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Burkhardt V, Kayser G, Villing T, Becker C. Tumor budding - a potential biomarker in low grade salivary gland carcinomas? Front Oncol 2024; 14:1410264. [PMID: 38983934 PMCID: PMC11231199 DOI: 10.3389/fonc.2024.1410264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 06/10/2024] [Indexed: 07/11/2024] Open
Abstract
Background Low-grade salivary gland carcinoma is regularly treated with surgical therapy of the salivary gland without elective neck dissection in T1/2 carcinomas, either alone or with adjuvant radiation therapy. However, occult metastasis and locoregional recurrence influence therapy and outcome. Tumor budding is an emerging prognostic pathological factor in many carcinomas, but has not yet been adequately considered in salivary gland carcinomas. Methods We conducted a retrospective single-center study of 64 patients diagnosed with low-grade carcinoma of the major salivary glands treated between 2003 and 2017. Pathological risk factors and TNM classification were thoroughly assessed for each case. All hematoxylin and eosin (HE)-stained histological specimens underwent careful examination, and tumor budding was identified following the guidelines set forth by the International Tumor Budding Consensus Conference in 2016. Results Tumor budding was not statistically significant concerning 5-year survival rate (5-YSR) (p=0.969) and mean overall survival (log-rank p=0.315). Whereas 5-year disease-free survival rate (5-YDFSR) was 87% in the low tumor budding group and 61.1% in the intermediate and high tumor budding group (p=0.021). Mean disease-free survival accounted for 100.2 months (CI: 88.6;111.9) in the low budding score group and 58.7 months (CI: 42.8;74.6) in the other group (log-rank p=0.032). Notably, pT1/2 showed significantly lower tumor buds than pT3/4 stages (2.43 tumor buds/0.785 mm2 vs. 4.19 tumor buds/0.785 mm2, p=0.034). Similar findings were noted comparing nodal-positive and nodal-negative patients, as well as patients with and without lymphovascular invasion and perineural invasion (each p<0.05). Conclusions Tumor budding might be used as an additional prognostic factor for recurrence in low-grade salivary gland carcinoma, seemingly associated with a higher nodal metastasis rate and advanced tumor stages and a worse 5-YDFSR. Consequently, the evaluation of tumor budding in resection specimens of low-grade salivary gland tumor may prove valuable in decision-making for neck dissection and follow-up strategy.
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Affiliation(s)
- Valentin Burkhardt
- Department of Oto-Rhino-Laryngology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gian Kayser
- Institute of Pathology Naehrig Mattern Kayser, Freiburg, Germany
| | - Theo Villing
- Institute of Pathology Naehrig Mattern Kayser, Freiburg, Germany
| | - Christoph Becker
- Department of Oto-Rhino-Laryngology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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2
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Liu L, Xiang Y, Shui C, Li C, Xiong L, Hu J, Ai H, Zhou Y, Jiang J, Cai Y. Long-term follow-up and prognostic analysis of parotid tumors in children and adolescents. Laryngoscope Investig Otolaryngol 2024; 9:e1275. [PMID: 38835331 PMCID: PMC11149764 DOI: 10.1002/lio2.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/07/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
Objectives The objective of this study is to summarize the clinical characteristics, treatment, and prognosis of parotid tumors in children and adolescents. Methods Fifty-three children and adolescents diagnosed with parotid gland tumors were included. Survival was evaluated using the Kaplan-Meier method. Log-rank test and multivariate analysis were used to analyze the association between clinical factors and recurrence. Results Of the 53 patients, 30 cases were benign and 23 cases were malignant. All patients underwent surgery. Patients with malignant tumors with high-risk factors received radiotherapy or chemotherapy. The median follow-up time was 61 months. Of these, 1 patient with benign tumor and 5 patients with malignant tumors recurred. Of the patients with malignant tumors, 2 developed distant metastases and 2 died. The 5-year overall survival (OS) and 5-year locoregional recurrence-free survival (LRFS) rates for benign tumors were 100.0% and 92.9%, respectively, whereas the 5-year OS and 5-year LRFS rates for malignant tumors were 94.4% and 72.5%, respectively. The log-rank univariate test showed that tumor size >3.5 cm (p = .056), distant metastasis (p = .056), and stage III and IV (p = .032) were associated with recurrence. However, multivariate analysis did not show the above factors to be independent prognostic factors for LRFS. Conclusion Surgery for benign tumors depends on the location and size. Surgery for malignant parotid tumors depends mainly on the stage, grade, pathological type, and recurrence. Prophylactic lymph node dissection is required for high-grade tumors. Radiotherapy or chemotherapy for children needs more research. Both benign and malignant tumors have high survival rates after active treatment. Level of evidence Level 2.
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Affiliation(s)
- Lei Liu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
| | - Yuqing Xiang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Chunyan Shui
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Lujing Xiong
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
| | - Jinchuan Hu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Hao Ai
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Yuqiu Zhou
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Jian Jiang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Yongcong Cai
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
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Talani C, Frånlund K, Unguras C. A rare case of tonsillar mucoepidermoid carcinoma. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2023. [DOI: 10.1080/23772484.2023.2183211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Affiliation(s)
- Charbél Talani
- Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Faculty of Medicine and Health Sciences, Linköping University, Linkoping, Sweden
- Department of Otorhinolaryngology, Region Östergötland Anaesthetics, Operations and Specialty Surgery Center, Linkoping, Sweden
| | - Karin Frånlund
- Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Faculty of Medicine and Health Sciences, Linköping University, Linkoping, Sweden
- Department of Otorhinolaryngology, Region Östergötland Anaesthetics, Operations and Specialty Surgery Center, Linkoping, Sweden
| | - Crina Unguras
- Department of Otorhinolaryngology, Region Östergötland Anaesthetics, Operations and Specialty Surgery Center, Linkoping, Sweden
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Daroit NB, Martins LN, Garcia AB, Haas AN, Maito FLDM, Rados PV. Oral cancer over six decades: a multivariable analysis of a clinicopathologic retrospective study. Braz Dent J 2023; 34:115-124. [PMID: 38133466 PMCID: PMC10759960 DOI: 10.1590/0103-6440202305264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/22/2023] [Indexed: 12/23/2023] Open
Abstract
Studies have reported changes in the epidemiological profile of patients with oral cancer in recent decades, especially regarding gender and age. This study aimed to evaluate a historical series of oral malignant lesions prevalence over six decades and define characteristics associated with the occurrence, mainly, of oral squamous cell carcinoma (OSCC). A retrospective review of histopathological records from 1953 to 2019 was conducted in three oral pathology laboratories in South Brazil about age, sex, anatomical site, clinical aspect, and histopathological diagnosis. Descriptive and analytical analyses were performed comparing the histopathological diagnoses with other variables. Multivariable logistic regression was applied to determine the associated predictors of OSCC. Of the 53,065 records available in the institutions, 986 were oral malignant tumors (including all malignant neoplasms), representing 1.86% of all diagnoses. The occurrence of OSCC in the 1960's was 80.0%, decreasing over time reaching the lowest percentage of cases in the 1990's (75.8%) and significantly increasing to 88.7% in the 2010s. Females had a lower chance than males of having OSCC independently of the decade (odds ratio=0.30, p<0.001). This was the same for older individuals compared to those younger than 40 years. No interactions between sex, age, and decade were observed. The number of diagnoses of oral malignant lesions increased over time, and the occurrence of OSCC varied. Older individuals and males had higher chances of having OSCC independently of the decade. Therefore, in this study sample, no changes were observed in the epidemiological profile over the years concerning these predictors.
