the rare and unusual neoplasms that may present in this area. <h3>Methods</h3> Our 5-year retrospective review of oral pathology reports identified 8 unusual neoplasms within the labial mucosa. Clinical case note review was conducted to identify patient demographics, presenting complaints, medical and social histories, diagnoses, and treatment. <h3>Results</h3> The patients were aged from 8 to 73 years old. Clinically, all lesions were described as well-defined submucosal swellings; however, their sizes ranged from 2 mm to 15 mm. Common clinical differential diagnoses included mucocele and lipoma. The histopathologic diagnoses included 2 cases of schwannoma and 1 case each of basal cell adenoma, papillary cystadenoma, canalicular adenoma, granular cell tumor, and myxoid neurothekeoma. One malignant secretory carcinoma was also identified in a child. All lesions were excised and monitored postoperatively, with the malignant neoplasm requiring a second surgery to gain complete excision. <h3>Conclusions</h3> This review demonstrates the interesting and unusual pathologies that may arise within the labial mucosa. It highlights the importance of performing biopsy of persistent swellings in both adult and pediatric patients to confirm the diagnosis. Although rare, malignant minor salivary gland tumors can occur within labial mucosa, and early histopathological diagnosis and surgical removal can significantly improve prognosis.

Imaging of Malignant Minor Salivary Gland Tumors of the Head and Neck.

Minor salivary gland carcinomas (MSGCs) are nonminor tumors in the head and neck region and account for about half of all salivary gland carcinomas. Imaging evaluation based on the anatomy of minor salivary and mucous glands in the head and neck region as well as invasion patterns in each site helps in identifying optimal treatment modalities and planning suitable treatment strategies. MSGCs can be divided radiologically into localized and invasive subtypes on the basis of the clinical utility of such categorization. Characteristic invasion patterns of the invasive type include deep submucosal extension, bone marrow infiltration, and perineural spread, which are difficult to assess clinically. MSGCs easily invade adjacent structures because of their submucosal location and may spread along the muscles, nerves, periosteum, and dura mater. Moreover, the tumor may spread into the bone marrow without obvious bone destruction. In addition to imaging classification, examining the anatomy and distribution of the minor salivary glands, including the palatal, lingual, buccal, labial, and retromolar glands, as well as other mucous glands, including the glands of the sinonasal cavity and nasopharynx, lacrimal glands, ceruminous glands, laryngeal glands, and tracheal glands, facilitates MSGC diagnosis and tumor extension assessment. The authors review the precise anatomy of the minor salivary and mucous glands in the head and neck region, discuss the MSGC imaging classifications, and describe how to evaluate the extent of MSGCs in each site on the basis of the imaging classification and invasion patterns. ©RSNA, 2020.

Primary Epithelial Minor Salivary Gland Tumors in South Africa: A 20-Year Review.

Minor salivary gland tumours represent 9-25% of all salivary gland tumours. South African epidemiological reports on minor salivary gland tumours are lacking. This study aims to evaluate the frequency, epidemiology and histology of minor salivary gland tumours in a defined South African population from 1997 to 2016. This cross sectional retrospective review of epithelial minor salivary gland neoplasms recorded patient demographic data: prevalence, age, gender, site, histology. There were 553 benign (57%) and malignant (43%) minor salivary gland tumours, in patients between the ages of 9 and 93years. There was no significant age (p = 0.64) or gender (p = 0.18) difference between males and females. Common histologic types of salivary gland tumours in the continually evolving spectrum were pleomorphic adenoma (52%), adenoid cystic carcinoma (12%) and mucoepidermoid carcinoma (10%). Common sites were the palate (56%), cheek (11%), lip (9%) and paranasal sinuses (7%). Minor salivary gland tumours represent 2.3% of head and neck pathology. Although this prevalence is higher than reported, there is no overall increase in number diagnosed per year. Minor salivary gland tumours were more prevalent in females. Benign tumours occurred at a younger age than malignant tumours. This study serves as a baseline for future studies, especially in South Africa.

