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level: SALIVARY GLAND TUMORS

Questions and Answers List

level questions: SALIVARY GLAND TUMORS

Question	Answer
dual proliferation and comingling of cells with ductal or myoepithelial features in a stroma of mucoid, myxoid, and less commonly, chondroid quality.	PLEOMORPHIC ADENOMA
composed of only one cell type and a more homogeneous or less varied stroma.	monomorphic adenomas
most common tumor of the major and minor salivary glands	PLEOMORPHIC ADENOMA
PLEOMORPHIC ADENOMA (Parotid gland): Generally painless and slow-growing; smooth, firm, and mobile unless they achieve large size, when they may become multinodular or bosselated.	below the ear and posterior to the mandible.
PLEOMORPHIC ADENOMA (Parotid gland): present below the angle of the mandible and anterior to the sternocleidomastoid muscle	inferior pole or tail of the parotid
PLEOMORPHIC ADENOMA (Parotid gland): tumors are nonpalpable and may present as a mass within the lateral pharyngeal wall	deep lobe of the parotid gland
PLEOMORPHIC ADENOMA: Occur at ___ age; but most prevalent in the 4th-6th decades	any
PLEOMORPHIC ADENOMA: gender predominance	males
mobile ; except when they occur in the hard palate	PLEOMORPHIC ADENOMA
Features: firm, painless swellings and do not cause ulceration of the overlying mucosa	PLEOMORPHIC ADENOMA
PLEOMORPHIC ADENOMA common sites (chronologic)	Palate (most common), Upper lip, Buccal mucosa
highly characteristic of mixed tumors; not seen in other salivary gland tumors	plasmacytoid cells
PLEOMORPHIC ADENOMA: TX	surgical excision
PLEOMORPHIC ADENOMA(Tx): site specific parotid	superficial parotidectomy (lateral lobectomy) with preservation of the facial nerve
PLEOMORPHIC ADENOMA(Tx): site specific submandibular gland	resection
Represents a group of benign salivary neoplasms of histologic uniformity.	BASAL CELL ADENOMA
Constitutes approximately 1% to 2% of all salivary gland adenomas.	BASAL CELL ADENOMA
70% are found within the parotid gland, followed by the submandibular gland	BASAL CELL ADENOMA
Most commonly occurs in the upper lip in minor salivary glands, followed in frequency by adenomas in the palate, buccal mucosa, and lower lip	BASAL CELL ADENOMA
Generally slow-growing, solitary, painless masses; Clinically distinct and firm on palpation	BASAL CELL ADENOMA
Can be multifocal and multinodular; Age range: between 35 and 80 years, with a mean age of 60 years.	BASAL CELL ADENOMA
Distinct male predilection has been noted; Clinically indistinguishable from mixed tumors	BASAL CELL ADENOMA
Their greatest dimension is usually less than 3 cm	BASAL CELL ADENOMA
BASAL CELL ADENOMA: least common; however formation either alone or with basal cell masses, can be found in most basal cell adenomas, at least focall	Tubular
BASAL CELL ADENOMA: It shows ductal structures as the dominant feature with lining cells of cuboidal type surrounded by single or multiple layers of basaloid cells.	Tubular
BASAL CELL ADENOMA: shows thin trabeculae and cords of epithelial cels separated by delicately vascularized stroma; cribriform	Trabecular
BASAL CELL ADENOMA: Characterized by the presence of abundant, thick, eosinophilic hyaline layer that surrounds and separates the epithelial islands	Membranous
BASAL CELL ADENOMA: Electron microscopy has shown that this hyaline material is reduplicated basement membrane. The epithelial islands are arranged in large lobules and appear to mould to the shape of other lobules to resemble a jigsaw puzzle pattern	Membranous
BASAL CELL ADENOMA: tx	conservative surgical excision
occurs almost exclusively in the oral cavity and accounts for 6% of all minor salivary glands neoplasms	CANALICULAR ADENOMA
Lesions are asymptomatic, well circumscribed, freely movable, size ranges from few mm to 2-3 cm; Occasionally, two separate distinct tumors may occur in the upper lip of an individual	CANALICULAR ADENOMA
“Party wall”; Bilayered strands of basaloid cells that branch and anastomose within a delicate stroma; Long columns or cords of cuboidal or columnar cells in a single layer forming long canals; Highly vascular stroma with few fibroblasts and little collagen	CANALICULAR ADENOMA
Ultrasound: homogeneous , poorly echoic (darker) mass with liquid region of low viscosity; MRI: isointense mass (increased intensity)	CANALICULAR ADENOMA
CANALICULAR ADENOMA: tx	Surgical excision, enucleation
Composed of single of cell type; it includes basal cell adenoma, canalicular adenoma, myoepithelioma and oncocytic tumor	MONOMORPHIC ADENOMAS
MYOEPITHELIOMA - Also known as ___	Myoepithelial adenoma
