Salivary

Submandibular gland megalith eroding the floor of the mouth: A case report

December 20, 2013     Sourav Singh, MDS; Smita Singh, MDS
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Abstract

Sialolithiasis is the most common pathologic condition affecting the salivary glands. However, large sialoliths (megaliths) are considered rare. The submandibular glands are more susceptible to stone formation than are the other salivary glands. We describe the case of a 55-year-old man with an unusually large sialolith that had eroded the floor of the mouth.

Mucocele: Retention and extravasation types

March 24, 2013     Lester D.R. Thompson, MD
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The extravasation type is the most common mucocele, more common in children and young adults, with a peak in the second decade of life.

Massive calcification in a pleomorphic adenoma: Report of an unusual presentation

January 24, 2013     Luiz O.M. Coelho, MD; Sergio E. Ono, MD; Arnolfo de Carvalho Neto, PhD; Christiane S. Kawasaki, MD; Luciano V. Sabóia, MD; Maria F. Soares, MD
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Abstract

We report a case of histology-proven pleomorphic adenoma of the parapharyngeal space in a 20-year-old man. This case was unusual in that a massive amount of dystrophic calcification was scattered throughout the tumor. The patient underwent successful surgical resection, and he exhibited no signs of recurrence during follow-up. Literature about such an unusual presentation is scarce.

Salivary duct carcinoma

September 7, 2012     Lester D.R. Thompson, MD
article

A case of a giant submandibular gland calculus perforating the floor of the mouth

June 4, 2012     Raffaele Rauso, MD; Giulio Gherardini, MD, PhD; Paolo Biondi, MD; Gianpaolo Tartaro, MD; Giuseppe Colella, MD, DDS
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Abstract

Sialolithiasis is characterized by the obstruction of salivary gland secretion by a calculus. It is associated with swelling, pain, and infection of the affected gland. More than 80% of all salivary calculi occur in the submandibular gland. One reason for this is the makeup of the saliva in the submandibular gland, which includes a higher mucus content, a greater degree of alkalinity, and greater concentrations of calcium and phosphate salts compared with the saliva of the parotid and sublingual glands. Other factors are that its duct is longer and its saliva flows against gravity. Sialoliths that reach several centimeters in diameter (megaliths, or giant calculi) are rare. Perforation of the floor of the mouth by a giant calculus is extremely rare. We report such a case in a 56-year-old man who presented with a 2-day history of severe pain in the left sublingual area and painful swelling in the left submandibular area. Removal of the stone and the left submandibular gland was performed via an extraoral incision. On gross examination, the sialolith measured 5.6 cm.

Poorly differentiated small-cell neuroendocrine carcinoma of the submandibular gland: A case report

March 31, 2012     Mary Scaduto, MD, Laura Matrka, MD, Manisha Shah, MD, Paul Wakely Jr., MD, and Enver Ozer, MD
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Abstract

Neuroendocrine carcinoma (NEC) is uncommon in the head and neck and rare in the salivary glands. In the latter location, it may manifest as pain or a palpable mass. These tumors can be quite aggressive, with a tendency toward recurrence and regional and distant metastasis. Because of the limited number of reported cases in the literature, no reliable treatment has been established. We describe the case of a 79-year-old man who presented with a persistent submandibular mass that was suspicious for a malignancy on imaging. Following surgical resection and histopathologic analysis, a diagnosis of poorly differentiated small-cell NEC was made. The patient was further treated with postoperative chemotherapy, and he exhibited no evidence of recurrence or metastasis on follow-up.

An analysis of salivary gland neoplasms: A 12-year, single-institution experience in Turkey

March 1, 2012     Demet Etit, MD, Nese Ekinci, MD, Ayca Tan, MD, Deniz Altinel, MD, and Filiz Dag, MD
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Abstract.

The epidemiology of salivary gland tumors worldwide is not very well defined. Although many studies on this subject have been undertaken, the data are generally focused on specific topics such as parotid gland neoplasms or tumors of the major salivary glands. We conducted a study to establish the prevalence and distribution of benign and malignant neoplasms of both the major and minor salivary glands at a single institution. We reviewed 244,204 cases that had come through our pathology department from January 1994 through December 2005 and found 235 cases of a salivary gland neoplasm (0.09%). The female-to-male ratio was 1.04:1, and the mean age of the patients was 47 years. Of the 235 neoplasms, 159 (67.66%) were located in the parotid gland, 34 (14.47%) in the submandibular gland, and 42 (17.87%) in the minor salivary glands. A total of 146 tumors (62.13%) were benign and 89 (37.87%) were malignant. Pleomorphic adenoma was the most common neoplasm, occurring in 98 cases (41.70%). The most common malignancy was mucoepidermoid carcinoma, with 27 cases (11.49%). Our data demonstrate that the characteristics of salivary gland tumors in a Turkish population at a single institution are similar to those reported in the literature worldwide.