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Affiliation(s)
- Natália Batista Daroit
- Oral Pathology - School of Dentistry, Atitus Educação, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Nunes Martins
- School of Dentistry, Atitus Educação, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Alex Nogueira Haas
- Periodontology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fábio Luiz Dal Moro Maito
- Celular and Molecular Biology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Pantelis Varvaki Rados
- Oral Pathology - School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Garg K, Kapila S, Gulati A, Azad RK, Thakur JS. Sonographic and Cytological Evaluation of Salivary Gland Tumors. Indian J Otolaryngol Head Neck Surg 2023; 75:3427-3431. [PMID: 37974681 PMCID: PMC10646000 DOI: 10.1007/s12070-023-04020-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Salivary gland tumours are relatively uncommon, but they have a multifaceted clinical presentation and varied morphological configuration. The investigations required for these tumours remain debatable. We conducted a study to determine the accuracy of various modalities used in salivary gland tumours. METHODS We enrolled 72 subjects, consisting of 44 females and 28 males, with a mean age of 40.93 ± 16.51 years (range: 15 to 79 years), suffering from various salivary gland tumours. The tumour distribution included 42 parotid gland tumours (58.33%), followed by 21 submandibular gland tumours (29.16%), three sublingual gland tumours (4.16%), and six minor salivary gland tumours (8.33%). These individuals were subjected to clinical examination, sonography, and fine needle aspiration cytology as per indications. The results of each modality were compared to surgical pathology to find sensitivity and accuracy. RESULTS The clinical examination was found to be least sensitive (83.8%) as compared to FNAC (97.6%), and ultrasound (100%). Ultrasound had the highest diagnostic accuracy (86.2%) as compared to clinical examination (80.6%) and FNAC (82.6%). CONCLUSION Although sonography was found to have the highest sensitivity and accuracy as compared to fine needle aspiration cytology and clinical examination, the difference was subtle, as both sonography and fine needle aspiration cytology had a statistically significant correlation with histopathology.
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Affiliation(s)
- Komal Garg
- Dept of Otolaryngology-Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, HP.171001 India
| | - Sumala Kapila
- Dept of Radiodiagnosis, Indira Gandhi Medical College, Shimla, HP.171001 India
| | - Anchana Gulati
- Dept of Pathology, Indira Gandhi Medical College, Shimla, HP.171001 India
| | - Ramesh K Azad
- Dept of Otolaryngology-Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, HP.171001 India
| | - Jagdeep S Thakur
- Dept of Otolaryngology-Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, HP.171001 India
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AlWatban Z, AlAnsari H, AlAseeri D, AlJawder A, Janahi W. Pleomorphic Adenoma of the Oral Cavity: Systematic Review. Indian J Otolaryngol Head Neck Surg 2023; 75:3288-3304. [PMID: 37974882 PMCID: PMC10646098 DOI: 10.1007/s12070-023-03927-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/31/2023] [Indexed: 11/19/2023] Open
Abstract
Pleomorphic adenomas are the most commonly presented salivary gland tumor; however, exact etiologies are unknown. We present a systemic review investigating the demographics, clinical presentations, characteristics, and anatomical locations of oral cavity pleomorphic adenoma. Three electronic databases (PubMed, MEDLINE, and Scopus) and one search engine (Google Scholar) were used to identify studies published in English with no restrictions on the year of publication up to the first week of August 2022. Studies retrieved from the literature involved clinical presentations, characteristics, and anatomical locations of oral cavity pleomorphic adenoma, data presented as frequencies and percentages. Our systematic review included 71 studies out of 2110 identified. Pleomorphic adenoma in the oral cavity was found more commonly in females [1508 (42.9%)] than males, with an age range of 6-83 years. The most common tumor location was the palate, followed by the lips; the jaw was the least common location identified. Most cases were not characterized of having a pleomorphic adenoma [(2,918 (83%))]. The most commonly mentioned characteristic was a painless mass [(561 (16%))] and the least common characteristics were dysphagia, change in sensation, and ill-fitting prosthesis. Pleomorphic adenoma of the oral cavity can have many presentations. In any oral cavity mass, pleomorphic adenoma should be included in the differential diagnosis and a complete surgical excision preferred treatment.
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Affiliation(s)
- Zaki AlWatban
- Ministry of Health, Riyadh, Kingdom of Saudi Arabia
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
| | - Hasan AlAnsari
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
- Pediatric Otorhinolaryngology, Sheffield Children’s Hospital, Sheffield, UK
| | - Danya AlAseeri
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
| | - Aysha AlJawder
- Pathology, Blood Bank and Laboratory Department, King Hamad University Hospital, Muharraq, Bahrain
| | - Waleed Janahi
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
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Duru Birgi S, Akyurek S, Birgi E, Arslan Y, Gumustepe E, Bakirarar B, Gokce SC. Dosimetric investigation of radiation-induced trigeminal nerve toxicity in parotid tumor patients. Head Neck 2023; 45:2907-2914. [PMID: 37740459 DOI: 10.1002/hed.27524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/23/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023] Open
Abstract
PURPOSE We aimed to describe the association between trigeminal nerve (TN) dose and toxicity and determine a threshold value that leads to TN toxicity in patients with parotid tumors treated with adjuvant conventional fractionated radiation therapy. METHODS AND MATERIALS Eighteen patients who underwent adjuvant radiotherapy (RT) between 2013 and 2018 were included in this retrospective study. TN and its branches were outlined subsequently on the planning CT scans. The doses received by TN were obtained based on the dose-volume histogram. The dose and toxicity relationship was investigated over the total prescribed dose. RT-related toxicity was graded according to Common Terminology Criteria for Adverse Events V4.0 (CTCAEv4.0). RESULTS The median follow-up was 29.5 months. After RT, 61% of patients had Grade I-II late TN toxicity divided into Grade I in 4 (22%) and Grade II in 7 (39%) patients. TN injury symptoms were as follows: loss of sensation in the chin area in 3, difficulty in jaw movements in 3, and paresthesia in 5 patients. The total RT dose (p = 0.001), Dmax (p = 0.001), PTV-TN Dmax (p = 0.001), D1cc (p = 0.004), D0.5cc (p = 0.001), and D0.1cc (p = 0.01) had a significant effect on TN toxicity. Cut-off values leading to toxicity were determined as 66, 65.5, 65.25, 63.6, and 62.7 Gy for Dmax, PTV-TN Dmax, D0.1cc, D 0.5cc, and D1cc, respectively. CONCLUSIONS Radiation-induced TN injury in head and neck cancer patients may further be investigated in clinically prospective trials by virtue of high toxicity rates with current RT doses in our retrospectively designed dosimetric study in parotid tumors.
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Affiliation(s)
- Sumerya Duru Birgi
- Department of Radiation Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serap Akyurek
- Department of Radiation Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erdem Birgi
- Department of Radiology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Yakup Arslan
- Department of Radiation Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Esra Gumustepe
- Department of Radiation Oncology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Batuhan Bakirarar
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saban Cakir Gokce
- Department of Radiation Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
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Vamesu S, Ursica OA, Gurita AM, Voda RI, Deacu M, Aschie M, Bosoteanu M, Cozaru GC, Mitroi AF, Orasanu CI. A retrospective study of nonneoplastic and neoplastic disorders of the salivary glands. Medicine (Baltimore) 2023; 102:e35751. [PMID: 37861511 PMCID: PMC10589586 DOI: 10.1097/md.0000000000035751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
The spectrum of major and minor salivary gland disorders varies widely. Epidemiological data on some injury categories are rare and often not up-to-date. This study aims to analyze epidemiological data using clinical, paraclinical, and histopathological parameters. Study was carried out for 5 years on the nonneoplastic and tumoral pathology of the salivary glands. Data were statistically analyzed using the appropriate parameters. Data analysis according to the biological behavior of the lesions revealed great heterogeneity. Statistically significant correlations were observed between the type of injury, age (P = .002) and gender (0.033). The environment of origin of the patients as well as the comorbidities reflected in most cases the nature of the process. Associations were also observed between the biological behavior of the lesions and the hemicranial topography (P = .019), the type of salivary gland (P = .024), and the surgical technique used (P < .001). Most cases were identified in the major salivary glands, often in the parotid. The most common diseases are represented by nonspecific chronic sialadenitis (nonneoplastic lesion), pleomorphic adenoma and Warthin tumor (benign tumors), mucoepidermoid carcinoma (malignant tumor), and squamous carcinoma (secondary tumor). They presented axial diameters between 2 to 95 mm. The most used curative technique was subtotal excision with facial nerve preservation. In conclusion, the study highlighted the main epidemiological aspects of salivary gland disorders. Some data agree with the specialty literature, and particular aspects are also observed. Therefore, this research is useful both in the medical and research fields.
