This is a case report of salivary gland tumors developed at buccal fat pad and masseteric area which are considered rare and characterized by asymptomatic mid-cheek mass. Three cases were diagnosed as accessory parotid gland tumor and the other 3 cases as minor salivary gland tumor with tissue pathology. Accessory parotid gland lies 6 mm anterior to the main parotid gland and accessory parotid gland tumors represent 1% of all parotid tumor. It can be managed solely by resection of the accessory parotid gland without superficial or total parotidectomy. Minor salivary gland tumors represent 10-20% of all salivary gland tumor and are usually found on the palate, paranasal sinuses and cheek. Buccal minor salivary gland tumors are usually found incidentally as submucosal mass at buccal mucosa and managed by wide excision including 1-2 cm free margin through intra-oral approach. This paper reviews our experience with these unusual tumors in terms of clinical manifestation, radiologic findings and the acceptable surgical management.
Adipose Tissue ; Cheek ; Mouth Mucosa ; Palate ; Paranasal Sinuses ; Parotid Gland ; Pathology ; Salivary Glands* ; Salivary Glands, Minor

Background: The minor salivary gland biopsy is an important diagnostic criterion of Gougerot-Sj\xf6gren syndrome. Objective: To describe histopathological characteristics of minor salivary gland of Gougerot-Sj\xf6gren syndrome combined to rheumatoid arthritis. Subjects and method: A prospective, descriptive, cross-sectional study included 108 patients with rheumatoid arthritis, who treated at Department of Rheumatology of Bach Mai hospital, from 1998 to 2003. The patients were divided into 2 groups: 50 patients with Gougerot-Sj\xf6gren syndrome and 58 patients without Gougerot-Sj\xf6gren syndrome. Results: Characteristics of minor salivary gland biopsy were lymphocytic infiltration of minor salivary glands (96%) with various distribution: periductal (86%), periacinic (72%), perivascular (36%). 78% of cases were plasmocytic infiltration, with periductal distribution (70%). 82% of cases were 3, 4 stages according to Chilsom clsssification. 67.5% of cases had ductal abnormality, glandular atrophy (62%), vascular edema (58%). Conclusion: Incidence of 3, 4 stages according to Chilsom classification was 82% in rheumatoid arthritis patients with Gougerot-Sj\xf6gren syndrome.
Arthritis ; Rheumatoid/ pathology ; diagnosis ; Sjogren's Syndrome/ pathology ; diagnosis ; Salivary Glands ; Minor/ pathology

Adenoma, Pleomorphic ; pathology ; surgery ; Adolescent ; Humans ; Male ; Palatal Neoplasms ; pathology ; surgery ; Salivary Gland Neoplasms ; pathology ; surgery ; Salivary Glands, Minor

Pleomorphic adenoma is the most common tumour of the salivary gland. While the majority arises from the parotid gland, only a small percentage arises from the minor salivary glands. The cheek, however, is a rarely affected site with respect to pleomorphic adenomas of the minor salivary glands. Herein, we report a case of pleomorphic adenoma of the cheek, which presented with intraoral swelling, and conclude that complete surgical excision can be a curative treatment for this benign tumour.
Adenoma, Pleomorphic ; pathology ; Adult ; Biopsy, Fine-Needle ; Cheek ; Diagnosis, Differential ; Humans ; Male ; Salivary Gland Neoplasms ; pathology ; Salivary Glands, Minor ; pathology

INTRODUCTIONClear cell carcinoma is a rare low-grade carcinoma that almost exclusively occurs in the minor salivary glands. This tumour is one of the new additions in the recent World Health Organization (WHO) classification of salivary gland tumours.

CLINICAL PICTUREA 50- year-old woman presented with a gradually enlarging painless submucosal mass of 3 months' duration over the left side of the palate.

TREATMENT AND OUTCOMEA preoperative diagnosis of primary clear cell carcinoma of salivary gland with focal surface epithelial dysplasia was rendered after thorough clinical examination to rule out renal origin. The lesions were excised with wide surgical margins and 3 years into the postoperative period, the patient was disease-free.

CONCLUSIONWe report a case of clear cell carcinoma of intra-oral minor salivary gland and draw comparisons with metastatic clear cell carcinoma of renal origin.

Adenocarcinoma, Clear Cell ; pathology ; surgery ; Female ; Humans ; Middle Aged ; Salivary Gland Neoplasms ; pathology ; surgery ; Salivary Glands, Minor

Myoepithelial carcinoma is an extremely rare, malignant epithelial tumor which is usually encountered in the parotid region. In this report, a myoepithelial carcinoma arising from a minor salivary gland in the nasopharynx is presented, along with a discussion of the clinical, histopathological and immunocytochemical characteristics of this rare disorder. Larger clinical series and longer follow-up periods are needed in order to establish the best therapy option for these patients.
Biopsy ; Female ; Human ; Middle Aged ; Myoepithelioma/*pathology ; Nasopharyngeal Neoplasms/*pathology ; Salivary Glands, Minor/*pathology ; Tomography, X-Ray Computed

OBJECTIVETo analyze the clinicopathologic features of salivary malignant pleomorphic adenoma (MPA) (the subtype of the malignant component was classified as non-specific adenocarcinoma).

METHODSThe clinical and pathological characteristics of 115 salivary gland tumors histologically diagnosed as MPA were analyzed.

