Head And Neck Salivary gland Tumours n Epithelial

Head And Neck

Salivary gland Tumours n Epithelial n Benign n Malignant n n n Pleomorphic adenoma (Mixed parotid) Monomorphic adenoma Adenolymphoma, oncocytoma Primary n Acini carci n Ducts Adenocarcinoma, adenoid cystic, acinic cell Mucoepidermoid High grade squamus cell carcinoma Low grade 10 times more comon n Mixed malignant mixed salivery Secondary rare Stromal Benign hemangioma, neurofibroma n Malignant sarcoma, lymphoma n

Incidence of Salivary tumors n Role of 80% of salivary tumors develop in the parotid n 80% are benign n 80% of bengin are mixed salivery n n Incidence of malignancy increase as the size of the gland decrease Parotid 20%, Submandibular 50%, Minor salivary 75%

Mixed Salivary tumors ( pleomorphic adenoma) n Incidence: 60% of all salivary tumors n 25 -50 y , females more, superficial lobe more n n Clinical picture Painless swelling over the angle of the mandibule anterior to ear lobule n Swelling very slowly growing, well defined, rounded, painless, smooth , lobulated, firm and mobile n

Salivary neoplasm ( pleomorphic adenoma)

Adenolymphoma n Incidence n n n Pathology n n n It is a hamartoma, inclusion of the parotid gland duds (ducts) into the LN near the parotid Cystic spaces, lined by epith, embeded in lymphoid matrix Clinical picture n n Second common benign, 97% in parotid Over 40 y, more in male, bilateral 10% Painless sweeling in the parotid area, more mobile, soft even cystic, no invasion Treatment n Superficial parotidectomy

Adenolymphoma

Malignant salivary tumors n Incidence n The most common is n n the Mucoepidermoid in the parotid Adenoid cystic carcinoma in other glands Age more in old age , except adenocarcinoma in children n Sex male and female equal n n n Male squamous cell carcinoma is more Female malignant mixed salivary is more

Carcinoma of the Parotid n Squamus cell carcinoma n n Signs of malignancy n n n The commonest S size recent rapid increase in size C hard on consistancy E irregular edges P pain M limited mobility Invade n n n skin ulcer Facial nerve Superficial temporal artery Muscles and bones Cervical LN

Malignant tumors

DD (lipoma)

Osteosarcoma bones

Hemorrhagic cyst in the parotid

Superficial parotidectomy

Total Parotidectomy