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Affiliation(s)
- Sorin Vamesu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
| | - Oana Andreea Ursica
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Ana Maria Gurita
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
| | - Raluca Ioana Voda
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
| | - Mariana Deacu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Mariana Aschie
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
- Academy of Medical Sciences of Romania, Bucharest, Romania
| | - Madalina Bosoteanu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Georgeta Camelia Cozaru
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Anca Florentina Mitroi
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
| | - Cristian Ionut Orasanu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
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Varazzani A, Tognin L, Bergonzani M, Ferri A, Ferrari S, Poli T. Diagnosis and Management of Parotid Gland Cancer with Focus on the Role of Preoperative Fine-Needle Aspiration Cytology: A 10-Year-Long Retrospective Study with 5-Year Follow-Up. J Maxillofac Oral Surg 2023; 22:373-380. [PMID: 37122797 PMCID: PMC10130240 DOI: 10.1007/s12663-023-01849-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/08/2023] [Indexed: 01/19/2023] Open
Abstract
Introduction Salivary gland cancers represent a rare heterogeneous group of neoplasms with complex clinicopathological characteristics and distinct biological behaviour. The appropriate diagnosis and management of parotid gland cancer are challenging and should be based on the clinical, imaging, cytological, and histological features. The present study analysed the use of preoperative fine-needle aspiration cytology (FNAC) and intraoperative frozen section (FS) to guide the appropriate surgical and postoperative treatment of parotid gland cancers. Materials and Methods We selected 48 patients with primary malignancy of the parotid gland surgically treated between 1 January 2008 and 30 June 2017 at the Maxillo-Facial Surgery Division, University Hospital of Parma, Italy. The patients had postoperative histological diagnosis of malignant parotid cancer and were followed up for longer than 5 years. Results The 48 patients included in this study had a mean age of 56.7 years. The most frequent type of parotid gland cancer was carcinoma ex pleomorphic adenoma (22.9%), followed by mucoepidermoid carcinoma (16.7%) and acinic cell carcinoma (14.6%). All 48 patients underwent preoperative FNAC: 29 (60.4%) and 19 (39.6%) were suggestive of malignant and benign lesions, respectively. In 31 patients, intraoperative FS was performed. Discussion Compared to previous studies, the present study showed significantly lower diagnostic sensitivity of FNAC for parotid gland cancers. The preoperative diagnostic accuracy for suspected malignant cases may be improved by repeat analysis of the cytological specimen by experts, preoperative core needle biopsy, and/or intraoperative FS analysis of the suspected mass.
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Affiliation(s)
- Andrea Varazzani
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Laura Tognin
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Michela Bergonzani
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Andrea Ferri
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Silvano Ferrari
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Tito Poli
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
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AlSalem A, AlKraidees M, AlKarni A, Yahya B, AlRamyan R, AlSumairi S, AlEssa M, Elkrim M. Major salivary gland carcinoma in KSA: A 10-year nationwide retrospective study of 571 cases. J Taibah Univ Med Sci 2023; 18:1148-1156. [DOI: 10.1016/j.jtumed.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/27/2023] [Accepted: 03/22/2023] [Indexed: 04/04/2023] Open
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11
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Mat Lazim N, Yousaf A, Abusalah MAH, Sulong S, Mohd Ismail ZI, Mohamud R, Abu-Harirah HA, AlRamadneh TN, Hassan R, Abdullah B. The Epigenesis of Salivary Glands Carcinoma: From Field Cancerization to Carcinogenesis. Cancers (Basel) 2023; 15:cancers15072111. [PMID: 37046772 PMCID: PMC10093474 DOI: 10.3390/cancers15072111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
Salivary gland carcinomas (SGCs) are a diverse collection of malignant tumors with marked differences in biological activity, clinical presentation and microscopic appearance. Although the etiology is varied, secondary radiation, oncogenic viruses as well as chromosomal rearrangements have all been linked to the formation of SGCs. Epigenetic modifications may also contribute to the genesis and progression of SGCs. Epigenetic modifications are any heritable changes in gene expression that are not caused by changes in DNA sequence. It is now widely accepted that epigenetics plays an important role in SGCs development. A basic epigenetic process that has been linked to a variety of pathological as well as physiological conditions including cancer formation, is DNA methylation. Transcriptional repression is caused by CpG islands hypermethylation at gene promoters, whereas hypomethylation causes overexpression of a gene. Epigenetic changes in SGCs have been identified, and they have been linked to the genesis, progression as well as prognosis of these neoplasms. Thus, we conduct a thorough evaluation of the currently known evidence on the involvement of epigenetic processes in SGCs.
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Affiliation(s)
- Norhafiza Mat Lazim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Anam Yousaf
- Department of Molecular Pathology Laboratory, Pakistan Kidney and Liver Institute and Research Centre, Lahore 54000, Pakistan
| | - Mai Abdel Haleem Abusalah
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Zarqa University, Al-Zarqa 13132, Jordan
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Sarina Sulong
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Human Genome Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Zul Izhar Mohd Ismail
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Rohimah Mohamud
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Hashem A. Abu-Harirah
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Zarqa University, Al-Zarqa 13132, Jordan
| | - Tareq Nayef AlRamadneh
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Zarqa University, Al-Zarqa 13132, Jordan
| | - Rosline Hassan
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Cohen Goldemberg D, Alves LDB, Antunes HS, Thuler LCS, de Melo AC. Epidemiology of major salivary gland cancer in Brazil: Incidence, morbidity, and mortality. Oral Dis 2023; 29:707-713. [PMID: 33930235 DOI: 10.1111/odi.13896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Daniel Cohen Goldemberg
- Clinical Research Division, National Cancer Institute of Brazil - INCA, Rio de Janeiro, Brazil
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Żurek M, Jasak K, Jaros K, Daniel P, Niemczyk K, Rzepakowska A. Clinico-Epidemiological Analysis of Most Prevalent Parotid Gland Carcinomas in Poland over a 20-Year Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10247. [PMID: 36011881 PMCID: PMC9408518 DOI: 10.3390/ijerph191610247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: Malignant tumours of the salivary glands have different clinical and histopathological characteristics. They most commonly involve the parotid gland. Histopathologically, the most common are mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (AdCC), acinic cell carcinoma (AcCC), adenocarcinoma, carcinoma in pleomorphic adenoma (CPA), and squamous cell carcinoma (SCC). (2) Methods: We analysed 2318 patients with malignant parotid gland tumours reported to the National Cancer Registry (NCR) in Poland over 20 years (1999-2018). The demographic characteristics of patients, clinical factors, and overall survival (OS) were analysed. (3) Results: The average age was 61.33 ± 16.1 years. The majority were males (55%) and urban citizens (64%). High percentage of carcinomas was diagnosed in locoregional (33.7%) and systemic (10.4%) stadium. The most prevalent diagnoses were SCC (33.3%) and adenocarcinoma (19.6%). Surgical resection with adjuvant RT (42.1%) was the most common treatment. The OS analysis showed a median survival time of 5.6 years. The most favorable median OS was found in patients with AcCC (18.30 years), the worst for SCC (1.58 years). (4) Conclusion: AcCC has the best prognosis and SCC the worst. Tumour stadium, treatment, and demographic factors affect prognosis. Improvements in diagnosis and re-evaluation of treatment standards are necessary to enhance the outcome of patients with parotid gland cancers in Poland.
