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134 Cards in this Set
- Front
- Back
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What is a MUCOCELE?
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common lesion resulting from rupture of a salivary gland duct and spillage of mucin into the surrounding soft tissues
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A MUCOCELE is often the result of _______.
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local trauma
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What is the MOST COMMON NON-NEOPLASTIC LESION OF SALIVARY GLANDS?
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mucocele
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What is the most common site of MUCOCELE?
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Lower lip
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What is the clinical presentation of a mucocele?
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- dome-shaped mucosal swelling
- soft and fluctuant - some may be firm |
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What is the treatment of MUCOCELE?
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- (chronic lesion) local excision along with adjacent granular tissue feeding into it
- submit for microscopic examination - good prognosis - superficial variants are short lived and heal on their own |
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What is a RANULA?
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mucocele of the floor of mouth
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RANULA usually arises from which gland?
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sublingual gland
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What is the clinical presentation of a RANULA?
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- blue
- dome shaped - fluctuant swelling |
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What is PLUNGING / CERVICAL RANULA?
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unusual clinical variant of ranula, spilled mucin dissects through the mylohyoid muscle and produces swelling within the neck and swelling of FOM may be present
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What is the treatment sequence for RANULA?
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- initial treatment is marsupialization
- further treatment involves removal of the salivary gland |
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Define "MARSUPIALIZATION"
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cannulation of the duct to re-establish communication with oral cavity
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What is SIALOLITHIASIS?
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occurence of calcified deposits in the salivary ductal system
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SIALOLITHIASIS arises from what?
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- deposition of calcium salts around nidus of debris within the lumen
- not related to systemic condition |
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SIALOLITHS most often develop where?
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Submandibular gland duct
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MAJOR GLAND SIALOLITHS most commonly present with:
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- episodic pain or swelling of gland, especially at mealtime
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MINOR GLAND SIALOLITHS most commonly present with:
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- often asymptomatic
- local swelling or tenderness - hard moveable nodule within submucosa |
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What is the treatment of SIALOLITHS?
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- small stones may be expressed from the duct
- large stones require surgical removal - gland may need to be removed if significant inflammatory damage has occurred |
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Inflammation of the salivary glands can arise from what two causes?
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INFECTION
- viral - bacterial NON-INFECTIOUS - Sjorgens - sarcoidosis - radiation therapy |
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Define SIALODENITIS:
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Inflammation of the salivary glands
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What is the most common viral infection of salivary glands?
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Mumps (epidemic parotitis)
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Patients with MUMPS are contagious from which period?
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1 day before clinical appearance of infection to 14 days after resolution.
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Incubation period of MUMPS is how long?
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16- 18 days
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In Canada the MMR vaccine is recommended for:
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all children 12-15 months,
with a second dose at 18 months |
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Most cases of BACTERIAL SIALADENITIS result from:
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- ductal obstruction (sialolithiasis, congenital structure, compression by tumour)
- decreased salivary flow (dehydration, debilitation, medication) |
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More common causes of BACTERIAL SIALADENITIS result from:
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recent major surgery
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Most cases of BACTERIAL SIALADENITIS are caused by which bacteria?
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Staphylococci aureus
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ACUTE BACTERIAL SIALADENITIS is most common in which gland?
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Parotid
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What is NECROTIZING SIALOMETAPLASIA?
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an uncommon locally destructive inflammatory condition of the salivary glands that clinically and histologically may mimic malignancy
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What are some potential predisposing factors for NECROTIZING SIALOMETAPLASIA?
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- trauma
- dental injection - ill-fitting dentures - adjacent tumours - upper respiratory tract infection - previous surgery |
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Most common location of NECROTIZING SIALOMETAPLASIA are:
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posterior hard palate
anterior soft palate |
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NECROTIZING SIALOMETAPLASIA is easily mistaken for:
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- mucoepidermoid carcinoma
- squamous cell carcinoma |
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What is the treatment of NECROTIZING SIALOMETAPLASIA?
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biopsy indicated to rule out malignancy
no specific treatment needed once diagnosis established |
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What is SIALADENOSIS?
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an unusual non-inflammatory disorder characterized by salivary gland enlargement, particularly the parotid
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SIALADENOSIS is usually in association with what three causes?
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- endocrine (diabetes mellitus)
- nutrition (malnutriotion) - neurogenic medications (antihypertensives, sympathomimetic drugs) |
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What are the clinical features of SIALADENOSIS?
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slowly evolving swelling of the parotid glands
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What is BLEL?
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benign lymphoid epithelial lesion
- autoimmune process which results in infiltration of the parotid gland with lymphocytes resulting in parenchymal destruction and enlargement of the area |
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What is Sjogrens Syndrome?
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SS is a chronic, systemic autoimmune disorders that principally involves the salivary and lacrimal glands
- continuation of BLEL |
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What are the two forms of SJOGRENS?
