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The role of radiotherapy in salivary gland neoplasms.

The role of radiation in the treatment of carcinoma of the salivary glands is expanding. It has a definite role in controlling the primary tumor, particularly in those postoperative cases with microscopic residua in the surgical field. Radiotherapy also plays a significant role in controlling the primary tumor in carcinomas that are inoperable or have recurred after surgery. The doses employed must be high (between 6000 and 7000 rads, given over six to seven weeks). The complications are tolerable and depend upon the area irradiated.

Carcinoma↗

[Skin adnexal and salivary gland neoplasms. Similarities and differences of selected patients].

Benign and malignant skin adnexal neoplasms, especially glandular lesions, show morphologically striking similarities to salivary gland tumors. On the other hand, histological and clinical differences are evident, and knowledge of their existence is important for adequate treatment and reliable prognostication. In this review similarities and differences of selected entities are briefly described and discussed. The following entities are reviewed: cylindroma (vs. membranous variant of basal cell adenoma), sebaceoma (vs. sebaceous adenoma), syringocystadenoma papilliferum (vs. sialadenoma papilliferum), chondroid syringoma (vs. pleomorphic adenoma), cutaneous myoepithelioma (vs. myoepithelioma of salivary glands), cutaneous malignant myoepithelioma (vs. malignant myoepithelioma of salivary glands), cutaneous adenoid cystic carcinoma (vs. adenoid cystic carcinoma of salivary glands), and mucinous eccrine carcinoma (vs. mucous carcinoma of salivary glands).

Adenoma↗

[Computed tomography in the diagnosis of salivary gland neoplasms].

To evaluate the efficiency of computed tomography (CT) in the diagnosis of salivary neoplasms, 68 patients (50 with benign tumors of the salivary glands, 10 with theirs malignant tumors, 8 with salivary cysts) were examined. The authors revealed the high informative value of CT in the diagnosis of salivary bulky lesions. CT defined the site of a tumor, the benign or malignant pattern of its growth, the extent of tumorous invasion. The diagnostic value of CT in the diagnosis of salivary glands was as follows: its sensitivity, specificity, and accuracy were 97.0, 81.8, and 94.9%, respectively.

Adolescent↗

Intraoral minor salivary gland neoplasm: a single institution experience of 80 cases.

From March 1991 to February 2001, 80 cases of minor salivary gland tumours were diagnosed in the Department of Oral and Maxillofacial Surgery at the University of Maryland at Baltimore (Baltimore, MD, USA). Data extracted from a retrospective chart review included age, sex, symptoms, site, histological diagnosis. treatment and outcome. Pleomorphic adenoma was the most common benign tumour and makes up 89.5% of all benign tumours. The percentage of malignancy (76.3%) was much higher than that found in other studies. Of the malignant tumours, 54.1% were mucoepidermoid carcinomas. This study differs from many previous reviews that were published by pathologists rather than a surgical unit.

Adenoma, Pleomorphic↗

Malignant salivary gland neoplasms of the lip.

The charts of fourteen patients with malignant salivary gland tumors of the lip were reviewed. These patients represented 1 per cent of all patients seen during this same period of time with malignant salivary gland tumors. No specific etiologic factors were implicated except that the tumors occurred predominantly in white males. The overall results of treatment were poor, perhaps secondary to delay in diagnosis, very biologically aggressive tumors, or inadequate or improper treatment. Hopefully, the 20 per cent survival can be improved with planned combined sequential surgery and radiation in those selected high risk patients.

Adenocarcinoma↗

Salivary gland neoplasms in children: a 10-year survey at the Children's Hospital of Philadelphia.