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Affiliation(s)
- Michał Żurek
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
- Doctoral School, Medical University of Warsaw, 61 Żwirki i Wigury Str., 02-091 Warsaw, Poland
- Department of Analyses and Strategies, Ministry of Health, Miodowa 15 Str., 00-952 Warsaw, Poland
| | - Kamil Jasak
- Students Scientific Research Group at the Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
| | - Karolina Jaros
- Students Scientific Research Group at the Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
| | - Piotr Daniel
- Students Scientific Research Group at the Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
| | - Anna Rzepakowska
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
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Wang H, Liang J, Belcher R, Compton M, Weiss VL, Ely K, Johnson J, Coogan A. Nondiagnostic category of Milan System for Reporting Pediatric Salivary Gland Cytopathology: outcomes and root cause analysis. Cancer Cytopathol 2022; 130:609-619. [PMID: 35298098 PMCID: PMC10030067 DOI: 10.1002/cncy.22571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fine-needle aspiration (FNA) results classified as the nondiagnostic category of the Milan system for reporting salivary gland cytopathology (MSRSGC) may be infrequently encountered in children. Clinical management may be challenging due to lack of data regarding outcomes and underlying causes. METHODS We retrospectively analyzed 106 consecutive pediatric salivary gland FNAs (2000-2020; 45% performed under image guidance). The outcomes of patients with nondiagnostic results were analyzed. Clinical parameters, FNA procedural parameters, and histopathologic parameters were compared between diagnostic and nondiagnostic cases. A root cause analysis was performed using the fishbone diagram and the 5 Whys method. RESULTS A total of 103 initial FNAs were identified. The nondiagnostic rates for initial and repeat biopsy were 16% (16/103) and 67% (2/3), respectively. Initial nondiagnostic FNAs were most frequently managed by clinical/radiologic follow-up only (56%, 9/16), followed by direct surgery (19%, 3/16) and repeat FNA (19%, 3/16). By histologic and clinical/radiologic follow-up, the risk of malignancy for nondiagnostic cases was zero. Palpation guidance (P < .05), inadequate sampling determined by rapid on-site evaluation (P < .01), and lesions with cystic, vascular, or diffuse nature (P < .05) were significantly associated with nondiagnostic results. By root cause analysis, proceduralist sampling error and lack of ultrasound guidance were the most common primary and secondary causes, respectively. CONCLUSIONS Pediatric salivary gland lesions of the nondiagnostic MSRSGC category have minimal risk of malignancy and may be successfully managed by clinical/radiologic follow-up. The root causes for nondiagnostic results were often multifactorial and primarily related to proceduralist sampling, characteristics of the lesions, and lack of ultrasound guidance.
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Affiliation(s)
- Huiying Wang
- Department of Pathology, Microbiology and Immunology
| | | | - Ryan Belcher
- Department of Otolaryngology, Vanderbilt University Medical Center
| | | | | | - Kim Ely
- Department of Pathology, Microbiology and Immunology
| | - Joyce Johnson
- Department of Pathology, Microbiology and Immunology
| | - Alice Coogan
- Department of Pathology, Microbiology and Immunology
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Wang H, Liang J, Borinstein SC, Belcher R, Mannion K, Virgin F, Compton ML, Weiss VL, Ely K, Johnson J, Coogan A. Fine-Needle Aspiration Biopsy of Pediatric Salivary Gland Tumors: Analysis of Patient Tolerability, Sedation Requirement, and Procedural Complication. Acta Cytol 2022; 66:179-186. [PMID: 35226899 PMCID: PMC9976783 DOI: 10.1159/000522208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/09/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Fine-needle aspiration (FNA) biopsy is the standard diagnostic tool recommended by consensus management guidelines for preoperative evaluation of salivary gland tumors in adults. However, its utility in the pediatric population remains debated due to a paucity of data and inherited challenges of pediatric management (patient cooperation, the need for sedation, and procedural complications). METHODS Consecutive series of 92 FNA biopsies of pediatric salivary gland lesions with available procedural data were included for retrospective analysis. Patient demographics, procedural characteristics, and complications were assessed. RESULTS Sixty-three patients (68%) tolerated FNA without sedation. Sedation need was significantly associated with younger age, concurrent non-FNA procedure requiring sedation, ultrasound guidance, interventional radiologist as the proceduralist, and radiology suite as the facility setting. The sedation rates for children, and early, middle, and late adolescents were 69%, 32%, 12%, and 10%, respectively, with an optimal cutoff point of ≤12 years for age derived from receiver operating characteristic curve analysis. No significant procedural complications were observed. Sedation did not provide significantly better diagnostic yield. CONCLUSION FNA biopsy of salivary gland tumors is safe, well tolerated by the pediatric population, and can be effectively performed in an outpatient setting without sedation in most cases. FNA biopsy is a useful tool in the preoperative management of pediatric patients with salivary gland tumors.
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Affiliation(s)
- Huiying Wang
- Department of Pathology, Microbiology and Immunology
| | | | | | - Ryan Belcher
- Department of Otolaryngology, Vanderbilt University Medical Center
| | - Kyle Mannion
- Department of Otolaryngology, Vanderbilt University Medical Center
| | - Frank Virgin
- Department of Otolaryngology, Vanderbilt University Medical Center
| | | | | | - Kim Ely
- Department of Pathology, Microbiology and Immunology
| | - Joyce Johnson
- Department of Pathology, Microbiology and Immunology
| | - Alice Coogan
- Department of Pathology, Microbiology and Immunology
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The Epidemiology of Salivary Glands Pathologies in Adult Population over 10 Years in Poland-Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010179. [PMID: 35010439 PMCID: PMC8750634 DOI: 10.3390/ijerph19010179] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022]
Abstract
Background: The aim of this study was a comprehensive analysis of the incidence of different salivary gland pathologies in the adult population of Poland. Methods: A retrospective analysis of salivary gland pathologies diagnosed in Poland in 2010–2019 based on the National Health Fund (NHF) database was performed. Non-neoplastic diseases, and benign and malignant lesions were identified using ICD-10 codes. Demographic characteristics, incidence rates, and the number of inpatient and outpatient medical services were analyzed. Results: Salivary gland pathologies were diagnosed in 230,589 patients over 10 years (85.5% were non-neoplastic lesions, 11.53% benign and 2.93% malignant neoplasms). Incidence rate for all pathologies was 59.94/100,000. The mean incidence for malignant neoplasms was 1.78, and decreasing trend was observed over the analyzed period. Contrarily, for benign neoplasms (mean incidence—6.91), an increase in numbers was noted annually. The incidence for non-malignant lesions was quite stable (mean: 51.25) over the time. The highest number of medical services per patient concerned malignant neoplasms (on average, two hospital stays, and eleven outpatient consultations). Conclusions: An increase of benign salivary gland tumors, and a decrease of malignant neoplasms was observed during the studied period. The number of medical services related to salivary gland pathologies increased during the period under study.
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López-Janeiro Á, Cabañuz C, Blasco-Santana L, Ruiz-Bravo E. A tree-based machine learning model to approach morphologic assessment of malignant salivary gland tumors. Ann Diagn Pathol 2021; 56:151869. [PMID: 34823074 DOI: 10.1016/j.anndiagpath.2021.151869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/11/2021] [Indexed: 01/26/2023]
Abstract
Malignant salivary gland tumors represent a challenge for pathologists due to their low frequency and morphologic overlap. In recent years machine learning techniques have been applied to the field of pathology to improve diagnostic performance. In the present work, we fitted a machine learning algorithm to approach the diagnosis of malignant salivary gland tumors. Twelve morphologic variables were scored across 115 samples representing the most commonly encountered malignant salivary gland tumors. The sample was randomly split into a discovery and validation set. A recursive partitioning algorithm was used to systematically screen and organize candidate variables into a classification tree using the discovery set. A cross-validation strategy was used to tune the algorithm hyperparameters. Inter-observer concordance was calculated by independent evaluation of 26 randomly selected cases. The five-tiered tree built, required the evaluation of 6 morphological variables. Basaloid appearance, presence of mucous cells, necrosis, cribriform pattern, clear cells and keratinization were selected by the algorithm to build the tree. This diagnostic tool correctly classified 89.9% and 84.6% of the samples in the discovery and validation sets respectively. Misclassification pattern was consistent between both sets. Misclassified tumors belonged to one of three histologic types: epithelial-myoepithelial, polymorphous and mucoepidermoid carcinomas. Other histotypes demonstrated perfect recall in both the discovery and validation sets. Overall inter-observer concordance was good, with median kappa scores between the expert evaluator and training pathologists being 0.81. Overall, our classification tool developed using a recursive partitioning algorithm can effectively guide the morphological approach to malignant salivary gland tumors.