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Primary: xerostomia and xeropthalmia
Secondary: sicca syndrome plus any other autoimmune disease eg: rheumatoid arthitis, SLE, Hashimoto's, |
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Define SIALADENITIS:
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inflammation of salivary glands
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Define CHRONIC SCLEROSING SIALADENITIS:
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chronic inflammatory infiltrate with associated acinar atrophy, ductal dilatation and fibrosis
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Define SIALOLITH:
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calcified structures that develop within ductal system
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Define XEROSTOMIA:
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dry mouth
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Define XEROPTHALMIA:
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dry eyes
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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MUCOCELE
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IDENTIFY THE LESION:
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RANULA
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IDENTIFY THE LESION:
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RANULA
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IDENTIFY THE LESION:
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RANULA
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IDENTIFY THE LESION:
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RANULA
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IDENTIFY THE LESION:
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RANULA
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IDENTIFY THE LESION:
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SIALOLITHIASIS
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IDENTIFY THE LESION:
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SIALOLITHIASIS
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IDENTIFY THE LESION:
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SIALOLITHIASIS
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IDENTIFY THE LESION:
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SIALOLITHIASIS
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IDENTIFY THE LESION:
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SIALOLITHIASIS
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IDENTIFY THE LESION:
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SIALOLITHIASIS
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IDENTIFY THE LESION:
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MUMPS
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IDENTIFY THE LESION:
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MUMPS
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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IDENTIFY THE LESION:
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NECROTIZING SIALOMETAPLASIA
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What is the basic unit of the salivary gland consist of?
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- secretory component (acinus and myoepithelial cells)
- ductal component (intercalated duct, striated duct, and excretory duct) |
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BENIGN parenchymal tumours are classified as what?
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ADENOMAS
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MALIGNANT parenchymal tumours are classified as what?
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ADENOCARCINOMAS
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What is the etiology of NEOPLASTIC SALIVARY GLAND DISEASE?
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- unknown
- risk factors include: - radiation exposure - genetic predisposition - tobacco use - exposure to certain industrial chemicals - viruses |
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What is the MOST COMMON SITE of salivary gland neoplasm?
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PAROTID GLAND
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NEOPLASMS of parotid gland are usually what kind?
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BENIGN
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NEOPLASMS developing within sublingual glands are ___ , but when they do occur they are usually ______ .
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RARE, MALIGNANT
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Where is the most frequent area to have malignancy of salivary tumour?
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SUBLINGUAL
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What is the SECOND most common site for salivary tumours?
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MINOR SALIVARY GLANDS
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What is the most frequent location of MINOR SALIVARY GLAND TUMOURS?
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Palate
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What is the SECOND most common area for MINOR SALIVARY GLAND TUMOURS?
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LIPS
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Which lip more commonly has minor salivary gland tumours?
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UPPER LIP more common
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Which MINOR SALIVARY GLAND sites have the HIGHEST frequency of MALIGNANT SALIVARY GLAND TUMOURS?
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- Retromolar
- FOM - Tongue - LOWER lip |
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What is the usual presentation of BENIGN salivary gland neoplasms?
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- slow enlargin
- painless - circumscribed - firm mass - freely moveable |
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What is the treatment of choice for all benign salivary gland tumours?
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SURGICAL EXCISION with a cuff of surrounding normal tissue
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What is the MOST COMMON SALIVARY GLAND NEOPLASM?
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PLEOMORPHIC ADENOMA (Benign Mixed Tumour)
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What are the most common INTRA-ORAL sites of PLEOMORPHIC ADENOMA?
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PALATE > upper lip > buccal mucosa
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What complication may arise if you DON'T remove a PLEOMORPHIC ADENOMA?
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May undergo malignant transformation (5% of cases)
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How is MONOMORPHIC ADENOMA different from PLEO?
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Tumour characterized by proliferation of one cell type only
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What are a few different types of MONOMORPHIC ADENOMA?
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- Canalicular
- Basal cell adenoma - Oncocytoma - Papillary Cystadenoma Lymphomatosum |
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Define "WARTHIN TUMOUR"
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- SECOND MOST COMMON benign parotid tumour
- exclusively in parotid gland - MONOMORPHIC adenoma - |
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What are some characteristic features of BENIGN SALIVARY GLAND TUMOURS?
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- slow growing
- no ulceration - no fixation - no facial nerve palsy - encapsulated - history of slow growth - no metastasis - treatment LOCAL EXCISION |
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What are some characteristic features of MALIGNANT SALIVARY GLAND TUMOURS?
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- growth rate varied, usually rapid
- ulceration - fixation - facial nerve palsy - non-encapsulated tumours - history of slow grow to rapid growth of lesion - metastasis - treatment is surgery WITH or WITHOUT radiation |
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What is the SECOND MOST COMMON BENIGN PAROTID TUMOUR?
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- Warthin tumour
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What is the MOST COMMON OF THE SALIVARY GLAND MALIGNANCIES?
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Mucoepidermoid Carcinoma
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What are the most common sites of MUCOEPIDERMOID CARCINOMA?
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PALATE > retromolar > FOM > buccal mucosa > Lower lip
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What is the 5 year survival rate of MUCOEPIDERMOID CARCINOMAS?
