53. BENIGN TUMOURS OF SALIVARY GLANDS

how are benign epithelial tumours classified?

pleomorphic ademona

basal cell adenoma

Warthin tumour

canalicular adenoma

sebaceous adenoma

ductal papilloma

cystadenoma

what are pleomorphic adenomas?

most common type of salivary gland benign tumour

mostly in parotid gland

mixed tumors - epithelial and mesenchymal

pleomorphic adenomas occur most in who and when

age 40-60

women

what are the clinical features of pleomorphic adenomas?

painless, firm, mobile swelling

slow growing

usually in posterior inferior part of superficial lobe of parotid

what is seen on biopsy in pleomorphic adenomas?

firm smooth mass with pseudo capsule

epithelial and mesenchymal elements

different types of stroma

projections of tumour come from capsule - must be removed so tumor doesn’t occur

what is the treatment for pleomorphic adenoma?

surgical removal with very good margins (must make sure no tumour projections are remaining)

superficial parotidectomy- avoiding facial nerve

what are (warthin’s tumors) papillary cystadenoma lymohomatosums?

Warthin's tumours

2nd most common benign tumour in parotid gland

who is affected by whartin tumors

men more

50-80

what are the clinical features of Warthin's tumour?

well defined

slow growing in tail of parotid gland

painless until the point of severe infection

what is seen in biopsy of Warthin's tumour?

smooth, well defined capsule

cutitng shows cyst spaces with thick mucous material

what is treatment for Warthin's tumours?

mostly found in the tail of the parotid gland which can easily be removed

or if big superficial parotidectomy

what are oncocytomas?

least frequent tumours

made up of oncocytes (large granular cells)

oncocytomas affected who most

equal spread men and women

60 most common age

what are the clinical features of oncocytomas?

solid and round

commonly found in the superior lobe of the parotid

what is seen on biopsy of oncocytomas?

non-cystic, firm, brown and granular eosinophilic cells

what is the treatment for oncocytomas?

because they are slow growing, can do a superficial parotidectomy with facial nerve preservation

what are basal cell adenomas?

originate from glandular epithelium

what are the clinical features of basal cell adenomas?

slow growing, painless

what is seen on biopsy of basal cell adenomas?

1. solid- sheets of basaloid cells

2. trabecular-tubular - cords of epithelium

3. membranous - multilocular and 50% lesions encapsulated

what is the treatment for basal cell adenomas?

surgical removal which should include healthy tissues

recurrence rare but occurs more in membranous type