Buccal Myomucosal Flap Reconstruction After Resection of Palatal Mucoepidermoid Carcinoma

Salivary gland tumors are rare, constituting approximately 0.5% of pediatric malignancies, yet account for over 50% of malignant salivary gland neoplasms, of which a majority are mucoepidermoid carcinomas (MECs). We present a case of MEC involving the palatal minor salivary gland of an adolescent patient successfully reconstructed using buccal myomucosal flap. The subject presented as a 17-year-old male with a painless left hard palatal mass found to have imaging suspicious for minor salivary gland tumor and punch biopsy consistent with a low-grade MEC. The subject underwent wide local excision of a 1.0 × 1.2 cm mass with 1.0 cm margins down to hard palate nasal mucosa excluding the abutting first and second molars of the ipsilateral maxilla. Pathology confirmed low-grade MEC confined to hard palate. Two weeks, thereafter, the subject underwent buccal myomucosal flap reconstruction inset into the palatal defect and divided 2 weeks thereafter. Postoperative course was complicated by a pinpoint oronasal fistula at the posterior aspect of the flap-palate junction requiring reelevation and advancement. The subject subsequently recovered without complication. Mucoepidermoid carcinomas represent rare, malignant minor salivary gland tumors with nonspecific presentations that require multidisciplinary workup and management. The authors recommend reconstruction of resultant palatal defects to prevent progression to oronasal fistulae or speech and swallow impairment.

Developmental localization of syntaxin 1 and synaptosomal‐associated protein 25 in rat palate

IntroductionThe palate, which plays an important role in oral cavity function, including the mastication and swallowing of food, obviously differs structurally with feeding habits. Nevertheless, the palate is considered the most common location of both benign and malignant minor salivary gland tumors. Soluble N‐ethylmaleimide‐sensitive fusion protein attachment protein receptor (SNARE) proteins are important in the control of tumorigenesis through the regulation of multiple signaling and transportation pathways. However, the developmental distribution of SNARE proteins on the palatal structures has been scarcely reported. Therefore, this study aimed to investigate SNARE proteins, syntaxin‐1, synaptosomal‐associated protein of 25 kDa (SNAP‐25) during the development of rat palates.Materials and MethodsImmunohistochemistry for protein gene product 9.5 (PGP 9.5), a pan‐neuronal marker, syntaxin‐1 and SNAP‐25 was performed on frozen sections of rat palatal tissues at different stages.ResultsPGP 9.5 immunoreactive fibers (IRF) were present in developing palate. They were observed along the palatal sub‐epithelial layer and the underlying connective tissues in association with developing acini, ducts, blood vessels. Nerve fibers containing syntaxin‐1 and SNAP‐25 showed similar distribution to PGP 9.5 and thick bundles of nerve fibers were observed with smooth muscles and varicoses. With maturation after postnatal day 7 (PN7), thin nerve fibers containing PGP 9.5 and SNAP‐25, but less syntaxin‐1, were detected penetrating into the epithelium, reaching beneath the cornified layer. They ramified out from subepithelial thick bundles into connective tissues until encircling the secretory units observed (PN21). In adults, the number of syntaxin‐1‐IRF was low in comparison with SNAP‐25 and PGP 5 fibers.ConclusionThe findings indicated the importance of SNARE proteins during the maturation of the palatal tissues.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Jaw pain secondary to atypical maxillary torus near the incisive canal: A cone beam computed tomography study

Pain in the anterior maxilla can be odontogenic or nonodontogenic. If it is not related to the teeth, then the differential diagnosis is based on a clinical exam, radiographic exam, and often, on advanced imaging. This case report is based on a 58-year-old male with a chief complaint of chronic pain with acute exacerbations in the region of the rugae of the maxillary central incisors. Clinical examination and planar radiography led to the suspicion of a cyst in the region of the incisive foramen. The patient was referred for advanced imaging. Cone beam computed tomography imaging confirmed the presence of an unusual tori in the region of the incisive foramen that led to periodic inflammation in the region. A differential diagnosis of the pain included pain secondary to a localized inflammation of the incisive canal and nasopalatine duct, and an inflammation of the soft tissue interdental col in the region of the central incisors as well as the benign and malignant minor salivary gland tumors. Because the rugae is attached to the palate, any expansion of the soft tissues in this region causes pain that must be diagnosed accurately to treat the cause.

