Diversity and diagnostic challenges in salivary neoplasms


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Article type :

Original Article

Author :

Jenita Christiana Samson, Umamaheswari Karuppanan, Indumathi Balakrishnan, Narmatha Murugesan

Volume :

6

Issue :

4

Abstract :

Introduction: Salivary gland lesions exhibit a wide spectrum of clinical and morphological diversity. The aim of this study was to evaluate the relative frequencies, types, site, distribution and histomorphological features of salivary gland lesions. Materials and Methods: A retrospective study for a period of two years was done on 40 cases of salivary gland lesions in the department of pathology at KAPV medical college, Trichy a Tertiary care centre. Cases were analysed based on demographics, anatomical locations and histopathological types. Specimens were fixed in 10% formalin, processed and embedded in paraffin. Sections were stained by hematoxylin and eosin. Histopathological examination was done by microscopy. Special immunohistochemical stains were used for certain rare cases of interest. Results: Out of 40 cases, 35 cases (87.5%) were neoplastic and 5 cases (12.5%) were non neoplastic. The mean age of presentation was 38.925 (13-67yrs) with equal gender distribution. Regarding the site distribution, Parotid was the common site for location of salivary tumours (18 cases, 45%). Most common benign tumour was pleomorphic adenoma (22 cases, 78.5%) followed by basal cell adenoma (4 cases, 14.2%). Among malignant tumours, mucoepidermoid carcinoma ranks the first (4 cases, 57.1%). One case of Acinic cell carcinoma, adenoid cystic carcinoma with dedifferentiation, and a rare recently described variant mammary analogue secretory carcinoma were also observed. Conclusion: Histopathology remains the gold standard for diagnosing salivary gland lesions. They have broad morphological spectrum and overlaps between tumour types. Immunohistochemistry serves as an adjunct tool to support histopathological diagnosis. It helps in planning treatment protocols to reduce morbidity and mortality.

Keyword :

 Salivary neoplasms, Dedifferentiated adenoid cystic carcinoma, Mammary analogue secretory carcinoma.