Salivary gland tumor is one of the most common tumors in oral and maxillofacial regions. The diagnosis and treatment of salivary gland tumors had been a clinical characteristic project in Peking University School and Hospital of Stomatology since long time ago. Here we introduced the research progress in diagnosis and treatment of salivary gland tumors during the past 10 years. Among 7 190 cases of salivary gland tumors treated in this institution, 4 654 cases (64.7%) were benign, and 2 536 (35.3%) were malignant, with benign ∶ malignant ratio of 1.84 ∶ 1. Parotid was the most common location, followed by minor salivary gland and submandibular gland, while sublingular gland tumor was seldom seen. The proportion of minor salivary gland tumor was relatively high. Among 1 874 cases with primary malignant tumors, the cases with T3 and stage Ⅲ accounted for only 9.6% and 10.3%, respectively, which indicated that there was shortcoming in the T classification and clinical stage formulated by Union for International Cancer Control (UICC), and further revision was required. The 5, 10, and 15 year survival rates of 1 637 cases with postoperative follow-up were 93.1%, 87.2% and 79.3%, respectively, which were much higher than those we reported 30 years ago. The improvement of treatment results was related to more widely used combined treatment with surgery and postoperative radiotherapy, and the increase in patients with early stage. Adenoid cystic carcinoma was the malignant tumor with high rate of distant metastasis. The 5 and 10 year survival rates of the patients with pulmonary metastasis were 76.2% and 51.8%, respectively, which indicated that the pulmonary metastatic carcinomas developed slowly. Recurrent rate of carcinoma ex pleomorphic adenoma was 46.7% after single treatment of sur-gery, while it decreased to 27.5% after combined theraphy with surgery and radiotherapy, indicating that postoperative radiotheraphy could reduce the recurrent rate effectively. The normal myoepithelial cells had the inhibiting role in the invasion and metastasis of carcinoma ex pleomorphic adenoma. The evaluation of integrity of myoepithelial cells surrounding the tumor mass is helpful to understand the invasiveness of the tumors. The new surgical modalities such as extracapsular resection and partial sialoadenectomy were used in treatment of benign tumors of parotid gland and submandibular gland with advantages of decreased tissue damage and preservation of glandular function. Application of digital surgical techniques such as mixed reality combined with surgical navigation and real-time three-dimensional holograms in the surgical treatment of parotid gland tumors showed the benifits of more safety and precision, and less tissue da-mage.
Humans ; Salivary Gland Neoplasms/pathology* ; Carcinoma, Adenoid Cystic/therapy* ; Adenoma, Pleomorphic/therapy* ; Neoplasm Staging

We experienced a case of carcinoma ex pleomorphic adenoma arising in the submandibular gland of a 47-year-old male patient. The patient underwent submandibular gland ressection and supraomohyoid neck dissection. Histologic examination revealed that the malignant component of carcinoma ex pleomorphic adenoma was adenosquamous carcinoma. The patient refused postoperative radiation therapy and tumor recurred at the neck and lung about 18 month later. Modified radical neck dissection was carried out, and additional postoperative radiotherapy and palliative chemotherapy were initiated. To the best of our knowledge, this is the first case of carcinoma ex pleomorphic adenoma, of which the malignant component is adenosquamous carcinoma in the submandibular gland. Therefore the authors report this rare case with a literature review.
Adenoma, Pleomorphic* ; Carcinoma, Adenosquamous* ; Drug Therapy ; Humans ; Lung ; Male ; Middle Aged ; Neck ; Neck Dissection ; Radiotherapy ; Submandibular Gland*

Subglottic pleomorphic adenoma is a rare disease . Surgery is the main curative treatment. To review some clinical cases and to summarize the characteristics and treatment experience of this disease,it is expected that we can provide more clinical thought and therapeutic strategy for subglottic pleomorphic adenoma.
Adenoma, Pleomorphic ; therapy ; Humans ; Hypothermia, Induced ; Rare Diseases