Fifteen salivary gland tumors were treated at The Children's Hospital of Philadelphia between 1982 and 1991. Eight of these lesions were malignant and 7 were benign. All of the benign tumors were pleomorphic adenomas. For these, superficial parotidectomy or excision of the submandibular gland was the treatment of choice. One child had recurrence 2 years after her initial surgery. Among the malignant lesions, mucoepidermoid carcinoma was diagnosed in 5 children, and acinic cell carcinoma in 3. Six malignant tumors involved the parotid gland, while 2 originated in the submandibular salivary gland. Superficial or total parotidectomy, or excision of the submandibular gland was performed, according to the nature and the location of the lesion. The facial nerve was sacrificed in one patient because of extensive involvement of the nerve. A 2-year survival rate of 100% was achieved, and all the patients were free of disease at the end of the follow-up period. Successful management of salivary gland lesions in children requires a high index of suspicion of possible malignancy and complete surgical removal as the initial treatment. Radiation therapy is recommended in the management of those patients with microscopic residual tumor and/or nodal involvement.

Adenoma, Pleomorphic↗

Salivary gland neoplasms in children: the experience of the Istituto Nazionale Tumori of Milan.

BACKGROUND: Epithelial salivary gland tumors are very uncommon in pediatric age. We report a series of 52 cases treated at the Istituto Nazionale Tumori of Milan, Italy, over a 30-year period. These results are presented in conjunction with a literature review of salivary tumors with a view to providing an up-to-date overview of the clinical course, prognosis, and treatment options for this rare tumor. PROCEDURE: Fifty-two cases of epithelial salivary tumors were reviewed and the clinical-pathological information concerning tumor characteristics, therapy, and follow-up were collected. Patients' age ranged between 4 and 18 years. RESULTS: The major salivary glands were the main site of tumor occurrence (79% of cases arose in parotid glands); 37 patients had benign tumors (pleomorphic adenoma), 15 had malignant tumors (12 mucoepidermoid carcinoma, 9 low grade). All the patients were treated by surgery; local relapses after parotidectomy were 4% and 25%, in benign and malignant tumors, respectively. When tumor enucleation was performed, recurrences occurred in 50% of benign neoplasms. At the time of the report, all patients with benign tumors were alive, 35(95%) without evidence of disease; only one patient with malignant tumor died of disease. CONCLUSIONS: Epithelial salivary glands tumor in children had different characteristics compared with their adult counterpart with respect to the frequency of histotypes and site of occurrence, but their prognosis seems to be similar. Parotidectomy (total or superficial) is the best choice for achieving good cure rates in both benign and malignant tumors.

Adenoma, Pleomorphic↗

Palliative chemotherapy in patients with salivary gland neoplasms and preliminary reports of 2 recent phase II studies with trastuzumab and gemcitabine.

Salivary gland malignancies are a diverse group of neoplasms. Patients are usually treated with surgery followed by adjuvant radiation therapy. Those presenting with recurrent or metastatic disease have limited treatment options for these patients and discuss the results of 2 recent studies that used trastuzumab and gemcitabine as single agents in patients with incurable disease.

Antibodies, Monoclonal↗

[Evaluation of the diagnostic value of color Doppler ultrasound examination of salivary gland neoplasms and metastatic tumors from the facial bones].

The aim of the study was to evaluate usefulness of colour Doppler ultrasound examination in diagnosing the salivary gland tumours and the metastatic tumours of the neck originating from the facial part of the skull. Epidemiology and histopathology of the neoplasms involving the salivary glands and the facial skeleton were discussed including the route of their spreading to the neck. The author presents update techniques of bony face radiologic imaging and basic principles of modern colour Doppler ultrasound. The examinations with the use of a colour Doppler equipment-Acuson 128-XP 10 were performed in 150 patients with the neck tumours. The exact location, size, morphology and blood supply were assessed using B and B colour mode. Then some big neck vessels like the common, internal and external carotid artery, vertebral artery, internal jugular vein were visualized. All the patients were divided into three groups according to what they were suffering from: sialoadenitis, benign and malignant tumours. The obtained results were compared and confronted with clinical features. The pattern of vascularization failed to allow for establishing preliminary diagnosis in patients in each group. Within the first group, with inflamed glands did not compress the neck vessels. Of all the patients with benign tumours, extrinsic compression on the internal jugular vein and the carotid arteries was found in 16 and 14 patients respectively. In the third group of patients with malignant disease, compression on the veins was detected in 10 cases while 5 tumours compressed the arteries. The invasion involved the internal jugular vein in 7 patients while the common and internal carotid arteries were invaded in 6. The vertebral artery was never found to be affected. It was demonstrated that compression on veins resulted in disturbing the flow which was not observed as far as the arteries were concerned. Disturbing in the flow of veins and arteries was disclosed in cases of invasion. Atheromatosis was detected in patients of each group, 7 of them had to be operated on due to a stricture within the proximal part of internal carotid artery. The results of the study express high diagnostic value of colour Doppler ultrasound examination in the neck tumours. The examination should be obligatory performed as one of the first diagnostic measures after admitting a patient. The method seems to be of very little use in diagnosis differentiating inflammation, benign and malignant salivary gland tumours and metastatic masses of the neck hence some other diagnostic procedures should be here employed.

