Malignant salivary gland tumors

Malignant salivary gland tumors

There are many types of salivary gland cancers and are named
according to which type of salivary gland cells they most look lik
e and are classified to :
Grade 1
Low grade

Grade 2
Intermediate grade

Grade 3
High grade
 Intraosseous
mucoepiderm
oid carcinoma

polymorphous
Acinic cell
low-grade
adenocarcino
adenocarcino
ma
ma

Malignant
salivary
gland
Malignant tumors Mucoepiderm
mixed tumors oid carcinoma

salivary
adenocarcino
Adenoid cystic
masnot
carcinoma
otherwise
specied
Malignant salivary gland tumors
Signs and symptoms

Fluid darning from the ear

Pain

Weakness
Painless lump in the affected gland
Malignant salivary gland tumors
Treatment

Surgery with or without radiation

Radiotherapy

chemotherapy
Mucoepidermoid carcinoma

One of the most common type

Can be found is other organs

Mucoepidermoid carcinoma
Clinical features

Age

Painless

Appearance

Location
Mucoepidermoid carcinoma
Clinical features

Mucoepidermoid carcinoma.
Mucoepidermoid Blue-pigmented
carcinoma. Mass of the
masstongue.
of the posterior lateral hard palate
Mucoepidermoid carcinoma
Histopathological features

Squamous cells (epidermiod cells)

Mucous cells with foamy cytoplasm

Intermediator cells (progenitor cells of both Mucous and

Squamous).
Mucoepidermoid carcinoma
Histopathological features

Mucoepidermoid
Mucoepidermoidcarcinoma.
carcinoma.High-power
High-powerviewviewshowing
showingaasheet
sheetof
of
pleomorphic squamous
squamous cells epithelial
with focal cells intermixed
mucus-producing cells with mucous and
intermediate cells
Mucoepidermoid carcinoma

Low grade

Classified into
Intermediate grade

High grade
Mucoepidermoid carcinoma
Mucoepidermoid carcinoma
Treatment

Early stage

Advanced stage

Treatment differ according to the histological

grade
Intraosseous mucoepidermoid
carcinoma

The most common and best recognized

Intraosseous
mucoepidermoid
carcinoma
Intraosseous mucoepidermoid
carcinoma

Pathogenesis

Differential diagnosis
Intraosseous mucoepidermoid
carcinoma
Clinical features
Age
Sex
Mostly seen in molar
ramus area
Mandible > maxillary
Symptoms
Cortical swilling
Pain, trismus
, paresthesia
Intraosseous mucoepidermoid
carcinoma
Radiographic features

Unilocular or multilocular
Well-differentiated borders

Intraosseous mucoepidermoid carcinoma.

Multilocular lesion of the posterior mandible
Intraosseous mucoepidermoid
carcinoma
Histopathological features
Similar to that of its soft tissue counterpart

island of mucous cells with clear cytoplasm (Red

arrows) surrounded by epidermoid cells
Intraosseous mucoepidermoid
carcinoma
Treatment & prognosis
Radical surgical resection
Surgery
Prognosis

recurrences Death

13% 40%
in radical in conversation 10%
treatment treatment
Acinic cell adenocarcinoma

Salivary gland malignancy

Non-aggressive

Acinic cell adenocarcinoma. Large,

rm mass of the right parotid gland
Acinic cell adenocarcinoma
Clinical features

Site
Age
Sex
Mostly asymptomatic

Acinic cell adenocarcinoma. Bluish swelling of the anterior

buccal mucosa, which could be mistaken for a mucocele
Acinic cell adenocarcinoma
Histopathological features

Well circumscribed and may be encapsulated.

