head and neck. salivary gland tumours epithelial epithelial benign benign pleomorphic adenoma (mixed...

Head And NeckHead And Neck

Salivary gland TumoursSalivary gland Tumours EpithelialEpithelial

BenignBenign Pleomorphic adenoma (Mixed parotid)Pleomorphic adenoma (Mixed parotid) Monomorphic adenoma Adenolymphoma, Monomorphic adenoma Adenolymphoma,

oncocytomaoncocytoma MalignantMalignant

PrimaryPrimary Acini Adenocarcinoma,adenoid cystic,acinic Acini Adenocarcinoma,adenoid cystic,acinic

cell carcicell carci Ducts MucoepidermoidDucts Mucoepidermoid High grade squamus cell carcinomaHigh grade squamus cell carcinoma Low grade 10 times more comonLow grade 10 times more comon Mixed malignant mixed saliveryMixed malignant mixed salivery

Secondary rareSecondary rare

StromalStromal Benign hemangioma, neurofibroma Benign hemangioma, neurofibroma Malignant sarcoma, lymphomaMalignant sarcoma, lymphoma

Incidence of Salivary tumorsIncidence of Salivary tumors Role of 80%Role of 80%

80% of salivary tumors develop in the parotid80% of salivary tumors develop in the parotid 80% are benign80% are benign 80% of bengin are mixed salivery80% of bengin are mixed salivery

Incidence of malignancyIncidence of malignancy

increase as the size of the gland increase as the size of the gland decreasedecrease

Parotid 20%, Submandibular 50%,Minor Parotid 20%, Submandibular 50%,Minor salivary 75%salivary 75%

Mixed Salivary tumorsMixed Salivary tumors ( pleomorphic adenoma)( pleomorphic adenoma)

Incidence:Incidence: 60% of all salivary tumors60% of all salivary tumors 25-50 y ,females more, superficial lobe 25-50 y ,females more, superficial lobe

moremore Clinical pictureClinical picture

Painless swelling over the angle of the Painless swelling over the angle of the mandibule anterior to ear lobulemandibule anterior to ear lobule

Swelling very slowly growing, well defined, Swelling very slowly growing, well defined, rounded, painless, smooth , lobulated,firm rounded, painless, smooth , lobulated,firm and mobileand mobile

Salivary neoplasmSalivary neoplasm( pleomorphic adenoma)( pleomorphic adenoma)

AdenolymphomaAdenolymphoma

IncidenceIncidence Second common benign,97% in parotidSecond common benign,97% in parotid Over 40y, more in male,bilateral 10%Over 40y, more in male,bilateral 10%

PathologyPathology It is a hamartoma,inclusion of the parotid gland duds It is a hamartoma,inclusion of the parotid gland duds

(ducts) into the LN near the parotid(ducts) into the LN near the parotid Cystic spaces,lined by epith,embeded in lymphoid Cystic spaces,lined by epith,embeded in lymphoid

matrixmatrix Clinical pictureClinical picture

Painless sweeling in the parotid area,more mobile,soft Painless sweeling in the parotid area,more mobile,soft even cystic,no invasioneven cystic,no invasion

TreatmentTreatment Superficial parotidectomySuperficial parotidectomy

AdenolymphomaAdenolymphoma

Malignant salivary tumorsMalignant salivary tumors

IncidenceIncidence The most common is The most common is

the Mucoepidermoid in the parotidthe Mucoepidermoid in the parotid Adenoid cystic carcinoma in other glandsAdenoid cystic carcinoma in other glands

Age more in old age ,except Age more in old age ,except adenocarcinoma in childrenadenocarcinoma in children

Sex male and female equalSex male and female equal Male squamous cell carcinoma is moreMale squamous cell carcinoma is more Female malignant mixed salivary is moreFemale malignant mixed salivary is more

Carcinoma of the ParotidCarcinoma of the Parotid Squamus cell carcinomaSquamus cell carcinoma

The commonestThe commonest Signs of malignancySigns of malignancy

S size recent rapid increase in sizeS size recent rapid increase in size C hard on consistancyC hard on consistancy E irregular edgesE irregular edges P painP pain M limited mobilityM limited mobility

Invade Invade skin ulcerskin ulcer Facial nerveFacial nerve Superficial temporal arterySuperficial temporal artery Muscles and bonesMuscles and bones Cervical LNCervical LN

Malignant tumorsMalignant tumors

DD (lipoma)DD (lipoma)

Osteosarcoma bonesOsteosarcoma bones

Hemorrhagic cyst in the Hemorrhagic cyst in the parotidparotid

Superficial parotidectomySuperficial parotidectomy

Total ParotidectomyTotal Parotidectomy