Mucoepidermoid Carcinoma of Hard Palate in a Pediatric Case

Salivary gland neoplasms are rare in childhood. Only 1 to5.5% of minor salivary gland tumours occur in children and adolescents. The most common malignant minor salivary gland tumours are mucoepidermoid carcinomas (MECs). Herein, we present a rare case of mucoepidermoid carcinoma occuring in the hard palate. Presentation of Case: A 12-year-old boy visited our hospital with a swelling and ulceration of the right hard palate. Clinical examination revealed a localized mucosal nodule of the right posterior hard palate, measuring 1*1 cm. Biopsy was performed. The tumour was diagnosed as a low grade MEC. Wide excision was performed. The patient didn’t need another therapy. During 15-month follow-up, the patient showed no evidence of local tumour recurrence or metastasis. Discussion: Mucoepidermoid carcinoma occurring in the oral cavity is extremly rare. These tumours are usually presenting as a painless, reddish-purple nodule. Biopsy is necessery for definitive diagnosis. Histologically, MECs are divided into low, intermediate and high grade subtypes. Differantial diagnosis of palatal tumours in children include pleomorphic adenoma, benign or malignant mesenchymal tumours, and less commonly giant cell granuloma. A wide local excision with safe free margins is the operative procedure for low-grade MECs.

Malignant minor salivary gland tumors: A retrospective study of 28 cases: Clinical experience of a single institution

Purpose: This retrospective study was done to report our experience with the management of patients with primary malignant tumors of minor salivary glands that were treated with various combinations of surgery, radiation, and chemotherapy and to review treatment outcome. Methods: The records of all patients with malignant minor salivary gland tumors presenting for treatment at our department between 2000 and 2010 were retrospectively reviewed. Variables were collected and outcome measures were defined in terms of overall survival, disease-free survival. Descriptive statistics were compiled and statistically evaluated. Survival was described using the Kaplan-Meier method. Results: Twenty eight patients (10 males and 18 females) ranging in age from 18 to 80 years (median, 64 years) met the criteria for inclusion in the study. The majority of tumors were located in the oral cavity (n = 20), followed by nasal cavity and paranasal sinuses (n = 8). Adenoid cystic carcinoma was the most common neoplasm (n = 18). All patients were treated with surgery as the primary modality. Neck dissection was performed in 18% of patients, and all patients (n = 28) were treated with adjuvant external beam radiation therapy to a dose of 50 to 60 Gy. The disease-free survival rate and overall survival at 5 years were 80% and 85%, respectively. Conclusion: Postoperative radiation therapy is effective in preventing local recurrence in most patients with minor salivary gland tumors after gross total excision.

Frequency and Distribution Pattern of Minor Salivary Gland Tumors in a Northeastern Chinese Population: A Retrospective Study of 485 Patients

The relative frequency of individual minor salivary gland tumors (MSGTs) is not well documented in the literature. The aim of this study was to determine the range and demographics of all histologically diagnosed MSGTs in a northeastern Chinese population. A total of 485 cases of MSGT were retrospectively studied. The files of the Department of Oral and Maxillofacial Pathology, School of Stomatology, China Medical University served as a source of material for this study. All epithelial tumors from minor salivary glands accessioned from August 2004 to April 2014 were analyzed for demographic features, anatomic location of tumors, and pathologic classification. Tumors were classified according to the 2005 World Health Organization classification of salivary gland tumors. Statistical analysis was performed using analysis of variance. MSGTs were identified in 485 (2.60%) of 18,670 accessed cases. There were 268 (55.26%) benign and 217 (44.74%) malignant tumors. Female outnumbered male patients (male-to-female ratio, 1:1.43). The mean ages of patients with benign and malignant MSGTs were 47.58 and 51.51 years, respectively. Pleomorphic adenoma and adenoid cystic carcinoma were the most frequent types of benign and malignant tumors, respectively. The palate was the most commonly affected site (64.74%), followed by the buccal mucosa (7.63%) and the tongue (5.98%). From the results of this study and a review of the literature, it is suggested that MSGTs in the northeastern Chinese population may be characterized by a higher incidence of MSGTs than in the populations of other reviewed regions, a higher incidence of myoepithelioma, a rarer occurrence of polymorphous low-grade adenocarcinoma, and an absence of canalicular adenoma occurrence.