Acinic
Acinic cell
cell adeno-
carcinoma.
adenocarcinoma.
High-power view
Papillary-cystic
of serous
variant cells with
showing
basophilic,
proliferation of
granular
tumor cytoplasm
cells into a large
cystic space
Acinic cell adenocarcinoma
Treatment and prognosis

Lobectomy

Total removal of gland 1/3 recurrences

prognosis
Surgical excision

10-15% metastases

6-26% death
Malignant mixed tumors

Carcinoma ex pleomorphic adenoma

Carcinoma sarcoma

Metastasizing mixed tumor

Carcinoma ex pleomorphic
adenoma
Clinical features
Previously benign

Malignancy transformation

Age

Site
Carcinoma ex pleomorphic
adenoma
Histopathological features

Carcinoma ex pleomorphic
Carcinoma adenoma
ex pleomorphic Malignant
adenoma portion of the
plasmacytoid
tumormyoepithelial
showing epithelial cells with
cells within pleomorphic
a myxoid nuclei.
background
Carcinosarcoma
Clinical features

Rare

Site

Appearance
Carcinosarcoma
Histopathological features

biophasic tumor

Poor differentiated or
undifferentiated
Carcinosarcoma
Histopathological features

Sarcomatous portion of predominates the tumor &

is usually in the form of chandrosarcoma
Metastasizing mixed tumor
Clinical features

Rare
Site
Metastasizing mixed tumor
Histopathological features

Benign pleomorphic adenoma. Within both

primary & metastasic sites
Pleomorphic Adenoma
Treatment and prognosis

Wide excision

Survival rate
Adenoid cystic carcinoma

One of the most common.

Was originally called Cylindroma

Adenoid cystic carcinoma
Clinical features

At any salivary gland

Palate is the most common site

Adenoid cystic carcinoma
Clinical features

Age
Sex
Appearance
pain
Adenoid cystic carcinoma
Radiograph

CT, massive palatal tumor shows extensive destruction of the hard

palate with extension of the tumor to the nasal cavity
Adenoid cystic carcinoma
Histopathological features

3 major patterns
Cribriform
Tubular pattern
Solid variant
Adenoid cystic carcinoma
Cribriform

Adenoid cystic carcinoma, Islands of hyperchromatic cells

forming cribriform and tubular structures. Inset shows a high-
power view of a small cribriform island
Adenoid cystic carcinoma
Tubular pattern

Trabecular and tubular pattern of adenoid cystic

carcinoma H&E
Adenoid cystic carcinoma
Solid variant

Solid pattern of adenoid cystic carcinoma H&E

Adenoid cystic carcinoma

Perineural invasion of adenoid cystic carcinoma

Adenoid cystic carcinoma
Treatment and prognosis

Surgical excision

Recurrence

Metastasis
death
polymorphous low-grade
adenocarcinoma

Before its identi cation as a distinct entity

EX :

1. pleomorphic adenoma
2. an unspecied form of
adenocarcinoma
3. adenoid cystic carcinoma
polymorphous low-grade
adenocarcinoma
Clinical features

Site
Age
Sex
Symptoms

Polymorphous low-grade adenocarcinoma.

Ulcerated mass of the posterior lateral hard palate
polymorphous low-grade
adenocarcinoma
Histopathological features

Polymorphous
low-grade
adenocarcinoma.
Polymorphous low-
Polymorphous low-
This
grademedium-power
grade
view shows a
adenocarcinoma.
adenocarcinoma.
cribriform arrangement
Pale-staining cells
Perineural invasion
of uniform
that tumor
in ltrate as cells
with pale-staining
single- le cords
nuclei
polymorphous low-grade
adenocarcinoma
Treatment and prognosis

Wide surgical excision

Death !!
salivary adenocarcinomas, not other
wise specied (NOS)
Clinical features
Site

Symptoms

Salivary
adenocarcinoma.
Clear cell
adenocarcinoma of
the submandibular
gland
Salivary adenocarcinoma.
Mass of the posterior
lateral hard palate
salivary adenocarcinomas, not other
wise specied (NOS)
Histopathological features

Adenocarcinoma not otherwise classified

salivary adenocarcinomas, not other
wise specied (NOS)
Treatment and prognosis

difcult to predict the prognosis

patients with early-stage, well-differentiated tumors

appear to have a better outcome
The reference

Oral and maxillofacial pathology nuevo

Neville, Damm, Allen .. third edition
http://www.jomfp.in
 Presented by :
Aya Ahmed 5214087
Alaa Mohamed 5214064

Enji Hosam 5214077

Ayman Saad 5214084
Eman Zoher 5214082