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Affiliation(s)
| | - Clara Cabañuz
- Hospital Universitario La Paz, Department of Pathology, Madrid 28046, Spain
| | | | - Elena Ruiz-Bravo
- Hospital Universitario La Paz, Department of Pathology, Madrid 28046, Spain
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Gontarz M, Urbańska-Gąsiorowska M, Bargiel J, Gąsiorowski K, Marecik T, Szczurowski P, Zapała J, Wyszyńska-Pawelec G. Sublingual gland neoplasms: clinicopathological study of 8 cases. Med Oral Patol Oral Cir Bucal 2021; 26:e626-e631. [PMID: 34415003 PMCID: PMC8412453 DOI: 10.4317/medoral.24634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/21/2021] [Indexed: 12/02/2022] Open
Abstract
Background Sublingual gland neoplasms are very rare and the majority of them are malignant. The aim of this study was to evaluate the clinical course, treatment, and outcomes of these uncommon neoplasms based on the authors’ experience and the recent literature. Material and Methods The medical charts of 8 patients with primary epithelial sublingual gland tumors treated between 1994 and 2020 were reviewed. Results Malignant tumors comprised 75% (6/8) of cases. Adenoid cystic carcinoma was the most common (50%, 3/6) and characterized by high risk of local recurrence and lung metastasis. Pleomorphic adenoma was the only representative of benign tumors with no evidence of local recurrence in follow up. Conclusions Treatment of choice of sublingual gland tumors is surgery. However, due to the fact that adenoid cystic carcinoma is the most common malignancy with poor prognosis, surgical treatment should be combined with postoperative radiotherapy. Benign sublingual tumors are less common and treatment of choice in these cases is tumor resection together with sublingual gland. Key words:Salivary gland neoplasms, sublingual gland, pleomorphic adenoma, adenoid cystic carcinoma, mucoepidermoid carcinoma.
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Affiliation(s)
- M Gontarz
- Department of Cranio-Maxillofacial Surgery Jagiellonian University Medical College, University Hospital 2 Jakubowskiego Street, 30-688 Cracow, Poland
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Wang H, Weiss VL, Ely K, Johnson J, Coogan A, Borinstein SC, Mannion K, Virgin F, Liang J. Application of the Milan System for Reporting Pediatric Salivary Gland Cytopathology: Analysis of histologic follow-up, risk of malignancy, and diagnostic accuracy. Cancer Cytopathol 2021; 129:555-565. [PMID: 33595882 PMCID: PMC10030063 DOI: 10.1002/cncy.22415] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/07/2021] [Accepted: 01/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The diagnosis and management of salivary gland tumors in pediatric patients can be challenging. The utility of fine-needle aspiration (FNA) cytopathology and the performance of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in this age group have not been systematically assessed. The paucity of data has contributed to the controversial role of FNA cytopathology in the presurgical management of these patients. METHODS The authors retrospectively analyzed 104 pediatric salivary gland FNAs (2000-2020). A correlation with the available histopathologic follow-up (n = 54) was performed. The distribution percentages, the risk of neoplasm (RON), and the risk of malignancy (ROM) were assessed for each category of the MSRSGC. RESULTS The overall sensitivity, specificity, negative predictive value, and positive predictive value of pediatric salivary gland FNAs were 80%, 97%, and 92%, respectively. The RON values for the nondiagnostic, nonneoplastic, atypia of undetermined significance, benign neoplasm, salivary gland neoplasm of uncertain malignant potential, suspicious for malignancy, and malignant categories were 60%, 11%, 100%, 100%, 100%, 100%, and 100%, respectively, whereas the ROM values were 0%, 11%, 100%, 6%, 67%, 100%, and 100%, respectively. The percentage of nonneoplastic FNAs was greater in comparison with the adult population (52% vs 8%). All neoplasms in patients aged 0 to 10 years were malignant, whereas benign neoplasms occurred only in patients aged ≥11 years; this supported an inverse correlation between age and malignancy rate in salivary gland neoplasms. CONCLUSIONS FNA cytopathology demonstrates excellent diagnostic performance in differentiating malignant and benign pediatric salivary gland lesions. The MSRSGC is a valuable tool for standardization of the reporting and preoperative risk stratification of these lesions.
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Affiliation(s)
- Huiying Wang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
| | - Vivian Lee Weiss
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
| | - Kim Ely
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
| | - Joyce Johnson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
| | - Alice Coogan
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
| | - Scott C. Borinstein
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt University Medical Center
| | - Kyle Mannion
- Department of Otolaryngology, Vanderbilt University Medical Center
| | - Frank Virgin
- Department of Otolaryngology, Vanderbilt University Medical Center
| | - Jiancong Liang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
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Luo XD, Han H. Prognostic analysis and nomogram establishment in patients with mucoepidermoid carcinoma of the tongue: a population-based study using the SEER database. Eur Arch Otorhinolaryngol 2021; 279:1489-1498. [PMID: 34152476 DOI: 10.1007/s00405-021-06919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/29/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe the clinicopathological characteristics and determinants of survival of patients with mucoepidermoid carcinoma (MEC) of the tongue. METHOD Retrospective population-based study was conducted using the data of patients diagnosed with MEC of the tongue from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. RESULTS A total of 200 cases of MEC of the tongue were identified. The cohort was composed of 56.5% females. The mean age at diagnosis was 58.8 years. The base of the tongue was the most common primary site (72.5%). Most cases (80.9%) presented with T1 and T2. Lymph node metastases was present in 40.9% of cases, while distant metastases only observed in 2.2% of cases. Overall survival (OS) at 2, 5, and 10 years was 80.2%, 69.8%, and 52.4%, respectively. 77.5 percent of cases (155/200) underwent surgery, and 66 cases received both surgery and radiation therapy. Patients with post-operative radiation had much longer disease-specific survival (DSS). Advanced T stage, distant metastasis contributed independently to shorter OS, while the use of surgery is an independently favorable prognostic factor for OS. In addition, an OS-specific nomogram was established, and the C-index for OS prediction was 0.74 (95% CI 0.67-0.81). CONCLUSION This rare malignancy is associated with a generally favorable prognosis, and T stage, distant metastasis as well as surgical therapy are independent predictors of OS.
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Affiliation(s)
- Xiao-Ding Luo
- Department of Implant Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin, 300070, China
| | - Hui Han
- Department of Pediatric Dentistry, Jinan Stomatological Hospital, No.101 Jinliu Road, Jinan, 250001, China.
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Abstract
There are several hundred minor salivary glands throughout the upper aerodigestive tract, aiding in lubrication and protection of the system. Compared with all tumors of the head and neck and those of the six major glands, neoplasms of the minor glands are rare. However, more than half are found to be malignant, prompting a low threshold for further work-up. This review discusses the evaluation of patients who present with masses of the minor salivary glands, including strategies for tissue diagnosis and staging. Management options for and long-term survival outcomes of the most common malignancies affecting these glands are also discussed.
