Scientific article
Intraoral Minor Salivary Gland Neoplasms: Review of 213 Cases

https://doi.org/10.1016/j.joms.2005.02.021Get rights and content

Purpose

Minor salivary gland tumors (MSGTs) constitute a heterogeneous group of neoplasms with great histomorphologic variation. This study reviews a large series of benign and malignant salivary gland tumors of the oral region and determines the incidence and the correlation of the histopathologic features with the clinical characteristics.

Materials and Methods

Two hundred thirteen cases of MSGT were retrospectively studied. Hematoxylin-eosin-stained slides were examined in all cases. Special stains and immunohistochemical stains were used in selected cases. Clinical characteristics of the neoplasms were also noted.

Results

One hundred nineteen tumors were benign (56%), and 94 tumors were malignant (44%). Pleomorphic adenoma was the most common benign tumor (93 of 119). Canalicular adenoma was the second most common benign MSGT in our series (25 of 119). Of the 94 malignant MSGTs, mucoepidermoid carcinoma (MEC) (45 of 94), adenoid cystic carcinoma (22 of 94), and polymorphous low-grade adenocarcinoma (18 of 94) were the most common. Most MECs (34 of 45) were low-grade lesions. Of 5 central MECs, 3 cases occurred in the maxilla and 2 cases arose in the mandible.

Conclusions

Benign intraoral MSGTs are slightly more common than malignant MSGTs. Pleomorphic adenoma is the most common MSGT, and MEC is the most common malignant variety. The palate is the most common site for minor gland neoplasms. Benign labial salivary gland neoplasms are more common in the upper lip, and malignant labial tumors are more common in the lower lip.

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Materials and Methods

Two hundred eight cases from the Oral Pathology Service of Oregon Health and Science University (1964–2001) and 5 cases from the Oral Pathology Service of the University of Pennsylvania (1995–1999) were retrospectively studied. Hematoxylin and eosin-stained slides were examined in all cases. Special stains including Masson’s trichrome, mucicarmine, PAS (with and/or without digestion), and immunohistochemical stains for keratin, vimentin, muscle specific actin, S-100 protein, and desmin were

Results

One hundred nineteen MSGTs were benign (56%) and 94 were malignant (44%) (Table 1). The most common tumor overall was pleomorphic adenoma (PA), followed by mucoepidermoid carcinoma (MEC) (Table 2).

PA was the most common benign tumor (93 of 119) (78.2%). PAs occurred between ages 17 and 88 years (average age, 46 years). PAs in females (61 cases) were more common than in males (32 cases) with a ratio of 1.9:1. The location of occurrence of PAs is listed in Table 3. The diverse microscopic pattern

Discussion

Epithelial neoplasms arising in minor salivary glands are relatively common, and they are regularly encountered in oral and maxillofacial surgical pathology services. They are a microscopically heterogeneous group of neoplasms, and some types have a propensity to develop in particular intraoral locations.

There have been several relatively recent reports of significantly large series of these tumors, including Eveson and Cawson’s series of 336 tumors reported in 1985,3 Waldron et al’s series of

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