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PubMed2002

Paediatric mucoepidermoid carcinoma of the palate.

The purpose of this paper is to review our experience with mucoepidermoid carcinoma (MEC), a rare tumour in minor salivary glands, in a small series of paediatric patients. A retrospective analysis of minor salivary gland tumours seen by one surgeon from March 1991 to December 1999 was undertaken. A total of 58 cases were identified and of these, five (9%) occurred in children. There were 23 cases of MEC, four (17%) of which occurred in patients under the age of 18 who presented with T1 or T2N0M0 low- to intermediate-grade MEC of the palate and adjacent structures. These patients form the basis of this study. All patients were treated with wide local excision, obtaining tumour-free margins, and followed for a mean number of 58 months. None of these tumours invaded bone and resection of bone was not performed in any case as the periosteum was intact and the tumours were low to intermediate grade. To date, all patients remain free of disease. One patient who went elsewhere for treatment, was treated with local resection only, and has also experienced no recurrence. Wide local excision is the treatment of choice for low to intermediate grade MEC of the minor salivary glands in paediatric patients.

Adolescent↗
PubMed2002

Juvenile intraoral pleomorphic adenoma: report of five cases and review of the literature.

The aim of this study is to report on five cases of intraoral pleomorphic adenoma (PA) in patients under 18 years of age and to review the literature. Intraoral salivary gland tumours were reviewed in two Brazilian institutions and five cases of PA in patients under 18 years of age were found. Clinical data were obtained from the medical records and paraffin-embedded tissues were sectioned for proliferating cell nuclear antigen (PCNA) and p53 immunohistochemical analysis. Four patients were female and one was male; two cases affected the palate, two the upper lip and one the tongue. All five patients were treated surgically and after long follow-up periods no recurrences were observed. Tumour cells were weakly positive for PCNA and negative for p53. PA should be considered in the differential diagnosis of submucosal nodules in young patients. In youngsters, PA seems to have similar biological characteristics as in adults, with low recurrence rates after surgical resection.

Adenoma, Pleomorphic↗
PubMed2003

Tumour of the juxtaoral organ.

The juxtaoral organ is a normal and constant structure of the oral cavity. It consists of benign epithelial nests. We describe an intraoral tumour of the juxtaoral organ in a child. The tumour was not diagnosed after clinical and radiological examinations because it is extremely rare. A histological examination revealed a tumour of the juxtaoral organ, presumed to be neuroid hamartoma. This is only the second time that a tumour of the juxtaoral organ has been described in a child. We also describe the location, the embryology, the histology and the function of this organ. This is important because this structure can be confused with carcinomas of the oral cavity when examining frozen sections.

Cheek↗
PubMed2003

Malignant myoepithelioma. Clinicopathological and immunohistochemical characteristics.

A malignant myoepithelioma arising in the submucosal accessory glands of the oral cavity of a 23-year-old woman is reported. The patient was very young compared to the cases in the literature, and the tumour had an unusual vestibular location. A false diagnosis of pleomorphic adenoma had been made by fine needle aspiration biopsy. The surgery comprised a wide tumour excision, but neck dissection was not indicated. The final histologic diagnosis was malignant myoepithelioma. Immunohistochemically putative myoepithelial markers were highly expressed.

Actins↗
PubMed2005

[Report of a spindle cell myoepithelialioma of the minor salivary glands with extensive lipomatous component].

Myoepitheliomas of the salivary glands are rare benign tumors composed of spindle-shaped myoepithelial cells, but may show plasmacytoid, epitheloid and clear cell-types that principally exhibit myoepithelial but not ductal differentiation. These tumors are mainly located in the major salivary glands and have sometimes abundant, acellular, mucoid or hyaline stroma but lack chondroid and myxochondroid foci, probably representing the one end of the spectrum of pleomorphic adenoma. Lipomatosis in the form of isolated small islands or scattered single lipocytes, is quite uncommon, and a large amount of adipose tissue in a pleomorphic adenoma and myoepithelioma is a rarity and only described in major salivary glands. We present the case report of a 38-year old man with a myoepithelioma of the minor palatinal salivary glands with extensive lipomatosis as an example of this rare phenomena.