Adolescent↗

Differential expression of galectin-1 and galectin-3 in benign and malignant salivary gland neoplasms.

Galectins are a family of non-integrin beta-galactosidase-binding lectins. Altered expression of galectins has been associated with neoplastic transformation and progression in several human tumors. In this study, we examined the distribution patterns of galectin-1 and galectin-3 in normal (n=45), benign (n=16), and malignant (n=49) salivary gland specimens using immunohistochemistry to determine their diagnostic and/or biological implications in salivary gland tumorigenesis. In normal salivary glands, galectin-3 expression was limited to ductal cells, and galectin-1 was usually faintly detected in ductal cells and strongly positive in myoepithelial cells. In benign tumors, galectin-3 maintained the ductal localization, but galectin-1 showed variable expression in ductal and myoepithelial cells. In malignant tumors, most of the polymorphous low-grade adenocarcinomas and carcinoma ex-pleomorphic adenomas expressed both galectins, whereas adenoid cystic and acinic cell carcinomas showed dramatically reduced galectin-3 expression and heterogeneous galactin-1 staining. Our data demonstrated altered localization and expression of galectin-3, and to lesser extent, galectin-1 in salivary gland carcinomas. These findings may assist in the differential diagnosis of some salivary gland malignancies, especially when using small and limited fine-needle aspiration materials.

Adenoma↗

Salivary gland neoplasms in children.

Of 29 patients, aged 3 to 16 years, with nonvasoformative salivary gland tumors, 21 had malignant tumors. Mucoepidermoid carcinoma was the most common; adenocarcinoma, adenoid cystic carcinoma, and acinic cell carcinoma were equally represented. Pleomorphic adenoma was the exclusive benign lesion, occurring in eight patients. Mean follow-up for patients with malignant lesions was 13.6 years (minimum, 3.5 years). Absolute 2- and 5-year survival rates were 100% and 90%, respectively. Mean follow-up for benign lesions was 15.9 years; none recurred. Superficial or total parotidectomy is the treatment of choice for malignant parotid neoplasms. Benign parotid lesions are adequately controlled with parotidectomy based on extent of disease. Facial nerve sacrifice can often be avoided. We advocate postoperative radiotherapy for high-grade lesions or those with adverse prognostic factors, such as soft-tissue extension and perineural invasion.

Adenocarcinoma↗

Immunohistochemical demonstration of S-100 protein in salivary gland neoplasms.

A peroxidase-antiperoxidase technique for S-100 protein has been applied to 68 salivary glands. These included 17 pleomorphic adenomas, seven adenoid cystic carcinomas, 23 adenolymphomas and a number of other neoplasms. In addition, five specimens of myoepithelial sialadenitis ('benign lymphoepithelial lesion') and five normal parotid glands were included. Consistent results were obtained, myoepithelial cells and cells in myxoid and chondroid areas in pleomorphic adenomas staining intensely. In adenoid cystic carcinoma, on the other hand, there was no staining. The adenolymphomas possessed intensely S-100 protein-positive cells in the interfollicular lymphoid areas; these were probably interdigitating reticulum cells. In addition, branching structures, probably corresponding to Langerhans' cells, were observed in the epithelium of adenolymphomas.

Adenolymphoma↗