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Minor salivary glands
Post tongue(serous)
Ant tongue(mucous)
palatal (mucous)
Buccal mucosa (mixed)
Floor of the mouth (mixed)
Lip (mixed)
Salivary tumor distribution
64-80% Parotid
9-23% Minor (Palate 50%>Lips22%(UL89%)>Buccal mucosa15%)
8-11% Submandibular
1% Sublingual
Incidence of benign vs. Malignant tumor of salivary gland
64-80% Parotid -15-30% M
9-23% Minor (Palate 50%>Lips22%(UL89%)>Buccal mucosa15%) -50% M
8-11% Submandibular- 45% M
1% Sublingual-90% M
Minor salivary gland incidence of M or B?
UL=75-86% B
LL=50-86% M
Tongue =Most M
Palatal/BM= 50% M
Retromolar area= 91% M
Pleomorhic adenoma (PA)=mixed tumor
Pleomorhic adenoma (PA)=mixed tumor
most common benign maj/min salivary glands
PA=common locations
Parotid= 77%
submandibular = 68%
Minor salivary gland =43%
PA=WHO
Female 30-50yrs old
Also in children
PA=presentation
small
painless
slowly enlarging nodule
reach large size if left untreated
Palate(fixed, otherwise movable)/lip= could reach several pds.
PA= histology
well-demarcated to encapsulated neoplasm
cartilage, bone and keratin pearls
PA=treatment
Remove gland with tumor with clean margins for most
Parotid=remove with perservation of facial nerve.
Palate=one piece with periosteum and overlying mucosa.
PA= DDX for lateral swelling
1. salivary gland neoplasm, PA
2. Sjogren's syndrom
3. related benign epithelial cyst of the parotid
4. Alcoholic sialadenosis
5. Mumps
PA= DDX for palatal swelling
1. taurus palatines
2. Salivary gland neoplasm, MT
3. Soft tissue neoplasm, leiomyoma
Monomorphic adenoma
=number of benign salivary gland tumors
DDX for submandibular swelling
1. salivary gland neoplasm (adenoid cystic carcinoma)
2. infection
3. soft tissue neoplasm
4. lymph node hyperplasia
Basal cell adenoma= occurs in major salivary gland esp parotid gland
Clinical features BCA
painless
slow-growing nodule
rare in oral cavity
commonin parotid
BCA who?
Older male
BCA Histology
encapsulated neoplasm
duct-like structures
mistaken for adenoid cystic carcinoma
BCA DDX
Fibroma
Mucocele
Soft tissue neoplasm
Salivary gland neoplasm
Canalicular Adenoma
occurs in minor salivary glands more in upper lips (75%)
CC-clinical features
well-circumscribed
movable
slow-growing
painless nodules
occurs in older patients
treated with simple enucleation
CC- WHO
older female
Warthins Tumor (Papillary cystadenoma Lymphomatosum)=accounts for 5-10% of all salivary gland neoplasm
Warthin's Tumor=clinical features
mostly parotid gland (5-14% are bilateral, but also on palate
Warthin's Tumor= Who
Older Male
M:F=10:1 before, but equal recently
Firm asymptomatic swelling

Warthin's tumor=histology
encapsulated tumor
papillary projection
Warthin's Tumor= DDX for bilateral face swelling
1 Sjogren's syndrome
2. Salivary gland neoplasm
3. Alcoholic sialadenosis
4. HIV related benign lympoepithelial cysts of the parotid

Oncocytoma (Oxyphilic adenoma)
rare neoplasm of salivary gland
Oncocytoma (Oxyphilic adenoma)
Major salivary gland, esp parotid

Oncocytic cystadenoma
variant of this lesion found in oral cavity
Oncocytoma WHO?
Older Female
Oncocytoma (oxyphilic adenoma)
WHERE
intraorally=BM, LIP
small asymptomatic, encapsulated nodule
Oncocytoma (oxyphilic adenoma)
Histology
sheets of oncocyte(epi cell with excess mito, B/M)
oncocytes are congested with non-functional mitochondria
Oncocytoma (Oxyphilic adenoma)
DDX
1. Salivary gland neoplasm
2. sjogren's syndrom(usually bilateral)
3. HIV related benign epithelial cyst of the parotid (usually bilateral)
4. Alcoholic sialadenosis (Usually bilateral)
5. Mumps (wrong age and usually bilateral)
Mucoepidermoid carcinoma
most common malignant salivary gland neoplasm (adults and children)
10% of all salivary gland neoplasm
Mucoepidermoid (mucous secreting and epidermoid type) carcinoma
WHERE
Majority=parotid
Minor salivar gland= palate, tongue, BM, retromolar pad
Mucoepidermoid carcinoma
Classification
1. Low grade, excellent prognosis
2. Intermediate
3. High grade, poor prognosis
Mucoepidermoid carcinoma, low grade
slwoly enlarging
painless lesions
not encapsulated, resembling mucoceles(mucus cyst) =(retromolar pad area)

HISTO: more mucuous secreting cells than epidermoid cell
mucoepidermoid carcinoma, high grade
rapidly growing
painful lesions with facial nerve paralysis
with regional lymph node metastasis

HISTO: more epidermoid cell than mucous producing
Mucoepiermoid carcinoma
TREATMENT
excision, but for recurrent and non curable, do radiotherapy
Mucoepidermoid carcinoma
DDX
1. Hemangioma
2. Hematoma
3. Mucoepidermoid carcinoma

Central mucoepidermoid carcinoma
Central mucoepidermoid carcinoma
occurance of mucoepidermoid carcinoma in jaw bone
Central mucoepidermoid carcinoma DDX
1. Odontogenic myxoma
2. Glandular odontogenic cyst
3. Central mucoepidermoid carcinoma
Polymorphous low grade adenocarcinoma= low grade malignant neoplasm of salivary gland origin
"terminal duct carcinoma"
Polymorphous low grade adenocarcinoma
Clinical features
most common in s=minor salivary glands
slow-growing
painless mass
Polymorphous low grade adenocarcinoma
WHO
60-80's Female
Polymorphous low grade adenocarcinoma
HISTOLOGY
mitosis is rare
neural invasion is common
Polymorphous low grade adenocarcinoma
PROGNOSIS
rare matastasis
multiple recurrences
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