Adipose Tissue↗
PubMed1994

[Site and epidemiology of mucoepidermoid carcinoma. Analysis of 327 cases].

The salivary gland registry of the University of Hamburg (1965-1992) comprises a total of 327 mucoepidermoid carcinomas (MEC). MEC occur between the age of 5 and 96 years, most frequently in the sixth and seventh decade of life. The average age lies below 50 years (48.9 years). There is a slight predisposition of females (56.3%). Nearly 60% of all MEC care localised in the major salivary glands. The parotid gland is the most frequent localisation (53.5%) followed by the palate (17.4%). MEC are less frequent in the submandibular and sublingual glands, such as the minor salivary glands of the oropharynx and the cavity of the mouth. 53.2% of all MEC's can be classified as highly differentiated, the remaining 46.8% as poorly differentiated. MEC's of the palate are predominantly highly differentiated (72.0%). Among the variants of MEC, cystic (25.4%), clear cell (11.0%) and oncocytic (0.6%) tumours can be observed. MEC's of the clear cell type tend to originate from minor salivary glands (69.5%). MEC of childhood and adolescence (8.6%) are preferably seen in the parotid gland (46.4%) and the palate (39.3%). Up to the 20th year of life, cystic tumours and tumours of the clear cell type are comparatively more frequent.

Adolescent↗
PubMed1994

[Histology of mucoepidermoid carcinoma. Analysis of 327 cases].

The mucoepidermoid carcinomas of the salivary glands (MEC) show histologically a wide spectrum of differentiation from solid epidermoid tumours to cystic mucous-filled tumours. Epidermoid cells, mucous cells and intermediate cells are the main cellular components. Besides clear cell (11.0%) and oncocytic (0.6%) variants and "cystic" (25.4%) tumours can be observed. According to the per cent of mucous cells and cystic spaces of the total tumour mass different degrees of histomorphologic differentiation can be distinguished. Therefore highly differentiated MEC (53.2%) with more than 50% mucous cells and cystic spaces, respectively low-differentiated MEC (46.8%) showing less than 50% mucous cells and cystic spaces can be subclassified. In respect of the therapeutic proceeding it should be recognized that the histopathological subclassification of MEC of the salivary glands (7) is based on morphological criteria only. It may not be equalized with a grading of malignancy since even highly differentiated MEC can grow infiltratively, sometimes osseo-destructively, to recur locally and to metastasize predominantly into the regional lymph nodes. Consequently the histopathological subclassification of MEC does not allow certain prognosis in individual cases.

Carcinoma, Mucoepidermoid↗
PubMed1989

[The significance and limits of cytologic diagnosis in myoepithelial sialadenitis].

In case of myoepithelial sialadenitis cytological diagnosis by fine-needle aspiration biopsy is not a reliable measure, because the typical islets of myoepithelial cells can be demonstrated by cytology in only 6% of cases. Since lymphocytic infiltrations dominate the histological aspect a cytological specimen that contains these cell elements, may be taken as an indication for the presence of myoepithelial sialadenitis if a sicca syndrome exists at the same time. If a non-Hodgkin lymphoma has to be suspected after cytology, this must be followed by a histological verification (despite the fact that this suspicion was unfounded in all the cases mentioned here), because it is well known that in myoepithelial sialadenitis there is a danger of transformation into a malignant lymphoma. By detailed anamnestic data, especially by mentioning an existing sicca syndrome, the clinician can help the cytologist in assessing his findings properly.

Adenoma↗
PubMed1992

[The value of digital subtraction sialography compared to conventional sialography, salivary gland sonography and surgical findings].

In a prospective study DSA sialography, conventional sialography (100mm technique) and sonography of the salivary glands were performed in 124 patients. The results of imaging could be correlated with those of operation and/or histology in 70 patients. Performing sialography in only one projection DSA sialography is superior to the conventional technique. The results of DSA are equivalent to those of conventional sialography in more than one projection. DSA sialography is the method of choice demonstrating salivary calculi, whereas sonography is superior to DSA sialography in the detection of tumors. In the diagnosis of chronic inflammation of the salivary glands DSA is slightly superior to the other imaging modalities.

