Salivary gland tumours: a hospital-based study on demographic and incidence pattern, histopathological types and treatment strategy

<p><strong>Background: </strong>Salivary gland tumours constitute 3-4% of all head and neck cancers (mostly benign). These tumours are epithelial (95%) or mesenchymal in origin. Pleomorphic adenoma is the most common benign salivary gland tumour and mucoepidermoid carcinoma (45%) is the most common malignant salivary gland tumour followed by adenoid cystic carcinoma (30%). The parotid, submandibular and the minor salivary glands of palate are commonly involved and the sublingual gland is rarely affected.</p><p><strong>Methods: </strong>Hospital based cross sectional study was done in a tertiary care centre during a period of 1 year, which included 21 patients (10 men and 11 women). Patients were analysed according to age, gender, food habits, histopathological type and site of the tumour and treatment strategy.</p><p><strong>Results: </strong>All the cases were from upper Assam province sharing a particular demographic pattern between 19-65 years. Peak incidence in males was fourth decade and females was third decade. Male female ratio was 0.9:1. Out of 21 cases, 14 were parotid gland tumours, 6 submandibular gland tumours and 1 minor salivary gland tumour. Most of the tumours were benign (16) and 5 were malignant.</p><p><strong>Conclusions: </strong>Two patients were of age 19 years which is conflicting the normal national incidence. All cases belonged to lower economic strata with decreased intake of beta carotene enriched food items. The most common site is parotid gland and most common tumour is pleomorphic adenoma which is in accordance to other studies. Benign cases were subjected to superficial parotidectomy and malignant cases to total parotidectomy with neck dissection.</p>

Clinicopathological profile of adenoid cystic carcinoma of minor salivary gland tumour: our experience at a tertiary care centre

<p class="abstract"><strong>Background:</strong> Adenoid cystic carcinoma (ACC) is a rare malignant tumour originating from minor salivary glands. It is known for perineural spread, local recurrences and distant metastasis. The minor salivary gland tumour represents 3% of all head and neck neoplasms, whereas ACC constitutes about 0.5% of all malignant salivary gland neoplasms. This study was done to evaluate the clinical presentation and histopathological findings of minor salivary gland tumour.</p><p class="abstract"><strong>Methods:</strong> This study was done in the department of ENT, Bangalore Medical College and Research Institute from May 2017 to July 2019. Of the 25 patients with minor salivary gland tumour, 10 patients with ACC were considered for the present study. A detailed clinical and histopathological evaluation was done. Results were documented and tabulated in excel sheet. </p><p class="abstract"><strong>Results:</strong> We analysed data of 25 (16 female, 9 male) patients in the age group of 30-60 years, of which 10 patients had adenoid cystic carcinoma of minor salivary gland tumour. The most frequent site of tumour occurrence was noted in the hard palate (6 patients), followed by retromolar trigone (2 patients), floor of mouth (1 patient) and tongue (1 patient). The histopathological pattern noted most commonly in our study: cribriform pattern (6 cases), tubular (1 case) and solid (3 cases).</p><p class="abstract"><strong>Conclusions:</strong> ACC of minor salivary glands is rare. The otorhinolaryngologist should bear this clinical entity in mind when encountered with a painless swelling over the hard palate. This would lead to an early diagnosis and prompt management in such patients.</p>

A clinical study of the incidence of salivary gland tumors in a tertiary care teaching hospital

Background: The salivary gland system of the upper aero digestive tract plays a critical role in the functions of digestion, respiration, communication, and overall homeostasis. The Salivary gland swellings can be broadly classified into inflammatory, non-inflammatory and neoplastic swellings like calculi, benign tumours such has pleomorphic adenoma, oncocytoma, Warthin's tumour, malignant tumors which include-adenocarcinoma, adenoid cystic carcinoma, undifferentiated carcinoma.Methods: The present cross-sectional study was conducted at the Department of general surgery, Sri Siddhartha Medical College over a period of 2 years from August 2016 to July 2018. All major salivary gland neoplastic swellings confirmed by FNAC were included in this study.Results: In our study 23 patients had major salivary gland tumours out of that 19 patients had parotid and 4 had submandibular major salivary gland tumour. In our study out 23 cases of salivary tumours 19 cases were benign and 4 cases were malignant, out of 19 cases of parotid tumours, 15 (78.94%) cases were seen in superficial lobe and 4 (21.06%) were in deep lobe, out of 23 salivary gland tumours, 19 (82.6%) cases were pleomorphic adenoma 3(13.05%) cases were mucoepidermoid carcinoma and one case (4.35%) was acinic cell carcinoma.Conclusions: Parotid gland was the most common site of origin of both benign and malignant tumours, Pleomorphic adenoma was the most common benign salivary gland tumour and mucoepidermoid carcinoma was the most frequent malignant neoplasm.

Clinical Presentation and Histological Variation of Pleomorphic Adenoma of Salivary Glands

Background: Pleomorphic Adenoma is the most common salivary gland tumour accounts 40-70% of all salivary gland tumour and about 60-80% of the benign tumours and 60- 70% of all parotid tumours. There is no study conducted in Bangladesh to observe the clinical and histological variation of the tumour. This study presents 36 cases of Pleomorphic adenoma collected over 11 months at the different territory hospital of Dhaka city. Design: Observational study (November’ 2011 to September’ 2012) Setting: Department of Oral and Maxillofacial Surgery (Dhaka Dental College and Hospital, Bangabandhu Sheikh Mujib Medical Universityl), Department of ENT and Head- Neck Surgery (Dhaka Medical College and Hospital, Bangabandhu Sheikh Mujib Medical University). Method: The entire patient clinically and cytologically diagnosed as Pleomorphic adenoma were selected. Data were collected in a summarized data sheet. Then histopathological types of them were analyzed from excisional biopsized tissue. Result: There were 36 patients of Pleomorphic adenoma of which 24(66.67%) in Parotid glands, 4(11.11%) in Submandibular glands and 8(22.22%) in minor salivary glands. Among the respondents, female was predominant 20(55.56%) with ages were between 29 years to 65 years old (mean age 44.83 ± 8.32 years) with most patients (44.44%) in 41 to 50 years of life. In histophathological study showed Stromal rich 38.89%, cell rich 36.11% and classic 25%. Cuboidal cells were the most commonly found cellular type followed by plasmacytoid and spindle.Trabeculae and duct like structures were the most frequent pattern by the epithelial cells.Myxoid and Hyalinization were the most frequently found mesenchymal like tissue.Cases presented with symptoms such as swelling (100%), limitation of mouth opening, paesthesia and pain. Conclusion: The knowledge about clinical presentation and the immense variety of cells, architectures and morphological characteristics present in Pleomorphic adenoma of the salivary gland is essential for correct diagnosis and prognosis. The need for improved diagnostic facilities and upgrading of infrastructure was stressed. J Bangladesh Coll Phys Surg 2019; 37(2): 72-77