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LOW GRADE - 89% cured
HIGH GRADE - 86% died |
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List the "HIGH GRADE" malignancies of SALIVARY GLANDS ?
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- MUCOEPIDERMOID CARCINOMA
- ADENOID CYSTIC CARCINOMA |
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List the "LOW GRADE" malignancies of SALIVARY GLANDS:
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- MUCOEPIDERMOID CARCINOMA
- ACINIC CELL CARCINOMA - POLYMORPHOUS LOW GRADE ADENOCARCINOMA |
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The major and minor salivary glands develop from which embryological structure?
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Oral ectoderm
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Salivary gland consists of which two components?
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SECRETORY
- acinus - myoepithelial cells DUCTAL - intercalated duct - striated duct - secretory duct |
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Tumours arising from salivary glands are generally derived from one of two structures:
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- salivary epithelium (parenchyma)
- supportive stroma (mesenchymal) |
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Define ADENOMA:
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benign parenchymal tumours
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Define ADENOSARCOMA:
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malignanry salivary gland tumours
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Which site has the higher occurence of PRIMARY EPITHELIAL SALIVARY GLAND TUMOURS:
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Parotid gland
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The frequency of malignancy is highest in which salivary gland area?
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sublingual
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The highest occurence of MINOR salivary gland tumours occurs in the:
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palate
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Highest percentage of MALIGNANCY for intraoral minor salivary glands is:
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- lower lip
- FOM - tongue - retromolar |
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Most common location of LABIAL salivary gland tumours are in:
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upper lip
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What is the usual clinical presentation of BENIGN SALIVARY GLAND NEOPLASMS?
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slow enlarging
painless circumscribed firm mass freely moveable |
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What is the treatment of choice for all benign salivary gland tumorus?
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surgical excision with a cuff of surrounding normal tissue
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What is the MOST COMMON salivary gland neoplasm?
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Benign Mixed Tumour (Pleomorphic Adenoma)
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What is it called Mixed Tumour?
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combination of neoplastic ductal epithelial and myoepithelial cells
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PLEOMORPHIC ADENOMA most commoonly occurs in:
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parotid gland
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What is the treatment of PLEOMORPHIC ADENOMA?
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parotid - remove lesion with involved lobe
submandibular - remove lesion and gland hard palate - remove lesion down to bone soft palate, labial, buccal mucosa - enucleation |
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What may occur if PLEOMORPHIC ADENOMA is not removed?
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may undergo malignant transformation in small percentage of cases
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What is MONOMORPHIC ADENOMA?
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proliferation of one type of cell of the salivary gland
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What are the different forms of MONOMORPHIC ADENOMA?
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- Cannalicular adenoma
- basal cell adenoma - oncocytoma - papillary cystadenoma lymphomatosum |
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Describe the clinical features of BENIGN SALIVARY GLAND TUMOURS:
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- slow growth
- no ulceration - no fixation - no facial nerve palsy - encapsulated - no metastasis - treatment is local excision |
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Describe the features of MALIGNANT SALIVARY GLAND TUMOURS:
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- growth rate varied
- usually rapid - ulceration - facial nerve palsy - non-encapsulated tumours - slow grow to rapid growth history - metastasis - treatment is surgery w or w/o radiation |
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What is the MOST COMMON of the salivary gland malignancies?
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mucoepidermoid carcinoma
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What are the most common sites of MUCOEPIDERMOID CARCINOMA?
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- palate
- retromolar region - FOM - buccal mucosa - lower lip |
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What are the treatment modalities of MUCOEPIDERMOID CARCINOMA?
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- low-grade (5-year survival: 89%): wide surgical excision
- high-grade (5 year survival 14%): wide surgical excision plus radiation |
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Which are the LOW-GRADE MALIGNANCIES of SALIVARY GLANDS?
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- acinic cell carcinoma
- polymorphous low-grade carcinoma (PLGA) - mucoepidermoid carcinoma |
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What are the HIGH GRADE MALIGNANCIES of SALIVARY GLANDS?
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- adenoid cystic carcinoma
- mucoepidermoid carcinoma |
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What are the BENIGN SALIVARY GLAND TUMOURS?
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- pleomorphic adenoma
- myoepithelioma - basal cell adenoma - canalicular adenoma - warthin tumour - oncocytoma - sebaceous adenoma - sebaceous lymphadenoma |
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What are some MALIGNANT salivary gland tumours?
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- Malignant mixed tumours
- mucoepidermoid carcinoma - acinic cell adenocarcinoma - adenoid cystic carcinoma - PLGA - basal cell adenoma - salivary duct carcinoma - myoepithelial carcinoma - cystadenocarcinoma |
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Define CARCINOMA EX PLEOMORPHIC ADENOMA:
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- malignant transformation of EPITHELIAL component of pre-existing benign mixed tumour.
- most common of the malignant mixed tumours - mostly within parotid gland - TWO SETTINGS: 1) benign mixed tumour that has been treated and has had multiple recurrences 2) benign tumour present for many years without treatment |
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What are the most common salivary gland tumours seen in children?
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- hemangioma
- lymphangioma - neurofibroma |