Polymorphous low-grade adenocarcinoma: an analysis of epidemiological studies and hints for pathologists

BackgroundThis study is an analysis of the prevalence of polymorphous low grade adenocarcinoma (PLGA) in epidemiological surveys of salivary tumors published in the English language from 1992 to 2012.MethodsThese surveys included studies from different researchers, countries and continents. The 57 surveys for which it was possible to calculate the percentage of PLGAs among all malignant minor salivary gland tumors (MMSGT) were included in this review.ResultsThe statistical analyses show significant differences in the PLGA percentage by time period, country and continent in the studies included in this review. The percentage of PLGAs among MMSGTs varied among the studies, ranging from 0.0% to 46.8%. PLGA rates have varied over the period studied and have most recently increased. The frequency of reported PLGA cases also varied from 0.0% to 24.8% by the country in which the MMSGT studies were performed. The PLGA percentages also varied significantly by continent, with frequencies ranging from 3.9% in Asia to 20.0% in OceaniaConclusionBased on these results, we concluded that although the accuracy of PLGA diagnoses has improved, they remain a challenge for pathologists. To facilitate PLGA diagnoses, we have therefore made some suggestions for pathologists regarding tumors composed of single-layer strands of cells that form all of the histological patterns present in the tumor, consistency of the cytological appearance and uniformly positive CK7, vimentin and S100 immunohistochemistry, which indicate a single PLGA phenotype.Virtual slideThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1059098656858324

Characteristics, management of the neck, and oncological outcomes of malignant minor salivary gland tumours in the oral and sinonasal regions

The aim of this study was to evaluate the characteristics of malignant tumours of the minor salivary glands in the oral and sinonasal regions, to make sure that the neck was managed correctly, and to identify oncological outcomes, retrospectively, at a single hospital. A total of 60 patients were reviewed. Forty-nine patients had intraoral lesions and 11 had sinonasal lesions. Of the 60 patients, 28 had stage I to II malignant tumours, and 32 had stage III to IV tumours. Treatment was almost exclusively surgical. One of the 16 patients whose nodes were clinically clear had an elective neck dissection. Adjuvant radiotherapy was given if indicated. The mean follow-up period was 52 months (range 13–190).Sinonasal lesions were all advanced T-stage at diagnosis, had more invaded resection margins, and a higher local recurrence rate than intraoral lesions. There was no regional recurrence in those patients whose nodes were clinically invaded and who had therapeutic neck dissection, or in the patient whose nodes were clinically clear and who had an elective neck dissection. Occult metastases developed exclusively in adenoid cystic carcinomas (ACC), the rate of which was 4/16. Regional recurrence developed in 4 patients who had never had elective treatment to the neck 2 of whom mixed pattern ACC and 2 who had low grade mucoepidermoid carcinomas (MEC). The overall survival was 90% at 2 years, 77% at 5 years, and 74% at 10 years.Sinonasal minor salivary gland tumours require careful follow-up because resection margins are more likely to be invaded by tumour, and they have a higher local recurrence rate than intraoral lesions. Elective neck dissection is needed, particularly for MEC and also to prevent regional recurrence in ACC.

