Malignant tumours of the minor salivary glands—a 20 year review

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Abstract

The UK incidence of malignant disease of the minor salivary glands is only 0.6 per million per year. The tumours have a varied histology, can present in any age group and are frequently advanced if located in the sinonasal cavities. In a 20-year review of 21 patients treated for minor salivary gland malignancy in a single institution, it was found that mucoepidermoid tumours were more common in the oral cavity and adenoid cystic carcinomas in the sinonasal tract (p=0.002). Outcome was variable with sinonasal and adenoid cystic carcinoma having a poorer outcome. Kaplan–Meier curves showed that oral tumours had a higher probability of long term survival.

Radical surgery with reconstruction and post-operative adjuvant radiotherapy was effective in achieving loco-regional control. There were no local recurrences within 5 years and three after 5 years. Five patients developed metastatic disease within 10 years and a further two after 10 years. Late recurrences occurred and survival was mainly determined by the presence of systemic disease.

Section snippets

Patients and methods

In the 20-year period (1980–2000) the case notes of all patients treated for malignant tumours of the minor salivary glands at the Head and Neck Oncology Clinic were reviewed. Malignant tumours of the parotid, submandibular and sublingual salivary glands were excluded. Data were collected from the operating records and pathology database, the histological slides were examined and surviving patients reviewed in the head and neck clinic. The staging of all cases was based on the TNM

Results

In the 20-year period (1980–2000) 21 patients with minor salivary gland malignancies were seen (15 males and six females), the median age at presentation being 54 years of age (range 34–80 years).

The most common clinical presentation was a mass in the oral cavity (50%), followed by a blocked or bleeding nose (30%), infra orbital nerve anaesthesia (10%) and orbital pain. (10%).

There were five different histological tumour types found, the most common being adenoid cystic carcinoma (seven

Discussion

This study confirms that minor salivary gland malignancies are uncommon and that adenoid cystic carcinoma and mucoepidermoid caricinoma are the most frequent histological types.1., 2., 9. Mucoepidermoid carcinoma occurred most often in the oral cavity whereas adenoid cystic carcinoma had a propensity for the sinonasal tract, consistent with the series reported by Lopes.7 Although Weber et al. reported that in lip and buccal mucosa a diagnosis of adenoid cystic carcinoma was the most likely,10

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Presented at the British Association of Plastic Surgeons, Birmingham, July 2000; and International Congress of Maxillofacial Surgeons, Edinburgh, May 2000.

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