OBJECTIVE: To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors. METHOD: This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications. RESULT: Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient. CONCLUSION CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.
Adenoma, Pleomorphic ; complications ; Carcinoma, Adenoid Cystic ; complications ; Diagnosis, Differential ; Facial Paralysis ; complications ; Horner Syndrome ; complications ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; diagnosis ; therapy ; Pharynx ; pathology ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Salivary Gland Neoplasms ; complications ; Tomography, X-Ray Computed

PURPOSE: To analyze the clinical and radiologic findings and to evaluate the treatment and prognosis of epithelial tumor patients. METHODS: We retrospectively reviewed clinical and radiologic findings of 36 patients who had been histopathologically diagnosed with epithelial tumors of the lacrimal gland after biopsy and surgery at Seoul St. Mary's Hospital from May 2005 to October 2012. RESULTS: Among the patients with epithelial tumors of the lacrimal gland based on histopathological findings, there were 21 cases of pleomorphic adenoma, seven cases of dacryops, four cases of adenoid cystic carcinoma, two cases of adenocarcinoma, one case of benign oncocytoma, and one case of mucoepidermoid carcinoma. The characteristic clinical finding of epithelial tumors of the lacrimal gland was proptosis (52.7%). In contrast with benign epithelial tumors of the lacrimal gland, the characteristic clinical findings of malignant epithelial tumors of the lacrimal gland were limitation of motion (57.1%), diplopia (57.1%), ocular pain (42.9%), and decreased visual acuity (42.9%). The mean duration of the symptoms of malignant epithelial tumors (5.0 +/- 4.2 months) was shorter than that of benign epithelial tumors (11.2 +/- 11.1 months) (t-test, p = 0.034). In radiologic CT and MRI findings, there was minimal bony destruction in two cases of pleomorphic adenoma and calcification in one case of pleomorphic adenoma. Malignant epithelial tumors of the lacrimal gland, in contrast to benign tumors, showed characteristic bony destruction (57.1%), poorly marginated tumor outline (42.9%) and calcification (14.3%). The 57.1% of patients in this study with malignant tumors were treated with chemotherapy and radiotherapy after surgical treatment, and there was one case (14.3%) of recurrence after treatment. CONCLUSIONS: Careful analysis of clinical and radiologic findings can lead to early diagnosis of malignant tumors.
Adenocarcinoma ; Adenoma, Oxyphilic ; Adenoma, Pleomorphic ; Biopsy ; Carcinoma ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Diplopia ; Drug Therapy ; Early Diagnosis ; Exophthalmos ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Prognosis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Seoul ; Visual Acuity

OBJECTIVETo study the therapeutic effects of combined gene therapy of wild type p53 (wt-p53) and herpes simplex virus thymidine kinase (HSV-tk) gene on pleomorphic adenoma cells of salivary gland.

METHODSWild type p53 and HSV-tk gene were transfected into human pleomorphic adenoma cells of salivary gland by using recombinant adenovirus vector. The efficiency of transfection was checked and gene was expressed by RT-PCR methods. The cell inhibition after transfected was verified by light microscope and MTT.

RESULTSThe proliferation of the pleomorphic adenoma cells transfected wt-p53 and HSV-tk gene was inhibited and the cell survival rate decreased to 54% and 38% respectively in 5 days. However, when wt-p53 gene combined with HSV-tk/GCV system, the killing effects was significantly stronger (P < 0.05) and the cell survival rate decreased to 20%.

CONCLUSIONCombining p53 gene with HSV-tk/GCV system for gene therapy in pleomorphic adenoma cells of salivary gland is a valuable method.