RESULTSIn all the 65 MPA cases, there were 58 male and 7 female patients, and the mean age was 57 years (from 23 to 83). Sixty-one tumors were located in major salivary glands, and 4 in minor. Histologically the malignant components of 39 tumors were high-grade, 14 intermediate-grade, and 12 low-grade. Thirty-seven tumors were invasive carcinoma, 13 minimally invasive, and 15 non-invasive. The high-grade tumors had positive correlation with the invasive carcinomas (P < 0.05). The invasive carcinomas had positive correlation with TNM clinical stage (P < 0.05). The invasive carcinoma and the high-grade tumor had correlation with cervical lymph node metastasis (P < 0.05).

CONCLUSIONSNon-specific adenocarcinoma are the most common malignant subtype in MPA. The invasive and the high-grade types are more likely to metastasize to cervical lymph node.

Adenocarcinoma ; pathology ; Adenoma, Pleomorphic ; pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; Salivary Glands ; pathology ; Salivary Glands, Minor ; pathology ; Young Adult

OBJECTIVETo analyze the clinical features, morphology and biologic behavior of primary malignant myoepithelioma (MME) of salivary glands.

METHODSThe H&E sections of 16 MME cases were reviewed. Immunohistochemical study using EnVision method for cytokeratin (CK), epithelial membrane antigen (EMA), vimentin, S-100 protein, desmin, muscle-specific actin (MSA), smooth muscle actin (SMA), Myo, proliferation cell nuclear antigen (PCNA), leukocyte common antigen (LCA) and glial fibrillary acidic protein (GFAP) was carried out.

RESULTSOf the 16 patients studied, 6 were males and 10 were females. Their ages ranged from 12 to 65 years (with an average age of 44 years). The tumor occurred predominantly in the parotid gland and minor salivary gland of the palate. Common clinical features included sudden and rapid tumor growth, superficial ulceration, bony destruction and nerve infiltration. Seven of the 16 patients developed local recurrences, while 2 patients had metastasis in the lymph nodes of submandibular or other cervical regions. Most tumors infiltrated adjacent normal salivary gland, adipose, muscular and bony tissues. The extent of local invasion however varied. Histologically, MME showed a wide range of morphologic appearance, with various combinations of clear, spindle, epithelioid or plasmacytoid cells. The tumor cells were atypical and demonstrated high mitotic activity. In this study, 9 cases were composed predominantly of clear tumor cells. Immunohistochemically the tumor cells were positive for CK, EMA, MSA, desmin and S-100 protein.

CONCLUSIONSIn general, MME is a rare and low-grade malignant salivary gland tumor. It carries a low potential for lymph node or distant metastasis but relatively high tendency for local recurrences, resulting in destruction of adjacent soft and bony tissues. The biologic behavior also varies, depending on the site of involvement. Morphologic diagnosis of MME can be difficult in view of the wide spectrum of histologic changes. A definitive diagnosis however is possible with the application of immunohistochemistry.

Adolescent ; Adult ; Aged ; Cytokines ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Myoepithelioma ; metabolism ; pathology ; Neoplasm Recurrence, Local ; Parotid Neoplasms ; metabolism ; pathology ; Retrospective Studies ; Salivary Gland Neoplasms ; metabolism ; pathology ; Salivary Glands, Minor ; pathology

OBJECTIVETo analyse the clinical and pathological characteristics of minor salivary gland tumors.

METHODSA retrospective analysis on 615 cases of intraoral minor salivary gland tumors from 1990-2002 with a confirmed pathologic diagnosis was carried out.

RESULTSIn 615 cases of minor salivary gland tumors, 265 cases were benign, 350 cases malignant. Pleomorphic adenoma was the most common entity and accounted for 81.1% of all benign tumors. Adenoid cystic carcinoma comprised 32.9% of the malignant sample and was the most frequent malignant tumor. The principal location was the palate. Female was a little more of the benign and a male prevalence was observed on the malignant tumor. The mean age of patients with benign and malignant tumors were 40.9 and 49.1 years old, respectively (P < 0.05).

CONCLUSIONWe consider extraordinary manifestation as histopathology, tumor, primary location, age and sex, presenting the results of a review of our experience with those minor salivary gland tumors.

Adenoma, Pleomorphic ; pathology ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Carcinoma, Adenoid Cystic ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; Salivary Glands, Minor ; pathology ; Sex Factors

AIMTo detect the expression of nerve growth factor (NGF) and vascular endothelial growth factor (VEGF) in salivary adenoid cystic carcinoma (SACC) tissues, as well as to determine the correlation between growth factor expression and prognosis in SACC.

METHODOLOGYMedical records of 63 patients surgically treated for SACC between January 1988 and October 2005 were reviewed. Immunohistochemistry was performed to examine the expression of NGF and VEGF in tumor tissues. Kaplan-Meier analysis and Cox's proportional hazard regression model were applied to assess predictors of survival.

RESULTSNGF and VEGF were overexpressed in SACC tissues, compared with those in normal salivary tissues (P < 0.05), and the staining intensity of these two factors was stronger in groups of solid subtype, advanced TNM stage, perineural invasion and recurrence. Patients with high-expression of NGF and VEGF, solid subtype, advanced stage, perineural invasion, recurrence and extended resection alone had worse survival rates (P < 0.05).

CONCLUSIONNGF and VEGF are expressed increasingly in the tissues of SACC cases with invasion and metastasis. NGF expression and VEGF expression are independent

Adult ; Aged ; Carcinoma, Adenoid Cystic ; pathology ; surgery ; Cranial Nerves ; pathology ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Nerve Growth Factor ; analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; surgery ; Salivary Glands ; pathology ; Salivary Glands, Minor ; pathology ; Survival Rate ; Vascular Endothelial Growth Factor A ; analysis ; Young Adult