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Gontarz M, Bargiel J, Gąsiorowski K, Marecik T, Szczurowski P, Zapała J, Wyszyńska-Pawelec G. Epidemiology of Primary Epithelial Salivary Gland Tumors in Southern Poland-A 26-Year, Clinicopathologic, Retrospective Analysis. J Clin Med 2021; 10:1663. [PMID: 33924553 PMCID: PMC8070067 DOI: 10.3390/jcm10081663] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/01/2021] [Accepted: 04/10/2021] [Indexed: 01/09/2023] Open
Abstract
(1) Background: Epidemiological studies of epithelial salivary gland neoplasms are difficult to conduct effectively due to tumor rarity, histological heterogeneity, tumor location diversity, and a lack of national registries collecting data. This study presents 26 years of epidemiological data from a single institution in southern Poland that estimates incidence rates of primary epithelial salivary gland tumors. (2) Methods: The charts of 805 patients with epithelial salivary gland tumors were retrospectively reviewed. (3) Results: Pleomorphic adenomas occurred less frequently in elderly patients; however, Warthin tumors were more common (p < 0.001). Pediatric patients mainly suffered from mucoepidermoid carcinoma. The estimated crude and European age-standardized incidence rates of all primary epithelial salivary gland tumors were 6.7 and 6.02 per 100,000 population, respectively. The incidence rates of salivary gland tumors increased in recent years; however, this is attributed to an increase in benign tumors (p < 0.001). (4) Conclusions: The incidence of primary epithelial salivary gland tumors in southern Poland has increased over the past 26 years. This increase is attributed to a rise in the number of patients with benign tumors, particularly Warthin tumors in elderly patients. Moreover, the incidence of malignant salivary gland tumors appears to be higher in pediatric patients.
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Affiliation(s)
- Michał Gontarz
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 31-008 Cracow, Poland; (J.B.); (K.G.); (T.M.); (P.S.); (J.Z.); (G.W.-P.)
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Santana BW, Silva LP, Serpa MS, Borges MD, Moura SR, Silveira MM, Sobral AP. Incidence and profile of benign epithelial tumors of salivary glands from a single center in Northeast of Brazil. Med Oral Patol Oral Cir Bucal 2021; 26:e108-e113. [PMID: 33247571 PMCID: PMC7806355 DOI: 10.4317/medoral.24056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
Background Benign tumors of the salivary glands are a group of lesions with varied histopathological and clinical spectrum. The aim was to determine the incidence and clinicopathological characteristics of benign salivary gland neoplasms diagnosed between 2007 and 2016 in a single center located in northeastern Brazil.
Material and Methods Records regarding sex, age, anatomical location, histopathological subtype and treatment were retrieved, and data were analyzed using the Stata/IC software (version 12.0).
Results There were above 7,100 cases of neoplasms in the head and neck region, of which 403 corresponded to salivary gland neoplasms. Of these, 238 (59%) were benign, being pleomorphic adenoma (PA) the most frequent neoplasm (n=178; 74.8%), followed by Warthin's tumor (WT) (n=23; 9.7%). Overall, most cases occurred in females (n=136; 57.1%) and age ranged from 11 to 83 years. The parotid gland (n=188; 79%) was the most common anatomical site, and all patients were treated by surgical excision. Of the cases diagnosed as PA, malignant transformation to carcinoma ex-pleomorphic adenoma (CAEXPA) occurred in 7 (3.9%) cases.
Conclusions The present study confirmed the clinical and demographic profile of benign salivary gland neoplasms, which contributes to the continuous knowledge of current data about these lesions. Key words:Salivary gland, benign neoplasms, epidemiology.
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Affiliation(s)
- B-W Santana
- Postgraduate Program in Dentistry, School of Dentistry, University of Pernambuco Av. General. Newton Cavalcanti, 1650 - Tabatinga Camaragibe, Zip code: 54756-220, Recife/PE, Brazil
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Cunha JLS, Hernandez-Guerrero JC, de Almeida OP, Soares CD, Mosqueda-Taylor A. Salivary Gland Tumors: A Retrospective Study of 164 Cases from a Single Private Practice Service in Mexico and Literature Review. Head Neck Pathol 2020; 15:523-531. [PMID: 33044721 PMCID: PMC8134594 DOI: 10.1007/s12105-020-01231-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/01/2020] [Indexed: 12/31/2022]
Abstract
Salivary gland tumors (SGT) represent an uncommon heterogeneous group of tumors with complex clinical and pathological characteristics. The prevalence of these lesions varies between studies but has been estimated between 3 and 6% of all tumors in the head and neck region. The present study aimed to evaluate the distribution and demographic findings of salivary gland tumors diagnosed in an oral pathology service in Mexico. A retrospective descriptive cross-sectional study was performed. A total of 164 cases of SGT from a private oral pathology service were diagnosed between 2000 and 2019 in Mexico City. All cases were reviewed histologically, and demographic data and histopathological diagnoses were collected. A total of 110 (67.1%) tumors were benign, and 54 (32.9%) were malignant. The majority of patients were female (n = 100, 61.0%) with an overall female:male ratio of 1.6:1. The minor salivary glands were affected more than the major salivary glands (68.9% vs. 25.6%). The palate (n = 67, 40.9%) was the most commonly affected site, followed by the parotid gland (n = 37, 22.6%), lips (n = 16, 9.8%), and buccal mucosa (n = 14, 8.5%). Pleomorphic adenoma (n = 88; 80.0%) and mucoepidermoid carcinoma (n = 16, 29.6%) were the most frequent benign and malignant tumors, respectively. The general features of SGT from the studied Mexican population shared some similarities and differences compared to previously reported series from various parts of the world.
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Affiliation(s)
- John Lennon Silva Cunha
- grid.411087.b0000 0001 0723 2494Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, P.O. Box. 52, Piracicaba, São Paulo 1314-903 Brazil
| | - Juan Carlos Hernandez-Guerrero
- grid.9486.30000 0001 2159 0001Facultad de Odontología, Laboratory of Immunology, Universidad Nacional Autónoma de México (UNAM), México City, México
| | - Oslei Paes de Almeida
- grid.411087.b0000 0001 0723 2494Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, P.O. Box. 52, Piracicaba, São Paulo 1314-903 Brazil
| | - Ciro Dantas Soares
- grid.411087.b0000 0001 0723 2494Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, P.O. Box. 52, Piracicaba, São Paulo 1314-903 Brazil
| | - Adalberto Mosqueda-Taylor
- grid.7220.70000 0001 2157 0393Facultad de Odontología, Universidad Autónoma Metropolitana Xochimilco (UAM), México City, México
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Poletto AG, Mello FW, Melo G, Rivero ERC. Prevalence of mucoepidermoid carcinoma among intraoral minor salivary gland tumors: A systematic review and meta-analysis. J Oral Pathol Med 2020; 49:720-726. [PMID: 32531838 DOI: 10.1111/jop.13073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/30/2022]
Abstract
This study aimed to synthetize and critically appraise available evidence regarding mucoepidermoid carcinoma (MEC) prevalence among intraoral minor salivary gland tumors (MiSGT). Five main electronic databases and three grey literature databases were searched. The risk of bias (RoB) was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Proportion meta-analyses were performed. From 1321 studies identified, 82 were included in qualitative synthesis and 80 in meta-analyses. Sixteen were classified as high, 33 as moderate, and 33 as low RoB. A total of 12 774 MiSGT were found, of which overall MEC prevalence was 16.5% (95% Confidence Interval [95% CI] = 14.8%-18.4%). Most MiSGT were found in the palate (n = 7115), although MEC pooled prevalence in this anatomic location was only 13.6% (95% CI = 11.7%-15.6%). The retromolar area presented the highest pooled prevalence (58.9%; 95% CI = 47.0%-70.3%), followed by gingiva (28.8%; 95% CI = 22.7%-35.4%) and tongue (27.2%; 95% CI = 21.2%-33.6%). Regarding geographic location, Middle East presented the highest pooled prevalence (20.8%; 95% CI = 14.8%-27.6%), followed by America (20.0%, 95% CI = 17.2%-23%) and Europe (15.6%; 95% CI = 9.2%-23.5%). Among MiSGT, the MEC overall prevalence was approximately 16.5%. Although most MiSGT were found in the palate, the retromolar area was proportionally more affected by MEC.