Adenoma, Pleomorphic ; Antiviral Agents ; Cell Line, Tumor ; Cell Survival ; Ganciclovir ; Genes, p53 ; Genetic Therapy ; Genetic Vectors ; Humans ; Salivary Glands ; Simplexvirus ; Thymidine Kinase ; Transfection

OBJECTIVETo study the clinical characteristics, treatment and prognosis 24 cases of carcinoma in pleomorphic adenoma in salivary gland.

METHODSThe clinical data of 24 patients with carcinoma in pleomorphic adenoma treated in our hospital from September 1974 to July 1995 were analyzed.

RESULTSThe overall 5-year survival rate was 66.7%. The five-year survival rates of patients with carcinoma in pleomorphic adenoma in the major and minor salivary glands were 63.6% and 2/2, respectively.

CONCLUSIONOperation is the optimal treatment and extensive resection at the initial operation is suggested. For lumps in the submaxillary gland, preventive neck dissection should be considered. Postoperative radiotherapy can not improve the local-control rate.

Adenoma, Pleomorphic ; diagnosis ; mortality ; therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Salivary Gland Neoplasms ; mortality ; pathology ; therapy ; Survival Rate

Carcinoma ex pleomorphic adenoma is one of the rare malignant tumors arising in the salivary glands. Parotid gland is the most frequently affected site, while the other minor salivary glands have much lower incidence rates. There has been no clinical report of the carcinoma ex pleomorphic adenoma developed in the maxillary sinus. Carcinoma ex pleomorphic adenoma is very malignant and its prognosis is rarest among those of parotid gland tumors. We experienced a 24-year-old male patient who had a bulging mass on his left infraorbital area for 18 months. A carcinoma ex pleomorphic adenoma arising in the left maxillary sinus was diagnosed and medial maxillectomy, postoperative chemotherapy and concurrent radiotherapy were done. So far we have followed up the patient for 15 months and there is no sign or symptom of recurrence or metastasis.
Adenoma, Pleomorphic* ; Drug Therapy ; Humans ; Incidence ; Male ; Maxillary Sinus* ; Neoplasm Metastasis ; Parotid Gland ; Prognosis ; Radiotherapy ; Recurrence ; Salivary Glands ; Salivary Glands, Minor ; Young Adult

Based on the histopathologic findings of the lacrimal gland tumor, the lesion is classified as either epithelial or nonepithelial tumor. 22% of lacrimal gland lesions were primary epithelial neoplasm. 4%of epithelial tumor of lacrimal glands were primary malignant tumor. Squamous cell carcinoma arising from pleomorphic adenoma of lacrimal gland is a very rare(0.4%). Inspite of surgical intervention, postoperative radiation and chemotherapy, the mortality and recurrence rate of the carcinoma ex pleomorphic adenoma of lacrimal gland is very high. We report a case of squamous cell carcinoma ex pleomorphic adenoma of lacrimal gland, which was completely removed via lateral orbitotomy with bicoronal incision and had no major complication or recurrence.
Adenoma* ; Adenoma, Pleomorphic ; Carcinoma, Squamous Cell ; Drug Therapy ; Lacrimal Apparatus* ; Mortality ; Neoplasms, Glandular and Epithelial ; Recurrence

Malignant chondroid syringoma, previously called "mixed tumor of the skin of the salivary gland type"is a fairly uncommon type of sweat gland tumor. Malignant chondroid syringoma frequently arises from the trunk and extremities, whereas the benign tumor is common to the head region. The present case occurred in a female. The malignant nature of the tumor was evident from repeated recurrences after excision of the mass and histopathological study. Lack of response to radiotherapy and chemotherapy led to widespread metastasis. We report a case of malignant chondroid syringoma with lung metastasis in a 39-year-old female patient and response to chemotherapy. We also reviewed the literatures of malignant chondroid syringoma.
Adenoma, Pleomorphic* ; Adult ; Drug Therapy ; Extremities ; Female ; Head ; Humans ; Lung* ; Neoplasm Metastasis* ; Radiotherapy ; Recurrence ; Salivary Glands ; Skin ; Sweat Glands