Ectodermal dysplasia: Otolaryngologic evaluation of 23 cases

February 18, 2012     Muzeyyen Yildirim, MD, Ediz Yorgancilar, MD, Ramazan Gun, MD, and Ismail Topcu, MD
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Abstract

The aim of this prospective study was to improve the quality of life of and reduce morbidity for patients with ectodermal dysplasia by assessing their actual and potential ENT pathologies, and offering methods of prevention and treatment. The study was conducted between 2006 and 2008 and included 23 patients diagnosed with ectodermal dysplasia. The major symptoms of ectodermal dysplasia were evaluated. Patient histories were obtained in all cases, and a complete head and neck examination was carried out. Of the 23 patients (11 males and 12 females, aged 5 to 45 years) diagnosed with ectodermal dysplasia, 22 had hypohidrotic ectodermal dysplasia and 1 had ectrodactyly-ectodermal dysplasia-clefting syndrome. In all patients diagnosed with hypohidrotic ectodermal dysplasia, the salivary glands were examined by ultrasonography and, when necessary, by scintigraphy. Hearing defects in patients with otologic problems were determined by audiometric examination: 39.1% of the patients had hearing loss, 43.5% had otitis media, and 39.1% had impacted cerumen. The most common rhinologic findings were saddle nose deformity in 56.5%, nasal obstruction and nasal dryness (52.2% each), and chronic rhinitis/rhinosinusitis (34.8%). The most common oral and oropharyngeal findings were difficulty chewing in 82.6% and dry mouth in 78.3%. All 23 patients had required dental work. Because this disorder affects several aspects of the body, its treatment requires a multidisciplinary approach, with the otolaryngologist being a vital part of the management team.

Unusual parapharyngeal acinic cell carcinoma

February 18, 2012     Jeremy Nguyen, MD, Enrique Palacios, MD; FACR, Elorice Horam, MD, and Harold Neitzschman, MD, FACR
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Myoepithelioma of the vallecula: A case report

July 13, 2011     Wassim Kermani, MD, Malek Belcadhi, MD, Moncef Ben Ali, MD, Badreddine Sriha, MD, and Kamel Bouzouita, MD
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Abstract

Myoepitheliomas are rare and generally benign neoplasms that account for fewer than 1% of all salivary gland tumors. A myoepithelioma neoplasm is almost entirely composed of myoepithelial cells and is most frequently located in the parotid gland and in the minor salivary glands of the hard palate. We report an extremely rare case of myoepithelioma of the vallecular region in a 65-year-old woman and describe this tumor's clinical peculiarity, diagnostic and therapeutic considerations, and prognosis.

Salivary gland cancer in patients younger than 30 years

March 31, 2011     Amy L. Rutt, DO, Mary J. Hawkshaw, BSN, RN, CORLN, Deborah Lurie, PhD, and Robert T. Sataloff, MD, DMA, FACS
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Abstract

Previous research has shown that salivary gland tumors are rare in the young population. A clinical diagnosis has to be made very carefully because the proportion of malignancies is higher in children than in adults. We present a review of cases of malignant salivary gland carcinoma (SGC) in patients younger than 30 years of age. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) 17 Registry. A total of 763 patients younger than 30 years with carcinoma of a major salivary gland from 1973 to 2004 were identified within the SEER database. The most common salivary gland cancer was mucoepidermoid parotid gland carcinoma. The incidence of all major salivary gland carcinomas increased with increasing patient age. The 5-year relative survival rate for salivary gland carcinomas in our population was calculated according to the Kaplan-Meier analysis in each age group. Relative 5-year survival was 100% in the 1 patient younger than 1 year, 50.0% in the 1- to 4-year-old group; 87.2% among the 5- to 9-year-olds; 97.0% among the 10- to 14-year-olds; 95.0% among the 15- to 19-year-olds; 95.1% among the 20- to 24-year-olds; and 93.6% in the 25- to 29-year-old group. We found that SGC affects patients of all ages, even children in the first year of life. It is essential for physicians to detect salivary gland neoplasms promptly and to evaluate them thoroughly when they are found in children.

Papillary cystadenocarcinoma originating from a minor salivary gland with lymph node metastases

March 1, 2011     Demet Etit, MD, Nese Ekinci, MD, Gozde Evcim, MD, and Kazim Onal, MD
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Abstract

Papillary cystadenocarcinoma is a rare malignant neoplasm of the salivary glands. This tumor most commonly arises in the major salivary glands, mainly in the parotid gland, and rarely metastasizes to regional lymph nodes. We report here a case of papillary cystadenocarcinoma originating from a minor salivary gland, localized in the lateral portion of the tongue and with neck metastases, in a 57-year old woman. We discuss histopathologic and clinical features of this lesion and review the literature.

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