Minor Salivary Gland Tumors Research Articles

Oral Rehabilitation After Surgical Removal of Pleomorphic Adenoma

Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient’s quality of life, allowing the patient’s reinsertion into society, and reducing the surgical treatment sequelae.

Adenoid Cystic Carcinoma: A Case Report

Adenoid cystic carcinoma (ACC) accounts for approximately 10 % of all salivary gland tumors. It is the most common malignant tumor of submandibular and minor salivary glands. The most common location is the palate, generally in the area of the greater foramen. ACC is generally characterized by a slow growth rate, and it is often present for several years before the patient seeks treatment. A 28 year old man reported with a swelling on the left side of palate since one and a half years which was diagnosed histopathologically as ACC. A detailed description of the case along with review of literature is presented here with an aim to focus on the importance of detailed or advanced investigations as in the present case. Keywords: Salivary gland tumors, Computed Tomography, Swiss cheese.

Pleomorphic adenoma of the buccal salivary gland: magnetic resonance imaging findings with differential diagnoses

The majority of minor salivary gland tumors are malignant. Of the benign tumors, pleomorphic adenomas are most common. The cheeks, lips, and gingiva are rarely sites of occurrence. A case of pleomorphic adenoma of the buccal salivary gland is presented here with a discussion of the importance of magnetic resonance imaging in demonstrating the extent of the lesion and establishing a differential diagnoses.

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.

Salivary gland tumours: 25 years of experience from a single institution in Croatia

IntroductionThe aim of this study was to determine the types, frequency, distribution, and demographic characteristics of salivary gland tumours in a large representative sample. Patients and methodsWe retrospectively analysed the medical records of 779 patients with tumours of the salivary glands surgically treated from 1985 to 2009 at a single institution. ResultsThere were 500 benign and 279 malignant tumours. The average age of patients with benign tumours was 50 years and of malignant salivary gland tumours 56 years. No differences in age and incidence of tumours existed between males and females. The majority of the tumours occurred in the parotid gland (509), followed by the minor salivary glands (212), the submandibular gland (51) and lastly, the sublingual gland (7). Minor salivary gland tumours occurred most frequently on the palate, the pleomorphic adenoma being the most frequent benign tumour type and the adenoid cystic carcinoma being the commonest malignant tumour. Tumours of the sublingual gland were rare, but all were malignant. Malignant tumours were more common in the minor salivary glands and the submandibular gland. ConclusionThis large study of salivary gland tumours in Croatia could improve our understanding of the significant differences in the global distribution of salivary gland tumours which have been reported.

Immunohistochemical assessment of CD1a‐positive Langerhans cells and their relationship with E‐cadherin in minor salivary gland tumors

The aim of this study was to investigate the presence of CD1a-positive Langerhans cells and their relationship with E-cadherin in minor salivary gland tumors. Twenty-seven minor salivary gland tumors were investigated using immunohistochemistry for CD1a and E-cadherin. A significant difference regarding the mean density of CD1a-positive Langerhans cells was observed between pleomorphic adenomas and malignant tumors studied (P = 0.001). No CD1a-positive cells were detected in most cases (n = 5) of cystic adenoid carcinomas. CD1a-positive cells were detected in one mucoepidermoid carcinoma case, and six low-grade polymorphous adenocarcinomas cases. Comparison of the mean density of CD1a-positive cells between the three malignant tumors showed no significant difference (P = 0.127). No significant difference was observed in the presence of E-cadherin between tumors (P = 0.73), but it was detected in 24 cases. The lack of CD1a-positive in malignant salivary gland tumors facilitates the neoplastic development and suggests that these cells might be useful as auxiliary diagnostic and prognostic tool in minor salivary gland tumors. Furthermore, it is suggested that E-cadherin mediates cell adhesion in these tumors although we did not demonstrate significance.

Adenoid cystic carcinoma of the head and neck (ACCHN) incidence and survival trends.

5580 Background: Adenoid cystic carcinoma (ACC) is a rare tumor of minor salivary, parotid, and submandibular glands. The biological behavior of the disease is poorly understood, and treatment stra...

