Term
| General overview of info for SG neoplasms |
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Definition
70% occur in major SGs (esp. parotid)
30% in minor SGs
Treatment benign SG neoplasms = surgical excision
Clinical presentation: mass, high grade malignant SG tumors may have "usual" signs of malignancy (rapid growth, surface ulceration, underlying bone destruction, etc...); no symptoms are specific for SG tumor
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Term
| Benign neoplasm characteristics (just a guide) |
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Definition
| Slow growth, not fixed to overlying mucosa, round or dome-shaped, normal surface texture, rare pain |
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Term
| Malignant neoplasm characteristics (just a guide) |
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Definition
| Rapid growth, fixed to overlying skin/mucosa, irregular, +/- ulceration, +/- pain, +/- perineural invasion |
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Term
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Definition
| BENIGN: Edwards Rule of 80s: 80% of parotid lesions = benign, 80% of benign parotid tumors = pleomorphic adenoma |
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Definition
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Term
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Definition
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Term
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Definition
50% malignant overall
90% of retromolar pad area = malignant
only 25% of upper lip = malignant |
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Term
| Another name for pleomorphic adenoma |
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Definition
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Term
| Demographics of pleomorphic adenoma |
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Definition
Most common salivary gland tumor (overall)
Most common benign SG tumor
Esp. parotid (85% of cases), submandibular gland and minor SGs
Most common neoplasm of parotid |
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Term
| Clinical features of pleomorphic adenoma |
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Definition
| Painless, slow-growing, firm mass, parotid gland (mass over angle of mandible, below and in front of ear), most common intra-oral locations (palate - 54%, upper lip - 18%, buccal mucosa - 11%) |
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Term
| Histopathology of pleomorphic adenoma |
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Definition
| well-circumscribed capsule, both myoepithelial + ductal (glandular) cells in background of "mesenchyme-like" (CT) tissues; some form hard tissue (bone, cartilage) |
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Term
| What benign neoplasm is assoc w/ myoepithelial cells? |
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Definition
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Term
| Treatment of pleomorphic adenoma |
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Definition
| Conservative complete surgical excision, monitor for recurrences, tendency to recur if incomplete excision, rare malignant transformation |
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Term
| What does pleomorphic adenoma look like when it is recurrent? |
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Definition
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Term
| Definition of monomorphic adenoma |
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Definition
| Generic term used to descsribe a group of benign SG tumors w/ a more uniform histpathologic pattern compared to the pleomorphic adenoma; includes: canalicular adenoma, basal cell adenoma |
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Term
| What category of benign neoplasms does basal cell adenoma belong to? |
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Definition
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Term
| Clinical features of canalicular adenoma |
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Definition
| Minor SG, 75% upper lip (remember mucoceles (extravasation RARE in upper lip); esp. > age 50 years |
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Term
| Another name for Warthin's tumor |
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Definition
| Papillary cystadenoma lymphomatosum |
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Term
| Etiology of warthin's tumor |
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Definition
| Only SG neoplasm w/ definite link to tobacco smoking |
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Term
| Clinical features of Warthin's tumor |
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Definition
Parotid exclusively, 2nd most common benign parotid tumor, 10% bilateral (metachronous; i.e. different times); esp. men Age 50-80, doughy/cystic mass, very benign (limited growth)
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Term
| Histopathology of warthin's tumor |
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Definition
| Encapsulated, multiple cystic spaces, bilayered oncocytic epithelium, surrounded by lymphoid tissue, +/- germinal centers |
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Term
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Definition
| Benign SG neoplasm characterized by proliferation of granular swollen cells caused by accumulation of mitochondria |
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Term
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Definition
| rare, 90% in parotid, nothing specific about clinical presentation, Bx is by histology |
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Term
| Demographics of mucoepidermoid carcinoma |
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Definition
| Most common salivary gland malignancy; both children + adults |
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Term
| Clinical features of mucoepidermoid carcinoma |
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Definition
| Major and minor SGs (parotid gland, retromolar pad, palate); bluish cast sometimes, may mimic mucocele; rare cases = intraosseous ("central mucoepidermoid carcionma") |
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Term
| Histologic grading of mucoepidermoid carcinoma |
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Definition
| Based on proportion of mucous cells to erpidermoid cells, very important to predicting prognosis AND dictating treatment |
