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Head and Neck

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Head and Neck

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    1. Head and Neck

    2. Head and Neck

    3. Salivary glands Major -parotid, Submandibular, sublingual Minor- mainly oral cavity multiple small glands Sialadenitis = inflammation of salivary glands Mucoceles are the MC type of inflammatory salivary gland lesion. MC viral cause Mumps In Children, mumps is not dangerous but in adults ? Orchitis , Acute Pancreatitis Bacterial (secondary to ductal obstruction) is associated with chronic dehydration Sjogrens syndrome= Autoimmune cause dry mouth, dry eyes ? infiltration of lymphocytes ? risk of lymphoma Age, sex, clinical presentation ?????

    4. Sialothiasis (stones) Dehydration & drugs that suppress salivary secretion may cause stones Submandibular salivary gland - MC affected Tumors of Salivary Glands Uncommon , in middle-aged adults (malignant if develop in older) 80% arise in the parotid gland & most are benign 10% in the Submandibular - 40% malignant, 10% in minor salivary glands - 50%are malignant when the gland size is big= decreased risk of malignancy

    5. SALIVARY GLANDS

    6. Sialadenitis

    7. SALIVARY GLANDS

    8. Mucocele

    9. Histologic Types: 1) Pleomorphic Adenoma- 45% (benign) 2) Warthins Tumor - 11% (benign) 3) Mucoepidermoid carcinoma- 15% (malignant) 4) Adenoid Cystic Carcinoma -10% (malignant) 5) Acinic Cell Carcinoma - 03% (malignant) Other Tumors: Lymphomas ((malignant) NOTE: Malignancy is inversely proportional to the size of gland, therefore: ? size of gland ? ? malignancy ? size of gland ? ? malignancy

    10. 1. Pleomorphic Adenoma also called mixed tumors MC in parotid (60% of tumors of the parotid) MC neoplasm in salivary gland MC benign neoplasm in salivary gland Composed of Benign epithelial elements dispersed in myxoid having varying degrees of Myxoid, Hyaline, Chondroid (cartilaginous) background all are derived from one germ layer (unlike Teratoma) Grow around facial nerve making it harder to remove (but not invades it) Treatment: Surgical enucleation ? 25% recurrence Adequate parotidectomy ? 4% recurrence rate facial nerve damage is possible Adenocarcinoma arises in 2-3% of pre-existing pleomorphic adenomas (very bad prognosis)

    11. Pleomorphic Adenoma

    12. 2. Warthins Tumor (papillary cystadenoma lymphomatosum) Benign cystic capsulated tumor, 2nd MC salivary gland neoplasm Restricted to the parotid gland. Incidence: M:F ratio is 5:1 Smokers 8 times more common Histology: Cystic spaces lined by a double layer of epithelial cells resting on dense Lymphocytic stroma (form follicles with germinal centers)

    13. Warthins Tumor

    14. 3. Adenoid Cystic Carcinoma MC in the minor salivary glands Small, poorly encapsulated, infiltrative gray-pink lesions Slowly growing, Locally invasive & Tending to spread in perineural spaces ( surrounding nerves) (this is also seen in Prostatic , breast ca., pancreatic,? pain 50% disseminate widely to bones, liver, brain, etc. Prognosis 5-year survival rate is above 60%

    15. Adenoid Cystic Carcinoma

    16. 4. Mucoepidermoid Carcinoma MC Primary malignant tumor of salivary glands ( in kids) Radiation-induced neoplasm Biphasic tumor (Glandular cells & Squamous cells) Morphology: Biphasic pattern Grading Low grade tumors: Squamous cells Intermediate grade tumors ( with increasing glandular content) High grade tumors - Glandular cells 5-year survival rate - 50%. 5. Acinic Cell Tumor Tumor cells similar to the normal serous cells of the salivary glands Mostly arise in parotids 90% 5-year survival rate

    17. Mucoepidermoid Carcinoma

    18. Tumors of Salivary Glands

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