Sclerosing mucoepidermoid carcinoma of the salivary gland: Case report and literature review

December 17, 2010     Asher A. Mendelson, MDCM; Khalil al-Macki, MD, FRCS(C); Peter Chauvin, DDS, MSc, FRCD(C); Karen M. Kost, MD, FRCS(C)


Sclerosing mucoepidermoid carcinoma (SMEC) is an extremely rare variant of mucoepidermoid carcinoma with unique histologic features. To the best of our knowledge, only 14 cases of salivary gland SMEC have been previously reported in the English-language literature since it was discovered in 1987. We report a new case of salivary gland SMEC, and we review the literature. Because of SMEC's distinctive histologic features and rarity, its diagnosis can be difficult. Moreover, no clear treatment strategy has emerged with regard to adjuvant postoperative radiotherapy. We attempt to elucidate a natural course of this disease, and we propose a conservative approach to postoperative management.

Salivary gland acinic cell carcinoma

October 31, 2010     Lester D.R. Thompson, MD

Submandibular giant sialoliths: Report of two cases and review of the literature

May 31, 2010     Rafa El Gehani, BDS, MDentSc, FFDRCSI, MOSRCSEd, Balasubramanian Krishnan, MDS, DNB, MOMS RCPS(Glasg), and Mohammed I.L. Shehoumi, BDS


Sialolithiasis is one of the most common diseases of the salivary gland, but giant sialoliths have been reported in the literature infrequently. The submandibular gland and its duct appear to be the sites most susceptible to this disease. We report 2 cases of giant sialoliths occurring solely in the submandibular duct. In both cases, transoral removal of the stone was performed under local anesthesia; one of the stones was 35 mm long and the other was 25 mm long. The patients' glands were managed conservatively with sialagogues and analgesics. The glands recovered normal function quickly after removal of the stones, which is noteworthy because such long-standing stones usually produce irreversible functional damage. Follow-up showed asymptomatic and normally functioning glands. The authors conclude that a conservative approach will spare the patient the morbidity associated with gland removal.

Diagnostic and interventional sialendoscopy

May 31, 2010     Ryan F. Osborne, MD, Lorraine M. Smith, MD, and Reena Gupta, MD

The pattern of presentation of salivary gland tumors in Africa: A review of published reports

February 1, 2010     Moses A. Yaor, MBBS, DLO, FRCSEd (Otol)


Salivary glands are the site of a wide variety of histopathologic types of benign and malignant tumors. The author reviewed 23 articles from 12 African countries published between 1980 and 2004 to examine patterns of salivary gland tumors. These neoplasms represent a significant health problem in Africa. The author found that patterns of presentation are different from those seen in Western countries; for example, African patients are generally younger at presentation. Also, there may be a female preponderance in Africa, and Warthin tumor is rare.

Salivary gland myoepithelioma with focal capsular invasion

June 30, 2009     Banu Dogan Gun, MD, Sukru Oguz Ozdamar, MD, Burak Bahadir, MD, and Lokman Uzun, MD


Salivary gland tumors that display myoepithelial differentiation exclusively or predominantly are relatively uncommon, and the assessment of malignancy in a myoepithelial tumor can be difficult. We report a case of parotid gland myoepithelioma composed predominantly of spindle cells with focal capsular invasion. The patient was a 65-year-old woman who presented with a painless mass in the right preauricular region. Histologically, the tumor had a solid and multinodular growth pattern and was predominantly made up of spindle cells with a minor component of epithelioid cells with moderate cellular atypia. Focal regions of tumor cells infiltrated the capsule with tongue-like processes, but tumor infiltration into the adjacent parotid tissue was absent. The tumor cells showed strong cytoplasmic immunoexpression of vimentin, pankeratin, S-100 protein, and smooth-muscle actin. Immunostains with glial fibrillary acidic protein, melanoma marker, epithelial membrane antigen, and carcinoembryonic antigen were negative. Expression of p53 was observed focally in the nuclei of the tumor cells. A final diagnosis of salivary gland myoepithelioma with focal capsular invasion was made, and the case was regarded as a myoepithelial tumor of uncertain malignant potential. In this report, we discuss the histologic criteria required to diagnose malignancy in salivary gland myoepithelial tumors.