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Affiliation(s)
- André Goulart Poletto
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Fernanda Weber Mello
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Gilberto Melo
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
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Cunha JL, Coimbra AC, Silva JV, Nascimento IS, Andrade ME, Oliveira CR, Almeida OP, Soares CD, Sousa SF, Albuquerque-Júnior RL. Epidemiologic analysis of salivary gland tumors over a 10-years period diagnosed in a northeast Brazilian population. Med Oral Patol Oral Cir Bucal 2020; 25:e516-e522. [PMID: 32388524 PMCID: PMC7338061 DOI: 10.4317/medoral.23532] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/24/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Salivary gland tumors (SGT) correspond to a heterogeneous group of lesions with variable biological behavior. The present study aimed to determine the distribution and demographic findings of salivary gland neoplasms in a northeast Brazilian population. MATERIAL AND METHODS A retrospective descriptive cross-sectional study was performed. A total of 588 cases of SGT were diagnosed between 2006 and 2016 of 4 pathology services in the state of Sergipe, Brazil. All cases were reviewed, and data such as sex, age, anatomical location, and histopathological diagnosis were collected. RESULTS A total of 470 (79.9%) tumors were benign and 118 (20.1%) were malignant. The majority of the patients were females (n=328, 55.8%) with an overall female:male ratio of 1.2:1. The major salivary glands were affected more than the minor glands (69.5% vs. 30.5%). Pleomorphic adenoma (n=419, 71.3%) and mucoepidermoid carcinoma (n=29, 4.9%) were the most frequent benign and malignant tumors, respectively. In addition, both benign and malignant tumors occurred more frequently in the parotid gland (n=300, 51%, p<0.05). CONCLUSIONS The epidemiologic profile and clinical characteristics of SGT were similar to those described in other countries and other regions of Brazil. Epidemiological studies of SGT help to understand their clinical and pathological features and are essential to establish the proper management and prognosis.
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Affiliation(s)
- J-L Cunha
- Laboratory of Morphology and Experimental Pathology Institute of Technology and Research, Tiradentes University Av. Murilo Dantas, 300, Farolândia, Aracaju, SE 49032-490, Brazil
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Leite AA, Vargas PA, Dos Santos Silva AR, Galvis MM, de Sá RS, Lopes Pinto CA, Kowalski LP, Saieg M. Retrospective application of the Milan System for reporting salivary gland cytopathology: A Cancer Center experience. Diagn Cytopathol 2020; 48:821-826. [PMID: 32374949 DOI: 10.1002/dc.24464] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/31/2020] [Accepted: 04/24/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was recently proposed. Herein, we retrospectively applied this nomenclature system to salivary gland lesions sampled by ultrasound-guided fine-needle aspiration (FNA). METHODS All cases of salivary gland FNA with available surgical follow-up, in the period from 2014 to 2017 at our institution were reviewed and reclassified according to one of the six categories of the MSRSGC, blind to the surgical outcome. Overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, as well as risks of neoplasm (RON) and risk of malignancy (ROM) for each of the proposed categories. RESULTS There were 104 salivary gland lesions, with a female predominance (57.7%), most cases from the parotid gland (89.4%). Mean age was 53.2 years. Distribution of the specimens according to the Milan System was as follows: 19.2% nondiagnostic (ND), 8.7% non-neoplastic (NN), 9.6% atypia of undetermined significance (AUS), 40.4% benign neoplasm (BN), 14.4% salivary gland neoplasm of uncertain malignant potential (SUMP), 1.9% suspicious for malignancy (SFM), and 5.8% malignant. Sensitivity, specificity, PPV, and NPV using MSRSGC were calculated as 75%, 98.4%, 88.9%, and 95.3%, respectively. RON/ROM for each category were 60%/15% for ND, 44.4%/0% for NN, 90%/40% for AUS, 100%/9.5% for BN, 100%/13.3% for SUMP, 50%/50% for SFM and 100%/100% for malignant. CONCLUSION The use of the Milan System proved to be a useful method to predict the risk of neoplasm and malignancy in the sample studied, with high sensitivity and specificity.
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Affiliation(s)
- Amanda Almeida Leite
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Marisol Miranda Galvis
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Raisa Sales de Sá
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Mauro Saieg
- Department of Pathology, Santa Casa Medical School, São Paulo, Brazil
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Chegini S, Brennan PA, Rahimi S, Shakib K. Recent advances in the histopathological assessment of salivary disease. J Oral Pathol Med 2020; 49:601-605. [PMID: 32027401 DOI: 10.1111/jop.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Salivary gland disease includes a wide range of unique and rare conditions that are treated by ear, nose and throat (ENT), oral and maxillofacial surgeons (OMFS) and oral medicine specialists. Histopathological diagnosis is pivotal to making a diagnosis and treatment planning. There is a vast range of conditions and controversies in the histopathological assessment of salivary gland diseases. Most colleagues in oral pathology and oral medicine work closely with the OMFS but might have missed some of the recent articles published by the speciality. METHODS We reviewed articles thought to be relevant to oral medicine and pathology specialists published over an 8-year period between 2012 and 2019 in the leading British Journal of Oral and Maxillofacial Surgery (BJOMS). RESULTS A total of 44 published articles relating to the histopathology of salivary glands disease were selected. Papers were published on population studies, benign and malignant tumours, sialadenitis, metastasis to the parotid gland and cytology. The publication type and numbers published were as follows: review (n = 9), meta-analysis/randomised controlled study (n = 1), retrospective study (n = 10) and case report/technical notes (n = 23). CONCLUSIONS The greatest proportion of publications published in BJOMS were case reports. This emphasises the paucity of consensus and the need for development in this field. Salivary gland disease remains an area with many controversies and would benefit from further research.
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Affiliation(s)
| | | | - Siavash Rahimi
- Frontier Pathology-Histopathology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Kaveh Shakib
- Department of Surgery, University College London, London, UK
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Reinheimer A, Vieira DSC, Cordeiro MMR, Rivero ERC. Retrospective study of 124 cases of salivary gland tumors and literature review. J Clin Exp Dent 2019; 11:e1025-e1032. [PMID: 31700577 PMCID: PMC6825733 DOI: 10.4317/jced.55685] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/07/2019] [Indexed: 11/05/2022] Open
Abstract
Background Salivary gland tumors are a rare and morphologically diverse group of lesions and their frequency is still unknown in several parts of the world. The knowledge of its population characteristics contributes to a better understanding of its etiopathogenesis. Objectives: This study investigated the frequency of salivary gland tumors in a region of southern Brazil and compared these data in a literature review. Material and Methods A retrospective study was conducted of salivary gland tumors diagnosed at two pathology centers from 1995 to 2016. Patient age and gender, tumor site and frequency, histopathological diagnosis, and symptomatology were evaluated. Chi-squared tests were used to assess the associations between variables. To compare our data, we also conducted a literature review of publications in the PubMed and LILACS databases of retrospective studies of salivary gland tumors. Results A total of 124 salivary gland tumor cases was identified, 81 (65.3%) of which were classified as benign and 43 (34.6%) as malignant. Most tumors occurred in the parotid gland (57.2%). Pleomorphic adenoma was the most common tumor (59.6%), followed by adenocarcinoma not otherwise specified (8.8%). The tumors occurred more often in women (54.8%) than in men (45.2%). Malignant tumors were associated with pain in 31.4% of cases (p<0.05). The literature review included 35 articles from different countries. Women were most affected, with a mean age of 41.7 years. The most common benign tumor was pleomorphic adenoma (48.2%) and the most common malignant tumor was mucoepidermoid carcinoma (8.7%). Conclusions The results of the present study showed that salivary gland tumors are rare. The parotid gland is the most common location and pleomorphic adenoma are the most frequent lesions. The malignant tumors presented as several histological types and the incidence was variable globally. Key words:Salivary gland neoplasms, salivary gland diseases, oral surgery, epidemiology.
