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ADENOMAS
Gregory Noah HenryLyfiona Wesley
Ros AlwaniIzatty Lim
Benign 80% parotid gland, followed by submandibular
gland and other minor salivary gland
Introduction
Epithelial MesenchymalPleomorphic adenoma HemangiomaAdenolymphoma (Warthin tumor)
Lymphangioma
Oncocytoma LipomaOther adenomas Neurofibroma
Mixed tumor Most common Arise commonly from parotid gland (tail)
Pleomorphic Adenoma
CLINICAL FEATURES:
30-40 y/o Female
Characteristic of tumor: Slow growing Painless Firm, single nodular mass
Dysphagia (if deep lobe if involve) Deviation of uvula & pharyngeal wall towards midline Facial nerve not involve Malignant transformation
Pleomorphic Adenoma
HISTOLOGICAL FINDINGS:
Biphasic: Polygonal epithelial Spindle-shaped myoepithelial
Stroma: Mucoid Fibroid Vascular Myxochondroid Chondroid
Encapsulated with pseudopods
Pleomorphic Adenoma
INVESTIGATION:
FNAC Imaging:
Ultrasound CT scan MRI
Pleomorphic Adenoma
MANAGEMENT:
Surgical: Enucleation high recurrence Total / superficial parotidectomy
Pleomorphic Adenoma
Papillary cystadenoma lymphomatosum Warthin tumor
Adenolymphoma
CLINICAL FEATURES
Male (5:1) Usually arise from tail of parotid
Characteristic of tumor: Rounded Encapsulated Cystic Mucoid / brownish fluid
Adenolymphoma
HISTOLOGICAL FINDINGS: Epithelial & lymphoid element Stroma:
Lymphoid Germinal center formation
Adenolymphoma
INVESTIGATION:
FNAC Imaging:
Ultrasound CT scan MRI
MANAGEMENT: Enucleation Superficial parodiectomy
Adenolymphoma
Most common benign tumour of parotid in
children
Hemangioma
CLINICAL FEATURES:
Children, predominantly affecting females Mostly discovered at birth Characteristic of tumor:
Grow rapidly in the neonatal period & then involute spontaneously
Soft Painless Increase in size with crying or straining Overlying skin: May show bluish discoloration
Hemangioma
INVESTIGATION:
MANAGEMENT: Surgical excision: If do not regress
spontaneously
Hemangioma
Less common May involve parotid & submandibular gland
Due to lymphatic sequestration of primitive embryonic lymph duct that undergo irregular growth and canalization.
Lymphangiomas (Cystic Hygroma)
CLINICAL FEATURES:
Can occur at any age, any part of body More common in children < 2 years, involve head & neck
Characteristic of tumor: Slow growing Soft (doughy) Cystic Usually painless Spongy, multiloculated mass Yellowish or bluish surface
Airway obstruction & swallowing difficutly
Lymphangiomas (Cystic Hygroma)
HISTOLOGICAL FINDINGS:
Large dilated spaces Formed by endothelial-lined space
Lymphangiomas (Cystic Hygroma)
INVESTIGATION:
HPE Prenatal Case:
Ultrasound Amniocentesis
MANAGEMENT: Medical:
sclerosing agents: OK-432 (an inactive strain of group A Streptococcus pyogenes) Bleomycin pure ethanol sodium tetradecyl sulfate doxycycline
Surgical excision Preservation of vital structure Cosmetic reason
Lymphangiomas (Cystic Hygroma)
Thank You