Minor Salivary Gland Tumours of Upper Aerodigestive Tract: A Clinicopathological Study

The aim of this retrospective study of 56 patients with minor salivary gland tumours (MSGTs) of the upper aerodigestive tract is to present demographic features, distribution of tumours as well as methods and results of treatment performed in our institution over a 10-year period. Of 221 patients with salivary gland tumours, 56 patients with MSGT were selected. There were 36 female and 20 male patients aged from 8 to 81 years. Male-to-female ratio was 1 : 2 in the group of benign MSGT and 1 : 1.7 in the group of malignant tumours. The palate was the most frequent site of MSGT (45.6%), followed by buccal mucosa (19.3%). Of all MSGTs 63.2% were malignant, and 36.8% were benign. Adenoid cystic carcinoma was the most common neoplasm (31.6%), followed by pleomorphic adenoma (29.8%). Surgery was the method of choice in the treatment of patients with MSGT. Postoperative defects were reconstructed by prosthetic obturators, local flaps, and free radial forearm flap. Relative survival for patients with malignant MSGT was 88% at three years and 71.5% at five years. MSGTs are more frequent in females and predominantly affect the palate. Malignant MSGTs are more common than benign.

P41. Carcinoma ex pleomorphic adenoma in a minor salivary gland of the upper lip

Introduction: We present the first case report of carcinoma ex pleomorphic adenoma (CXPA) arising in a minor salivary gland of the upper lip.Methods: We present the case of a 55 year old female with CXPA in an unusual site and a literature review of the relevant issues.Results: A 55 year old female presented with a 30 year history of a painless lump in her upper left labial sulcus. An excisional biopsy revealed a yellow glistening mass that appeared to be well encapsulated. Histopathology review identified features of CXPA.A wide local excision and local flap repair was undertaken. Microscopically no residual tumor was identified. The case was discussed at the local head and neck multidisciplinary team meeting, and owing to the small volume of disease and wide margins, it was agreed that radiotherapy was not indicated. At 18 months the patient remained disease free.Discussion: Oral lumps are common and are often given low priority by patients, as demonstrated in this case. Unfortunately the longer a pleomorphic adenoma (PA) remains untreated, the greater the risk of malignanat transformation to CXPA. Johns and Goldsmith report a 1.6% incidence of malignant transformation in tumors of 5 years duration compared with 9.4% in tumors present for 15 years. This highlights the importance of early surgical review and definitive treatment of PAs.A wide surgical excision with adequate margins is essential for a favorable outcome in patients with malignant minor salivary gland tumors. Postoperative radiotherapy is reserved for patients with high grade tumor histology, large primary lesions, perineural invasion, bone invasion, cervical lymph node metastasis, and positive margins, although clear-cut survival advantage has not been proven. Recurrence, especially regional and distant metastases, portends an extremely poor prognosis.Although this case had a favorable outcome, it highlights the need for early surgical review and management of oral lesions of uncertain and/or unpredictable nature. Patients with known or suspected PA should be encouraged to undergo definitive surgical treatment early in their disease to avoid malignant transformation to CXPA at a later date.

A Retrospective Review of Malignant Minor Salivary Gland Tumors and a Proposed Protocol for Future Care

Malignant tumors affecting minor salivary glands present a wide range of histopathologic types. The present study sought to design a protocol for management of patients with malignancy of minor salivary glands. The data of 22 patients with malignant tumors of the minor salivary glands, surgically treated at our department in the past 10 years, were accumulated and studied. All patients underwent a diagnostic workup prior to surgery. The most useful examinations were magnetic resonance imaging of the head and neck and computerized tomography of the thorax. Wide local excision was sufficient for the majority of patients. Adjuvant treatment is indicated for high-grade, tumor-positive lymph nodes and residual disease. Malignant tumors of minor salivary glands are very rare. Therefore, design of management protocols is challenging. Management of the neck is necessary in evidence of metastasis and in high-grade and advanced-stage disease. Adjuvant treatment should be included in the treatment protocol in certain indications. Most importantly, long-term follow up is very important for all patients with malignant minor salivary tumors.