Uncommon salivary gland tumor which accounts for less than 1% of all major and minor salivary tumors	MYOEPITHELIOMA
Many authorities, such as Batsakis, consider _______ to be a “one-sided” variant at the opposite end of the spectrum from the pleomorphic adenoma	MYOEPITHELIOMA
No gender predilection; Adults (peak at the 3rd to 5th decades); Parotid gland most commonly involved; Palate is the most frequent intraoral site; Also found on retromolar glands and upper lip	MYOEPITHELIOMA
MYOEPITHELIOMA: tx	Surgical excision
characterized by the accumulation of large, eosinophilic, mitochondria-rich cells. often arise in various organs, including the kidneys, salivary glands, and thyroid.	ONCOCYTIC TUMORS
another name for oncocytic tumor	oxyphilic adenoma
rare lesion seen predominantly in the parotid gland; The histogenetic source of this lesion is believed to be the salivary duct epithelium, in particular the striated duct	Oncocytoma
solid, ovoid encapsulated lesions, usually smaller than 5 cm in diameter when they are noted within the major salivary glands (parotid gland); In minor salivary glands: palate, buccal mucosa, tongue	Oncocytoma
In some instances, bilateral occurrence may be noted; These lesions are rarely seen intraorally; growth rate is slow; usually occurs in the elderly, more commonly to old females 7th to 8th decade of life	Oncocytoma
Oncocytoma: tx parotid	superficial parotidectomy
Oncocytoma: tx minor salivary glands,	removal of the tumor with a margin of normal tissue
thought to arise within lymph nodes as a result of entrapment of salivary gland elements early in development. This theory is supported by the occasional case of multicentricity, as well as by normal lymph node architecture surrounding many early or developing tumors	Papillary Cystadenoma/ Warthin’s Tumor
Most common salivary gland tumor occur bilaterally; Seen predominantly in men, typically between 5th and 8th decades of life	Papillary Cystadenoma/ Warthin’s Tumor
Association of cigarette smoking; Represents a doughy to cystic mass in the inferior pole of parotid gland	Papillary Cystadenoma/ Warthin’s Tumor
Papillary Cystadenoma/ Warthin’s Tumor: Treatment	Surgical removal
gradual onset of small, usually less than 0.5 cm in diameter (2-4 mm), smooth, yellow, sometimes speckled papules that may feature crusting or central umbilication	SEBACEOUS ADENOMA
asymptomatic; intraoral lesions have been reported, chiefly in the buccal mucosa and retromolar region.	SEBACEOUS ADENOMA
SEBACEOUS ADENOMA: tx parotid	Parotidectomy
SEBACEOUS ADENOMA: tx intraoral neoplasms	surgical excisions
first described by White et al, in 1982. It is a very rare tumor and has been described only in minor salivary glands of adults; etiology is unknown, though some authors have related it to human papillomavirus (HPV) infection	INVERTED DUCTAL PAPILLOMA
This rare entity presents as a nodular submucosal mass resembling a fibroma or lipoma.	INVERTED DUCTAL PAPILLOMA
Inverted ductal papillomas: The ____is the most frequently involved site followed by buccal vestibular mucosa.	lower lip
appear to arise from the excretory ducts near the mucosal surfac; Clinically, these tumors are seen as submucosal nodules which may have a pit or indentation in the overlying surface mucosa.	INVERTED DUCTAL PAPILLOMA
INVERTED DUCTAL PAPILLOMA: tx	excision
unusual benign salivary gland neoplasm that was first reported in 1969 as a distinct entity of minor and major salivary gland origin.	SIALADENOMA PAPILLIFERUM
SIALADENOMA PAPILLIFERUM: most common sites	buccal mucosa and the palate
It usually presents as a painless exophytic papillary lesion of the surface mucosa and salivary duct epithelium. Most cases have been reported in men between the fifth and eighth decades of life.	SIALADENOMA PAPILLIFERUM
The clinical impression is that of a simple papilloma, owing to its frequent keratotic appearance and papillary surface configuration.	SIALADENOMA PAPILLIFERUM
SIALADENOMA PAPILLIFERUM: tx	Conservative surgery
This rare lesion is the third form of ductal papilloma which arises from a greater depth within the ductal system, often presenting as a salivary obstruction caused by intraluminal exophytic growth.	INTRADUCTAL PAPILLOMA
Occurs mostly in the minor salivary glands; Shows a characteristic papillary growth of ductal epithelium	INTRADUCTAL PAPILLOMA
Appears as a submucosal small nodule predominantly in lip and buccal mucosa; Occur in the middle-aged and elderly and rarely in children	INTRADUCTAL PAPILLOMA
INTRADUCTAL PAPILLOMA: tx	simple excision.