Malignant salivary gland tumors

Records of 60 patients with primary salivary gland tumors were retrospectively analyzed. Most were European Jews, 60% were males, and the average age was 57 years. The parotid gland was the most frequent site of origin (76%). The main presenting symptom was painless swelling. Pain or facial palsy were rare and associated with poor prognoses. The most common types were mucoepidermoid, adenocystic, adenocarcinoma and malignant, mixed carcinomas (in descending order of frequency). Squamous cell carcinoma was the most prevalent histologic type. Most patients presented at an advanced stage. Treatment was mainly surgical and postoperative radiotherapy was given to those with advanced disease. Most recurrences occurred within 3 years of initial treatment. Actuarial 10-year survival for all patients was 40%. Superior survival rates were achieved in women, probably due to less aggressive malignancies. Low grade mucoepidermoid carcinoma had a favorable prognosis, whereas anaplastic carcinoma had the worst. Other significant prognostic factors included stage and grade of disease.     

Gingival salivary gland choristoma. A case report

Gingival salivary gland choristoma is an extremely rare disturbance of glandular development. A review of the literature disclosed only 5 reported cases of this entity and 7 gingival salivary gland tumors or alterations. We present a case of this condition present in a 43-year-old female patient, which was found while reviewing casts for the design of a prosthetic appliance. This case suggests that embryonal pluripotentiality of gingival epithelial cells is retained and that development of salivary glands in gingival tissue is feasible. An additional discussion about its histogenesis is presented.     

Haemangiopericytoma of the parotid salivary gland: report of a case with literature review

Haemangiopericytoma is a rare, soft tissue, tumour with unpredictable biological behaviour. A case of haemangiopericytoma of the parotid salivary gland is reported. The clinical, surgical and histological features are described.     

Clinical aspects of salivary gland tumors

This paper reports on epithelial tumours arising primarily in the major and minor salivary glands. The purpose of this presentation is to summarize our experience of salivary gland tumours on the basis of a material comprising of approximately 3000 salivary gland tumours as well as a review of the literature to date. The tumours are classified according to the classification recommended by WHO 1972. The incidence, location, symptomatology, grade of malignancy and treatment of the different tumour types in this classification are reviewed. Diagnostic procedures are discussed and a scheme for surgical treatment and radiotherapy of the different types of salivary gland tumours is proposed.     

Recurrences from malignant parotid salivary gland tumors

The clinical course of 130 patients treated for malignant parotid tumors at the three institutions have been reviewed. Fifty-six of these 130 patients developed recurrences following their primary treatment by a surgical procedure. There were a total of 109 recurrences among these 56 patients. The average number of recurrences was two per patient. The average survival from first recurrence was 3.7 years, with the median survival 2 years. The range of survival was 0.5 to 17 years. Once recurrence developed, treatment was by surgery, radiation therapy, chemotherapy, or a combination. Of 56 patients with recurrence, 33 are dead and 9 patients are alive with disease. Fourteen patients are alive and well with no evidence of disease. These NED patients had an average number of 1.6 recurrences and a median survival to date of only 3 years. Our study indicates that for the majority of patients who develop recurrence, survival is relatively short and treatment is usually ineffective in three of four patients. The authors conclude that after a surgical procedure for malignant salivary gland tumors, a trial of wide field postoperative radiation therapy to high dose should be considered as part of the initial treatment.     

Determination of DNA content in salivary gland tumors

BACKGROUND: DNA content determination is a useful tool in the characterization of different malignant tumors. AIM: To measure DNA content in cells of salivary gland tumors as adjunct to histological diagnosis, correlating morphologic and biological features of these tumors. MATERIAL AND METHODS: From the archives of the Pathology service of a general hospital, 21 salivary gland tumors, 15 pleomorphic adenomas, 3 mucoepidermoid carcinomas and 3 cystic adenoid carcinomas were selected. DNA content was determined in the histological samples using a flow cytometric DNA analysis. RESULTS: All pleomorphic adenomas had a normal or diploid DNA content. Fifty percent of malignant tumors had an aneuploid DNA content (1 mucoepidermoid carcinoma and 2 cystic adenoid carcinomas). CONCLUSIONS: DNA determination may help in the histological diagnosis of salivary gland tumors. The presence of aneuploidy suggests malignity.     

放射性粒子组织间植入治疗口腔颌面-头颈部腺源性恶性肿瘤近期疗效分析

目的:回顾分析单独应用125Ⅰ放射性粒子组织间植入近距离放疗治疗口腔颌面-头颈部腺源性恶性肿瘤的近期疗效.方法:2001年至2008年北京大学口腔医院颌面外科头颈部腺源性恶性肿瘤患者43人,因全身或局部因素不能进行手术切除,肿瘤部位包括腮腺、舌、上颌、颌下、咽旁、颅底颞下凹和口底.肿瘤直径为2～8 cm.本组患者均采用了单独125Ⅰ放射性粒子组织间植入治疗,粒子活度2.59×107～2.96×107 Bq(0.7～0.8 mCi),周缘匹配剂量为120～160 Gy.术后复查随访,统计有效率、局部控制率和生存率,以及副反应等情况.结果:治疗使29人获得了肿瘤完全消退(完全缓解complete remission,CR),7人消退大于50%(部分缓解partial remission,PR),4人消退小于50%,2人无效,有效率CR+PR为83.7%.术后随访时间为8～48个月,平均21个月,失访1人,局部控制率为79%,总生存率为76.7%,最长无瘤生存已达48个月,未发现严重放疗副反应.结论:对于手术禁忌的患者或无法切除的腺源性肿瘤,放射性粒子组织间植入近距离放疗可以获得较好的近期疗效.     

