Tips for using my ppt presentation on salivary gland tumors
1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.
3. Classification
A) Epithelial (90%)
1) Adenomas
Pleomorphic adenoma
Monomorphic adenoma(Adenolymphoma)
2) Carcinomas
Mucoepidermoid carcinoma ( most common)
Acinic cell Ca.
Adenoid cystic Ca.
Adenocarcinoma
Sq. cell Ca.
Ca. in ex pleomorphic adenoma
9. Adenolymphoma
- Warthin’s Tumor/ Papillary Cystadenolymphomatosum
- Misnomer – Neither malignant nor Lymphoma
- 5-15% of Parotid tumor (2nd most common tumor)
- Smoking – 8 times more risk
- Mostly in the lower pole & overlies the angle of mandible
10. - Usually involve only the superficial lobe
- More common in male, elderly and in whites
- No malignant transformation
Microscopy –:
- Cystic/Glandular spaces
- Lined by columnar epithelium
- Abundant lymphoid tissue in the stoma
14. Mucoepidermoid Ca.
- Most common malignant tumor of the parotid
- Occurs both in minor & major glands
- Slow growing attaining large size
- High grade – Epidermoid cells mainly –regional & distant
spread
- Low grade – Mucous cells mainly – regional nodes spread.
15. TNM staging of malignant salivary tumors (AJCC 7th edition)
16. TNM staging of malignant salivary tumors (AJCC 7th edition)
Primary tumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor 2 cm or smaller in greatest dimension, with or without
extraglandular extension into the orbital soft tissue
T2 Tumor larger than 2 cm but not larger than 4 cm in greatest dimension
T3 Tumor larger than 4 cm in greatest dimension
T4 Tumor invades periosteum or orbital bone or adjacent structures
T4a Tumor invades periosteum
T4b Tumor invades orbital bone
T4c Tumor invades adjacent structures (brain, sinus, pterygoid fossa,
temporal fossa)
20. Investigations
FNAC – Confirms possibility of lymphoma/inflammatory mass
CT scan – To see the deep lobe
Bone involvement
Extension into the base of the skull
Parapharyngeal space extension
Neck nodes assessment
MRI - Perineural spread
Bone marrrow involvement
22. Treatment
a) Surgery
- Total conservative parotidectomy
T1,T2,T3
- Radical Parotidectomy(T4)
- Both lobes
- Facial nerve
- Soft tissues with skin
- Mandibular ramus
- Masseter muscle
Facial N reconstruction – Greater auricular nerve/sural nerve
23. b) Radiotherapy
3-6 weeks after surgery
Delayed for 6 weeks if nerve grafting is done
Dose – 50-70 Gy (1.5 - 2Gy in 5-8 weeks.
c) Chemotherapy
5FU
Cisplatin
Doxurubicin
Epirubicin
26. Get this ppt in mobile
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next slide.