Head And Neck

Salivary gland Tumours Epithelial Epithelial Benign Benign Pleomorphic adenoma (Mixed parotid) Pleomorphic adenoma (Mixed parotid) Monomorphic adenoma Adenolymphoma, oncocytoma Monomorphic adenoma Adenolymphoma, oncocytoma Malignant Malignant Primary Primary Acini Adenocarcinoma,adenoid cystic,acinic cell carci Acini Adenocarcinoma,adenoid cystic,acinic cell carci Ducts Mucoepidermoid Ducts Mucoepidermoid High grade squamus cell carcinoma High grade squamus cell carcinoma Low grade 10 times more comon Low grade 10 times more comon Mixed malignant mixed salivery Mixed malignant mixed salivery Secondary rare Secondary rare Stromal Stromal Benign hemangioma, neurofibroma Benign hemangioma, neurofibroma Malignant sarcoma, lymphoma Malignant sarcoma, lymphoma

Incidence of Salivary tumors Role of 80% Role of 80% 80% of salivary tumors develop in the parotid 80% of salivary tumors develop in the parotid 80% are benign 80% are benign 80% of bengin are mixed salivery 80% of bengin are mixed salivery Incidence of malignancy Incidence of malignancy increase as the size of the gland decrease increase as the size of the gland decrease Parotid 20%, Submandibular 50%,Minor salivary 75% Parotid 20%, Submandibular 50%,Minor salivary 75%

Mixed Salivary tumors ( pleomorphic adenoma) Incidence: Incidence: 60% of all salivary tumors 60% of all salivary tumors y,females more, superficial lobe more y,females more, superficial lobe more Clinical picture Clinical picture Painless swelling over the angle of the mandibule anterior to ear lobule Painless swelling over the angle of the mandibule anterior to ear lobule Swelling very slowly growing, well defined, rounded, painless, smooth, lobulated,firm and mobile Swelling very slowly growing, well defined, rounded, painless, smooth, lobulated,firm and mobile

Salivary neoplasm ( pleomorphic adenoma)

Adenolymphoma Incidence Incidence Second common benign,97% in parotid Second common benign,97% in parotid Over 40y, more in male,bilateral 10% Over 40y, more in male,bilateral 10% Pathology Pathology It is a hamartoma,inclusion of the parotid gland duds (ducts) into the LN near the parotid It is a hamartoma,inclusion of the parotid gland duds (ducts) into the LN near the parotid Cystic spaces,lined by epith,embeded in lymphoid matrix Cystic spaces,lined by epith,embeded in lymphoid matrix Clinical picture Clinical picture Painless sweeling in the parotid area,more mobile,soft even cystic,no invasion Painless sweeling in the parotid area,more mobile,soft even cystic,no invasion Treatment Treatment Superficial parotidectomy Superficial parotidectomy

Adenolymphoma

Malignant salivary tumors Incidence Incidence The most common is The most common is the Mucoepidermoid in the parotid the Mucoepidermoid in the parotid Adenoid cystic carcinoma in other glands Adenoid cystic carcinoma in other glands Age more in old age,except adenocarcinoma in children Age more in old age,except adenocarcinoma in children Sex male and female equal Sex male and female equal Male squamous cell carcinoma is more Male squamous cell carcinoma is more Female malignant mixed salivary is more Female malignant mixed salivary is more

Carcinoma of the Parotid Squamus cell carcinoma Squamus cell carcinoma The commonest The commonest Signs of malignancy Signs of malignancy S size recent rapid increase in size S size recent rapid increase in size C hard on consistancy C hard on consistancy E irregular edges E irregular edges P pain P pain M limited mobility M limited mobility Invade Invade skin ulcer skin ulcer Facial nerve Facial nerve Superficial temporal artery Superficial temporal artery Muscles and bones Muscles and bones Cervical LN Cervical LN

Malignant tumors

DD (lipoma)

Osteosarcoma bones

Hemorrhagic cyst in the parotid

Superficial parotidectomy

Total Parotidectomy