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Affiliation(s)
- Angélica Reinheimer
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Edafe O, Hughes B, Tsirevelou P, Goswamy J, Kumar R. Understanding primary parotid squamous cell carcinoma - A systematic review. Surgeon 2019; 18:44-48. [PMID: 31040083 DOI: 10.1016/j.surge.2019.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 03/24/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The true incidence of primary parotid squamous cell carcinoma (SCC) is unknown and likely overestimated in the literature. The aim of this systematic review is to examine the diagnosis, aetiology and incidence of parotid SCC by analysing studies evaluating primary parotid SCC. METHODS A systematic search of Medline, EMBASE and Cochrane library was performed. A narrative synthesis was done. RESULTS A total of 14 observational retrospective studies on primary parotid SCC were included. There are currently no standard criteria for ascertainment of primary parotid SCC. Primary parotid SCC is thought to be due to squamous metaplasia within the ductal epithelium and subsequent invasive squamous carcinoma. Histological features that favour primary disease includes SCC confined to parotid parenchyma with no direct communication to the skin and the absence of mucin. Incidence of primary parotid SCC varied from 1.54 to 2.8 cases per million person-years. Around 30%-86% of patients recorded to have primary parotid SCC on clinical records, when scrutinised, were in fact secondary to parotid lymph node involvement following regional advancement from skin or upper aerodigestive tract SCC. CONCLUSION Primary parotid SCC is rare and it is currently a diagnosis of exclusion. Thorough clinical assessment including endoscopy, preoperative imaging and the scrutiny of histopathological findings allow for differentiation between primary and secondary SCC within the parotid. This thus affects both initial treatment and subsequent follow-up.
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Affiliation(s)
- O Edafe
- Department of ENT, Sheffield Teaching Hospitals Foundation Trust, UK.
| | - B Hughes
- Warrington and Halton Hospitals NHS Trust, UK
| | - P Tsirevelou
- Department of ENT, Sherwood Forest Hospitals NHS Foundation Trust, UK
| | - J Goswamy
- Department of ENT, Manchester University NHS Foundation Trust, UK
| | - R Kumar
- Department of ENT, Manchester University NHS Foundation Trust, UK
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Abstract
Salivary gland tumors are rare pathologic entities that are derived from major and minor salivary gland tissue located throughout the head and neck region. These tumors are distinctly heterogenous, comprising numerous cell types, especially those deemed malignant. The incidence of malignant salivary gland tumors is widely distributed in both adult and pediatric patient populations. Accurate diagnosis and optimal treatment of these tumors pose challenges to both interpreting pathologists and ablative surgeons. This article examines the epidemiology and pathology of malignant tumors of the major and minor salivary glands and provides recommendations for the most successful treatment approaches.
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Affiliation(s)
- Eric R Carlson
- Department of Oral and Maxillofacial Surgery, University of Tennessee Cancer Institute, 1930 Alcoa Highway, Suite 335, Knoxville, TN 37920, USA.
| | - Thomas Schlieve
- Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical School, Parkland Memorial Hospital, 5323 Harry Hines Boulevard, Mail Code 9109, Dallas, TX 75390, USA
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Salivary gland tumors in a Brazilian population: A 20-year retrospective and multicentric study of 2292 cases. J Craniomaxillofac Surg 2018; 46:2227-2233. [DOI: 10.1016/j.jcms.2018.09.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/30/2018] [Accepted: 09/24/2018] [Indexed: 11/24/2022] Open
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Shen SY, Wang WH, Liang R, Pan GQ, Qian YM. Clinicopathologic analysis of 2736 salivary gland cases over a 11-year period in Southwest China. Acta Otolaryngol 2018; 138:746-749. [PMID: 29656683 DOI: 10.1080/00016489.2018.1455108] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To investigate the epidemiological and clinicopathological characteristics of salivary gland tumors in southwest China in order to provide data for clinical diagnosis and other similar research. METHODS Between March 2007 and December 2017, 2736 patients with salivary gland tumors were recruited, the clinical and pathological data were retrospectively analyzed. RESULTS A total of 2736 patients had a ratio of males to females of about 1.02:1. The ratio of benign to malignant tumors was 3.46:1. Pleomorphic adenoma and adenoid cystic carcinoma had 50.8% and 7.2%, respectively. About 65.4% tumors occurred in the parotid gland. There was no significant difference between the tumor in the left or right parotid and the use of cell phones. There were significant differences between gender and both the characteristics and locations of salivary gland tumors (p < .05). There were also significant differences between the pathological characteristics and location of the salivary gland (p < .05). CONCLUSIONS The salivary gland benign and malignant tumors were more common in pleomorphic adenoma and adenoid cystic carcinoma, most occurred in the parotid gland. The minor gland tumors are lower than other parts of China. The incidence of parotid gland tumors is not related to the use of cell phones.
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Affiliation(s)
- S. Y. Shen
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - W. H. Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - R. Liang
- Department of Pathology, First People’s Hospital of Yunnan Province, Kunming, China
| | - G. Q. Pan
- Department of Pathology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Y. M. Qian
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
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Epidemiological Evaluation of Palatal Cancers in Iran: A Study on 303 Cases. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.61788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cavalcante RB, Nonaka CFW, Santos HBDP, Rabenhorst SHB, Pereira Pinto L, de Souza LB. Assessment of CTNNB1 gene mutations and β-catenin immunoexpression in salivary gland pleomorphic adenomas and adenoid cystic carcinomas. Virchows Arch 2018; 472:999-1005. [DOI: 10.1007/s00428-018-2335-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/09/2018] [Accepted: 03/09/2018] [Indexed: 12/13/2022]
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Carlson ER, McCoy JM. Margins for Benign Salivary Gland Neoplasms of the Head and Neck. Oral Maxillofac Surg Clin North Am 2017; 29:325-340. [DOI: 10.1016/j.coms.2017.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Collazo-Fernández L, Campo-Trapero J, Cano-Sánchez J, García-Martín R, Ballestín-Carcavilla C. Retrospective study of 149 cases of salivary gland carcinoma in a Spanish hospital population. Med Oral Patol Oral Cir Bucal 2017; 22:e207-e213. [PMID: 28160579 PMCID: PMC5359697 DOI: 10.4317/medoral.21419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 01/11/2017] [Indexed: 11/14/2022] Open
Abstract
Background The clinical and histological characteristics of salivary gland tumors vary widely, complicating their diagnosis and management, and major differences have been recorded in the distribution of histopathological diagnoses among different countries. Material and Methods This retrospective study reviewed the demographic (age, sex) and clinicopathological (pathology diagnosis and localization) characteristics of cases diagnosed with primary SGC between June 1992 and May 2014 in the Pathology Department of the 12 de Octubre Hospital of Madrid. Diagnoses were recorded according to the 2005 WHO classification. Results The study included 149 SCG patients, aged between 11 and 94 yrs, with mean age at onset of 55.56 yrs and peak incidence in the eighth decade of life. The male:female ratio was 1.01. The parotid gland was the most frequently involved (75.2%). The most frequent carcinoma was mucoepidermoid carcinoma (24.2%), followed by acinic cell carcinoma (15.4%). Conclusions The demographic and histopathological characteristics of patients with salivary gland carcinomas in Spain, reported here for the first time, are broadly similar to those found in other countries. Key words:Salivary gland carcinomas, descriptive, salivary glands, salivary gland tumors, head and neck cancer, oral cancer, Spain.
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Affiliation(s)
- L Collazo-Fernández
- Department of Medicine and, Orofacial Surgery (Stomatology III), School of Dentistry, Complutense University of Madrid, Pza. Ramón y Cajal, s/n, 28040, Madrid, Spain,
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Mucoepidermoid Carcinoma of the Palatine Tonsil. Case Rep Oncol Med 2015; 2015:827560. [PMID: 26550506 PMCID: PMC4624925 DOI: 10.1155/2015/827560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/30/2015] [Indexed: 11/17/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) is the most common primary salivary gland malignancy in both adults and children. It has a slight female predilection and usually presents as a painless, rubber-like or soft mass, which may be fixed or mobile. Histologically, MEC is comprised of a mixture of cell types including mucous, epidermoid, and intermediate cells that can be arranged in solid nests or cystic structures. In the oral cavity, it most frequently occurs at the palate or buccal mucosa. The present paper aimed to describe an unusual case of MEC arising in the palatine tonsil.
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