Adolescent↗
PubMed2000

P53 and Ki-67 antigen expression in small oral biopsy specimens of salivary gland tumors.

OBJECTIVE: To investigate the possibility that various salivary gland tumors that look histologically similar could express p53 oncoprotein and Ki-67 proliferation antigen differentially and possibly aid in distinguishing benign from malignant lesions. STUDY DESIGN: Intraoral paraffin-embedded biopsy specimens of salivary gland tumors were used. Thirty-eight pleomorphic adenomas, 17 adenoid cystic carcinomas, 23 monomorphic adenomas, and 17 polymorphous low-grade adenocarcinomas were stained with p53 and Ki-67 antibodies by using an immunoperoxidase detection system. Each case was evaluated in terms of staining intensity and percentage of cells staining. RESULTS: Ki-67 and p53 antigens are expressed in generally low levels in the histologically well-differentiated salivary tumors that were studied here, both benign and malignant. Only 1 solid-type adenoid cystic carcinoma showed a high percentage of cells expressing p53. CONCLUSIONS: The histologically well-differentiated salivary tumors studied do not show differential expression of p53 and Ki-67, in spite of their differing courses of biologic behavior. These antibodies should not be relied on to distinguish benign from malignant lesions of the salivary glands; however, they might be markers for those lesions that are dedifferentiating histologically and, therefore, might be displaying more aggressive behavior.

Adenoma↗
PubMed2001

Polymorphous low-grade adenocarcinoma versus pleomorphic adenoma of minor salivary glands: resolution of a diagnostic dilemma by immunohistochemical analysis with glial fibrillary acidic protein.

OBJECTIVES: Differentiating polymorphous low-grade adenocarcinoma (PLGA) from pleomorphic adenoma (PA) in salivary gland biopsy specimens from the palatal region might be a diagnostic dilemma for the pathologist when tumors are cellular with minimal matrix material. Glial fibrillary acidic protein (GFAP), expressed by a number of cells in the mature central nervous system, is also expressed in tumors not generally considered to be of glial origin. PAs have previously been reported to strongly express GFAP. PLGAs have been examined for the expression of this protein only in small group studies with variable results. The objective of this study was to determine whether differential expression of GFAP in these 2 tumors could be diagnostically significant. STUDY DESIGN: A total of 42 PLGAs and 36 PAs, formalin-fixed and paraffin-embedded, were immunostained with rabbit polyclonal antibodies to GFAP. CNS tissue was used as a positive control. RESULTS: Results showed the 36 cases of PA to be strongly positive for GFAP. Of PLGAs, 31 were negative and 11 showed faint patchy reactivity in luminal cells. CONCLUSIONS: The results strongly support a role for GFAP as a diagnostic adjunct in the microscopic differential diagnosis of PLGA versus PA. This study is the largest investigation with consistent results to date addressing the application of this antibody to the diagnostic problem of PA versus PLGA.

Adenocarcinoma↗
PubMed1987

The effect of different levels of dietary beta-carotene on DMBA-induced salivary gland tumors.

Different levels of beta-carotene (0, 5, 25, 125, and 250 mg/kg diet) were tested for their chemoprevention effects using 9,10-dimethyl-1,2-benzanthracene-induced salivary gland tumor model in rats. Tumor incidence and tumor weights were slightly lower in rats fed diets supplemented with 25 mg or more beta-carotene/kg diet. Hepatic vitamin A and beta-carotene levels were increased in a dose-dependent fashion, reaching a plateau at 125 mg beta-carotene/kg diet. In plasma, beta-carotene concentrations were also increased with an increase in dietary beta-carotene. Vitamin A levels in plasma were not affected. The normal salivary glands had higher concentrations of beta-carotene than did the tumors. The results suggest that the decreases in tumor incidence and tumor weight may be related to the increase in plasma and tissue levels of beta-carotene as a result of feeding high levels of beta-carotene.

9,10-Dimethyl-1,2-benzanthracene↗