Unique presentation of adenoid cystic carcinoma in postcricoid region: a case report and review of the literature

Malignant tumors of minor salivary glands are uncommon, representing only 2-4% of all head and neck malignancies. In the larynx, minor salivary gland tumors rarely occur and constitute less than 1% of laryngeal tumors. Most of the minor salivary gland tumors arise in the subglottis; however, they can also occur in the supraglottis in the false vocal cords, aryepiglottic folds, and caudal aspect of the epiglottis. The most common type of malignant minor salivary gland tumor is adenoid cystic carcinoma. In the last 20years, only 40 cases of adenoid cystic carcinoma arising in variable locations of the larynx have been reported in the English language literature. We present a case of adenoid cystic carcinoma of the larynx arising in the inter-arytenoid and postcricoid region in a 54-year-old woman. To our knowledge, this is the first case of adenoid cystic carcinoma arising in this particular region of the larynx.

Transoral Robotic Surgery for Tongue-Base Adenoid Cystic Carcinoma

i s c p p f s Adenoid cystic carcinoma (ACC) is a well-known salivary gland tumor, with a much lower occurrence rate on the tongue base. ACC accounts for 1% to 2% of all head and neck malignancies. This report presents a case of a 56-year-old man with ACC on the tongue base. To our knowledge, this is the first report of the use of transoral robotic surgery (TORS) for tongue-base ACC resection in otolaryngology practice. The operation was performed without tracheostomy, skin incision, or mandibulotomy. The patient could begin peroral intake 3 days after surgery. There were no complications in the postoperative period. After the operation, the patient underwent chemoradiotherapy. The present results indicate that TORS is a safe and effective form of treatment for tongue-base tumors. ACC is a relatively uncommon malignancy that accounts for approximately 22% of all salivary gland cancers. Salivary adenoid cystic carcinoma was first efined by Billroth in 1856. ACC of the head and neck s characterized by a slow growth rate, multiple recurences, and late distant metastasis. The most common ntraoral site for minor salivary gland tumors is the hard alate, followed by the base of the tongue. Three histologic types of ACC have been identified: tubular, cribriform, and solid. The solid type has the poorest prognosis, whereas the tubular type has a less aggressive pattern. Although there have been many studies of the histologic pattern of ACC and histopa-

Solitary Fibrous Tumor with Entrapment of Minor Salivary Gland Tissue: An Unusual Presentation That Requires Exclusion of Pleomorphic Adenoma

We report two unusual cases of solitary fibrous tumor (SFT) of minor salivary glands that microscopically mimicked pleomorphic adenoma. One of these lesions presented in the retromolar region and the other in the buccal mucosa. The microscopic features of these two tumors and their intimate relationship with regional mucous minor salivary glands posed a diagnostic challenge. Awareness of the morphological diversity of SFT coupled to a judicious use of appropriate immunohistochemical probes should prove valuable to accurately segregate SFT from pleomorphic adenoma.

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.

Expression Of Ki-67 and MUC1 In mucoepidermoid carcinomas of young and adult patients: Prognostic implications

Mucoepidermoid cancer (MEC) is the most malignant neoplasm of minor salivary glands. The aim of this study was to compare the expression of Ki-67 and MUC1 and clinicopathological data of mucoepidermoid carcinoma (MEC) in minor salivary glands of young and adult patients. The MEC cases in patients under 25 years old ( n = 8) and over 26 year old ( n = 8) were matched by gender, location and TNM staging. Immunohistochemical analysis of Ki-67 and MUC1 was carried out and correlated with clinicopathological data. The expression of Ki-67 and MUC1 was similar between the groups, although a tendency towards higher Ki-67 and MUC1 expression was observed in the younger group. Despite no significant differences, survival time was shorter in adults (71.37 ± 17.44 months) compared to the younger group (97.62 ± 25.81). While no patient deaths or tumor recurrences were found in the younger patient group, the adult group presented recurrence in 25% of cases and one patient died. In conclusion, our findings showed that age can be an important factor in MEC prognosis.

Pleomorphic adenoma of the lower lip: A review

The lower lip is a very rare emerging site for pleomorphic adenoma. The present review is to accentuate the definition, frequency, clinical and histopathological features, differential diagnosis, prognosis, and treatment choices of pleomorphic adenoma. We reviewed the English-language literature addressing pleomorphic adenoma of the lower lip. The tumors of minor salivary glands are not frequent among whole salivary glands tumors. Pleomorphic adenoma is the most common neoplasm among the minor salivary glands. A wide excision is recommended if there is no cosmetic care and no risk of damage to the functional structures of head and neck. Malignancy of the minor salivary glands are not rare. In addition, malignant transformation of pleomorphic adenoma involved in the benign tumors of minor salivary glands are possible. Thus, awareness of the possibility of existence of a pleomorphic adenoma or a malignant tumor within a mass located on the lower lip has a mentionable importance.

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.