Ancient schwannoma of the submandibular gland: a case report

Schwannomas (neurilemmomas) are neurogenic tumors that arise from the Schwann cells of the neural sheath. They are most often benign and solitary. Extracranial schwannomas are rare, and can be mistaken for metastatic disease or other non-neurogenic tumors. Ancient schwannoma is a rare variant of schwannoma with a course typical of a slow-growing benign tumor. Histologically, it can be confused with a malignant mesenchymal tumor. An unusual case of an ancient schwannoma of the submandibular gland is reported. The clinical, histological and surgical aspects of this tumor are discussed, and the literature regarding this rare entity is reviewed.     

Cytomorphology of adenocarcinoma of lung presenting as submandibular salivary gland mass: report of a case diagnosed by fine-needle aspiration biopsy

The present study firstly aimed at understanding the relationship between sun exposure, pigmentary traits and the history of sunburns. Secondly, the significance of UV-exposure for cutaneous melanoma and for melanocytic naevi was investigated. The case-controlled study comprised 513 patients with primary cutaneous melanoma and 498 controls matched by age and gender. Multivariate logistic regression analysis was used to study melanoma risk factors. The number of common melanocytic naevi was associated with age, gender, the history of sunburns and UV-exposure during holidays (odds-ratio = 1.9; 95% confidence interval = [1.1, 3.4]) for 3 weeks or more. The number of atypical melanocytic naevi was significantly related to age, gender, pigmentary traits, the history of sunburns and UV-exposure during holidays (odds-ratio = 3.5; 95% confidence interval = [1.4, 9.0]) for 2 months or more. The results of the present study showed that both the history of sunburn and intensive sun exposure during holidays were important for the development of melanocytic naevi and, therefore, indirectly for cutaneous melanoma. In addition, a particular type of pigmentation was found to be related to atypical melanocytic naevi.     

Collagenous crystalloids in a fine needle aspirate of a pleomorphic adenoma of the minor salivary gland. A case report

BACKGROUND: Collagenous crystalloids were previously observed in histologic sections of pleomorphic adenoma. However, to the best of our knowledge, there have been no English-language reports dealing with collagenous crystalloids in fine needle aspirates. CASE: A fine needle aspiration specimen obtained from a mass in the hard palate of a 52-year-old female revealed collagenous crystalloids. The crystalloids were yellow to green, measured 30-50 microns in diameter and were radially arranged. CONCLUSION: This case indicates that collagenous crystalloids in salivary gland aspirates may be a clue to the diagnosis of pleomorphic adenoma.     

Neuroblastoma of parotid gland: report of a case and immunohistochemical characteristics

A case of a parotid mass in a 2-year-old boy, postoperatively diagnosed as neuroblastoma, a rare tumour not previously reported in the parotid gland is presented. The neoplasm developed within the parotid gland as a painless mass without regional lymphadenopathy. Histopathologically, the tumour showed primitive nerve cells-neuroblasts-with round or oval dark basophilic nuclei and scanty cytoplasm. The cells were arranged in circular rosettes around an eosinophilic mass consisting of very fine filaments originating in the tumour cells or papillary configuration and sometimes scattered in the poorly developed stroma. Immunohistochemical evaluation of the tumour showed a positive immunoreactivity for vimentin, alpha and beta subunits of S-100 protein, neurone-specific enolase (NSE), substance P, met-enkephalin and chromogranin but cytokeratins, desmin, actin, myosin, glial fibrillary acidic protein (GFAP) and calcitonin gene related peptide (CGRP) were negative. The histopathological and immunohistochemical findings conclude a diagnosis of neuroblastoma of the parotid gland.     

Leiomyosarcoma of the adrenal gland and its angiographic features: a case report

A case of leiomyosarcoma of the adrenal gland is reported. This is a rare neoplasm at this location and actually may arise from the venous wall of the gland. Angiographically, this lesion is demonstrated as a vascular mass with early draining of the vein.     

Differentiating myoepithelial and acinar cells in rat neonatal parotid gland and histogenetic concepts for salivary gland tumors

Histogenetic concepts for salivary gland tumors are predicated on the presence of reserve or undifferentiated cells in normal glands, presumably the source for cell renewal and induction of tumors. Developing rat parotid gland, which remains fetal-like at birth, provides the opportunity to study differentiation and observe whether cytologically undifferentiated cells do or do not have functional indicators of specific differentiation pathways. Immunohistochemistry and immuno-electron microscopy, when applied to parotid gland at birth, at 12 days of age and in the adult gland, indicate that commitment to myoepithelial cell differentiation occurs prior to development of structural changes characteristic of these cells. Conversely, secretory granules are evident in differentiating acinar cells prior to synthesis of amylase. The results suggest that an appearance of undifferentiation does not confer reserve cell status either in the normal salivary gland or their tumors.