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Term
| Low grade mucoepidermoid carcinoma |
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Definition
| Many mucous cells, fewer epidermoid cells, very good prognosis, tx=surgical |
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Term
| High grade mucoepidermoid carcinoma |
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Definition
| Epidermoid cells >> mucous cells, fair-guarded prognosis, tx=aggressive surgical +/- neck dissection +/- radiation |
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Term
| True or false: low grade mucoepidermoid carcinoma has more epidermoid cells than high grade mucoepidermoid carcinoma. |
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Definition
| False - high grade more epidermoid cells |
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Term
| Histopathology of mucoepidermoid carcinoma |
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Definition
| Mixture of mucus-producing cells, epidermoid (squamous cells and "intermediate cells); mucin cells stain for mucin (PAS, mucicarmine stains) |
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Term
| Malignant neoplasm that contain mucin cells that stain w/ PAS, mucicarmin stains |
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Definition
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Term
| Definition of adenoid cyst carcinoma |
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Definition
| Malignant SG tumor that has a predilection for invading and spreading along perineural spaces |
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Term
| Adenoid cystic carcinoma consists of... |
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Definition
| BOTH minor and major SGs: palate: CN-VII involvement leads to weakness of facial mm; hard palate: mass, commonly w/ surface ulceration; any other location w/ SG tissue |
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Term
| Histopathology of adenoid cystic carcinoma |
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Definition
| Cribiform "swiss cheese" (dark basophilic cells in nests w/ circular to ovoid spaces; tubular patterns; solid pattern; combination |
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Term
| Which malignant neoplasm is described as swiss cheese? |
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Definition
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Term
| Prognosis of adenoid cystic carcinoma |
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Definition
| Good-fair short term survival (5 year = 70%); VERY POOR long term survival (15 year = 10-15%) CHARACTERISTIC of adenoid cystic carcinoma; follows unrelenting course that defies treatment, related to propensity for perineural spread, metastasis to distant sites such as lung |
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Term
| What is the characteristic feature of adenoid cystic carcinoma? |
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Definition
| Very poor long term survival (15 year = 10-15%) |
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Term
| Treatment of adenoid cystic carcinoma |
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Definition
| Complete/aggressive surgical excision, followed by radiation therapy, new molecular therapies under investigated |
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Term
| Definition of acinic cell adenocarcinoma |
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Definition
| Salivary gland malignancy showing serous acinar differentiation |
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Term
| Clinical features of acinic cell adenocarcinoma |
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Definition
| 90% in parotid gland (a serous gland), "low grade" malignancy, none specific clinically |
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Term
| Histology of acinic cell adenocarcinoma |
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Definition
| Proliferation of atypical serous acini |
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Term
| Polymorphous low grade adenocarcinoma (PLGA) demographics |
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Definition
| 20-26% of all malignant minor SG tumors, (almost) EXCLUSIVELY minor SG, esp. palate, buccal mucosa |
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Term
| Clinical features of PLGA |
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Definition
| Asymptomatic firm usually non-ulcerated swelling, can be long-standing (slow-growing) |
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Term
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Definition
| Un-encapsulated, but circumscribed mass; bland cytology, "single file", infiltrative, perineural invasion, resembles ACC |
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Term
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Definition
| Conservative surgery (wide local excision) |
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Term
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Definition
| Very good, "indolent" malignancy, 17% recurrence, 10% regional lymph nodes metastasis |
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Term
| Carcinoma Ex Pleomorphic adenoma etiology |
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Definition
| Malignant transformation in long-standing pleomorphic adenoma; very uncommon |
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Term
| Clinical features of carcinoma ex pleomorphic adenoma |
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Definition
| Sudden, rapid growth; +/- pain |
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Term
| Definition of adenocarcinoma NOS |
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Definition
| Malignant SG tumor that does not fit into other existing classifications |
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Term
| Clinical adenocarcinoma NOS |
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Definition
Non-specific appearance
Wide spectrum: from well-differentiate to low-grade to poorly differentiated, high-grade lesions |
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Term
| Other malignant salivary gland neoplasms |
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Definition
| Epimyoepithelial carcinoma, salivary duct carcinoma, basal cell adenocarcinoma, many other primary malignant salivary gland tumors, SCCA, lymphoma (esp sjogren's syndrome), metastatic disease |
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