Factors Predicting Outcome in Malignant Minor Salivary Gland Tumors of the Oropharynx

to report our experience in the care of patients with minor salivary gland cancers occurring only in the oropharynx and to determine factors predictive of outcome. Retrospective analysis. memorial Sloan-Kettering Cancer Center. sixty-seven patients with malignant minor salivary gland tumors were identified from a preexisting database of patients with cancers of the oropharynx between January 1985 and December 2005. overall survival, disease-specific survival, and recurrence-free survival were calculated by the Kaplan-Meier method. Factors predictive of outcome were identified by univariate and multivariate analyses. the most common histologic types were mucoepidermoid carcinoma in 26 patients (39%), adenoid cystic carcinoma in 16 (24%), adenocarcinoma in 16 (24%), and malignant mixed tumor in 7 (10%). The tumors were located in the base of the tongue in 41 patients (61%), soft palate in 20 (30%), and tonsil in 6 (9%). With a median follow-up time of 86 months (range, 12-249 months), overall outcomes at 5 and 10 years were overall survival, 80% and 53%; disease-specific survival, 87% and 67%; and recurrence-free survival, 69% and 60%, respectively. Tumor recurred in 20 patients (34%); 12 of these patients had locoregional failure and 15 developed distant metastases. Multivariate analyses showed that clinical T stage, anatomic subsite, and margin status were independent predictors for overall survival; T stage and margin status were independent predictors for locoregional recurrence-free survival. clinical T stage, anatomic subsite, and margin status are independent predictors of outcome of patients with minor salivary gland cancers of the oropharynx.

Estrogen receptor overexpression in malignant minor salivary gland tumors of the sinonasal tract

Objectives To identify the expression of estrogen receptors in malignant minor salivary gland tumors of the sinonasal tract. Study Design Case series with chart review. Subjects and Methods A retrospective review of a pathology database identified 17 patients with malignant salivary gland tumors between December 1987 and January 2006. Clinicopathologic data were collected, and immunohistochemical staining for estrogen receptor α and β was performed. Results Among these malignant tumors, adenoid cystic carcinoma was the predominant histologic type. In addition to epistaxis and nasal obstruction, the headache, facial, or ocular symptoms were also commonly noted in this cohort. Seventy-five percent of cases of adenoid cystic carcinoma were positive for estrogen receptor α. In contrast, only 17 percent of cases of adenoid cystic carcinoma were positive for estrogen receptor β. Conclusion Malignant minor salivary gland tumors of the sinonasal tract are rare disease entities. In the present series, adenoid cystic carcinoma was the most common form of tumor, but the prognosis was poor. Most of the cases were positive for expression of estrogen receptor α, which suggests that hormone therapy may have a role in the management of certain minor salivary gland tumors of the paranasal sinus and nasal cavity.

Malignant minor salivary gland tumors of the larynx

To study the clinical features, treatment and prognosis of malignant minor salivary gland tumors of the larynx. Treatment and outcome were retrospectively analyzed in a consecutive series of 15 patients with malignant minor salivary gland tumors of the larynx treated in this hospital from 1959 to 2005. Ten patients (66.7%) had adenoid cystic carcinoma and 2 (13.3%) had adenocarcinoma. The other three patients had mucoepidermoid carcinomas, polymorphic adenocarcinoma and base cell carcinoma respectively. Eleven (73.3%) were located in the supraglottis and 4 (26.7%) in the subglottis. Fourteen had surgery (7 with adjuvant radiotherapy) and one was treated with radiotherapy plus chemotherapy. Five patients were found to have recurrent disease, 4 of whom underwent salvage surgery, 1 of whom had palliation radiotherapy. With a median follow-up of 8 years (ranging from 2 to 16 years), 7 patients are alive. Five patients have no evidence of disease, 1 of whom had surgery alone, 4 of whom were treated with surgery plus radiotherapy. Four patients died of distant metastases in a range of 2 to 10 years. The other 4 patients were lost to follow-up after treatment (ranging from 2 years to 16 years). Seven patients developed recurrent disease, 1 of whom had local recurrence alone, 1 had regional recurrence alone, 2 had distant metastases alone, and 3 had local and distant metastases. Minor salivary gland carcinomas of the larynx are rare and they are prone to the local recurrence and the distant metastasis in advanced stage. Distant metastases remain the principal cause of treatment failure. Surgery is the primary treatment modality used in most cases and the radiotherapy combining surgery has better local and regional control rate.