Unilateral submandibular gland aplasia: A rare phenomenon

March 1, 2009     Neel Gupta, MD, Enrique Palacios, MD, FACR, and Shannon Barry, MS

Vocal fold immobility from a primary minor salivary gland small-cell carcinoma: Case report

February 1, 2009     Robert L. Witt, MD, FACS and Patrick A. Wilson, MD, FCAP


Small-cell carcinoma of a minor salivary gland is a rare and to the best of our knowledge previously unreported cause of vocal fold immobility. We describe the case of a 68-year-old woman who presented with hoarseness, dysphagia, and weight loss. Examination revealed left vocal fold immobility. She had no other obvious abnormality of the upper airway, neck, or skin. Computed tomography and magnetic resonance imaging demonstrated a 4-cm submucosal oropharyngeal mass with extension to the parapharyngeal space and involvement of the carotid sheath and the foramen ovale at the skull base; imaging also revealed cervical adenopathy. Fine-needle aspiration biopsy identified the mass as a small-cell carcinoma, a finding that was confirmed by immunohistochemistry. Extensive tumor invasion and multiple comorbidities precluded an aggressive management strategy, and the patient was treated palliatively. She died of her disease shortly after her diagnosis. Vocal fold immobility of unknown etiology mandates imaging from the skull base to the upper mediastinum.

Chondrosarcoma of the greater cornu of the hyoid: A case report and literature review

September 25, 2008     Sanjay Verma, MBBCh, MA, FRCS (ORL-HNS), PhD, Perumal Chokkalingam, BSc, FRCS, and Duncan McRae, FRCS, FRCS (ORL-HNS)


We report an unusual case of a young woman with chondrosarcoma affecting the greater cornu of the hyoid bone. Only a handful of reports of primary chondrosarcoma involving the hyoid exist in the world literature. The case described presented as a swelling in the submandibular triangle, and as such posed a particular clinical and radiologic diagnostic challenge. Our subsequent surgical management of this rare entity comprised local excision followed by close observation, and is defined in the context of the existing literature. Two years after surgery, the patient remained free of tumor recurrence; she was subsequently lost to follow-up.

Osteoclast-like giant-cell tumor of the parotid with salivary duct carcinoma: Case report and cytologic, histologic, and immunohistochemical findings

September 30, 2007    

Maryam Kadivar, MD, APCP;
Yalda Nilipour, MD;
Alireza Sadeghipour, MD, APCP


Primary giant-cell tumor of the salivary gland is a rare lesion with an incompletely characterized histogenesis. To the best of our knowledge, only 16 cases have been previously documented in the English-language literature. We report a new case, which occurred in a 75-year-old man who presented with a parotid mass and cervical lymphadenopathy. The patient underwent a left total parotidectomy and cervical lymph node dissection. As far as we know, ours is the only reported case of a primary giant-cell tumor of the salivary gland in which the patient presented with lymph node metastasis. Because so little is known about giant-cell tumor of the salivary gland, we use the occasion of this case report to describe the cytologic, histologic, and immunohistochemical characteristics that we observed.

Salivary gland lymphoepithelial cysts

April 30, 2007     Heike Varnholt, MD; Lester D.R. Thompson, MD, FASCP; Liron Pantanowitz, MD

Necrotizing sialometaplasia: A potential diagnostic pitfall

August 31, 2006     Pavel Komínek, MD, PhD; Petr Blasch, MD
Necrotizing sialometaplasia is a benign, spontaneously healing inflammatory condition. It usually affects the hard palate, and it can mimic a malignancy both clinically and histologically. We report a new case of this rare disorder.
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