Epithelial-myoepithelial carcinoma ex pleomorphic adenoma in breast : An exotic rarity

Similarities in the embryogenesis of breast and salivary gland and the dual epithelial myoepithelial cell differentiation in both anatomical sites account for the occurrence of salivary gland-type neoplasm in the breast [1]. Pleomorphic adenoma (PA) is one such benign neoplasm that occurs in both salivary gland and breast. In salivary gland, malignant transformation of PA is a well-recognized, albeit relatively, uncommon event. Malignant transformation can take the form of superimposed adenocarcinoma or development of a malignant mixed tumour with dual epithelial and mesenchymal elements [2]. PA, also known as benign mixed tumour, accounts for 45 to 74% of all major and minor salivary gland tumours and has been reported in other, less common sites such as the paranasal sinuses, larynx, palate, nasal septum, skin and breast [3, 4], It occurs less frequently in the human breast. Since the first case report by Lecene [4] in 1906, 68 cases of PA of the human breast have been documented in the world literature [5]. Malignant PA has been reported to occur outside of the major salivary glands but its occurrence in breast is rare. There are only three such case reports in English language literature [1]. However, there is no case of epithelial-myoepithelial carcinoma on a PA of breast reported. We describe a case of epithelial-myoepithelial carcinoma ex pleomorphic adenoma of breast diagnosed and managed at our hospital.

The frequency and distribution pattern of minor salivary gland tumors in a government dental teaching hospital, Chennai, India

Data are not available regarding distribution of minor salivary gland tumors from the specialist pathology setting in India. The purpose of this study was to determine the relative frequency and distribution of minor salivary gland tumors and to compare the data with pertinent studies. The records and archival samples of the Department of Oral and Maxillofacial Pathology, Tamil Nadu Government Dental College and Hospital, Chennai, India, served as source material for this retrospective study. All cases with a diagnosis of minor salivary gland tumors recorded between 1971 and August 2008 were retrieved and reviewed. A total of 185 minor salivary gland tumors were identified with reference to the latest World Health Organization classification, representing a relative frequency of 1.52% over the study period of 37 years (1971-2008) from 12,147 biopsy samples. Malignant tumors (75%) predominated over benign tumors (25%). The age range was 12-82 years with a mean of 46 years. Mucoepidermoid carcinoma was the most frequent tumor (34%), followed by pleomorphic adenoma (22%), adenoid cystic carcinoma (15%), and polymorphous low-grade adenocarcinoma (10%). The overall gender distribution was almost equal. Palate was the most frequent involved site, followed by alveolar mucosa and floor of the mouth. The present study shows a higher proportion of malignant tumors and a tendency toward male predilection during the past decades. The overall data are consistent with hospital-based studies from Asia and series from other geographic regions.

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.

Pleomorphic Adenoma of Minor Salivary Gland in a 14 year Old Child

Salivary gland tumours are rare in childhood, and almost all of them occur in parotid gland. Minor salivary gland tumours are even rarer, pleomorphic adenoma being the most frequently found tumour. Only seventeen cases of pleomorphic adenoma arising in the minor salivary gland tumour have been reported in children and adolescents. Pleomorphic adenoma of minor salivary gland represents about 45% of all the tumours of the minor salivary glands. Pleomorphic adenoma is slowly enlarging tumour indistinguishable from adenoid cystic carcinoma clinically, except for pain and ulceration, which is more common in the latter. Carcinoma arising from pleomorphic adenoma has been reported in 3% cases amongst the minor salivary gland tumours. This report presents a case of pleomorphic adenoma of minor salivary gland in a 14year old female patient with a brief review of literature.

Signet-ring cell (mucin-producing) adenocarcinoma of minor salivary glands: report of a case

Salivary gland tumors account for a significant group of head and neck neoplasms. Signet-ring cell (mucin-producing) adenocarcinoma of minor salivary glands was described by Ghannoum and Freedman in 2004. We report a case of this extremely rare minor salivary gland neoplasm in an 18-year-old male. To our knowledge, this patient is the youngest to ever be reported having this tumor.

Primary clear cell carcinoma of the nasopharynx: a case report

Primary clear cell carcinoma of the nasopharynx is a rare and locally invasive minor salivary gland neoplasm, only two cases have been reported yet in the literature. Now a 57-year man, with primary nasopharyngeal clear carcinoma, received radiotherapy and chemotherapy. After treatment, the mass of nasopharynx visibly reduced. Follow-up two months and repeated MRI, CT, abdominal B-ultrasonograpy, electronic nasopharyngoscopy, no tumor recurrence or metastasis.