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Malignant salivary gland tumor - Oral Mucosal Lesion
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Malignant salivary gland tumor - Oral Mucosal Lesion

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Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
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Synopsis

Malignant salivary gland tumors represent a heterogeneous group of neoplasms that arise from either major or minor salivary gland tissue. The most common of these tumors include mucoepidermoid carcinoma, polymorphous low-grade adenocarcinoma, adenoid cystic carcinoma, and acinic cell carcinoma. Carcinoma can also evolve from a pre-existing pleomorphic adenoma (benign mixed tumor).

Most salivary gland malignancies are detected in adult patients, although they can affect a wide age range. Most series describe a slight female predilection.

The most common symptom associated with salivary gland malignancies is swelling, although pain is classically an early symptom of adenoid cystic carcinoma. Tenderness may be present.

These lesions are usually rather slow growing, and patients may not be aware of their presence due to slow evolution of the process.

Codes

ICD10CM:
C08.9 – Malignant neoplasm of major salivary gland, unspecified

SNOMEDCT:
255072001 – Malignant tumor of salivary gland

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Mucocele – Sudden onset of the mucocele is often helpful in distinguishing this lesion from salivary gland malignancy.
  • Palatal dental abscess (see abscess, cellulitis) – This lesion is usually quite painful, has a sudden onset, and is associated with an adjacent non-vital carious tooth.
  • Necrotizing sialometaplasia – The sudden onset of necrotizing sialometaplasia plus the absence of a tumor mass are helpful features in distinguishing this process.
  • Benign salivary gland tumor – Benign salivary gland tumors are usually more sharply demarcated or encapsulated than their malignant counterparts, and ulceration is seen less frequently.
  • Squamous cell carcinoma – This malignancy generally arises from the surface epithelium, resulting in a more superficial presentation with adjacent areas of leukoplakia or erythroplakia in most cases.
  • Non-Hodgkin's lymphoma – This process often has a more boggy texture compared to salivary gland malignancy.
  • Benign mesenchymal tumors - These tumors are generally more sharply demarcated or encapsulated in comparison to salivary gland malignancy.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 01/21/2015
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Malignant salivary gland tumor - Oral Mucosal Lesion
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Malignant salivary gland tumor : Hard palate, Mouth pain, Oral tumor, Soft palate/tonsillar, Oral nodule
Clinical image of Malignant salivary gland tumor
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