Tumors of the salivary glands. Pleomorphic Adenoma. Adenolymphoma. Hemangioma. Lymphangiomas.

1. Gregory Noah Henry
Lyfiona Wesley
Ros Alwani
Izatty Lim

2. 
 Benign
 80% parotid gland, followed by submandibular
gland and other minor salivary gland
Introduction
Epithelial Mesenchymal
Pleomorphic adenoma Hemangioma
Adenolymphoma (Warthin
tumor)
Lymphangioma
Oncocytoma Lipoma
Other adenomas Neurofibroma

3. 
 Mixed tumor
 Most common
 Arise commonly from parotid gland (tail)
Pleomorphic Adenoma

4. 
 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

5. 
 Biphasic:
 Polygonal epithelial
 Spindle-shaped myoepithelial
 Stroma:
 Mucoid
 Fibroid
 Vascular
 Myxochondroid
 Chondroid
 Encapsulated with pseudopods
Pleomorphic Adenoma

6. 
 FNAC
 Imaging:
 Ultrasound
 CT scan
 MRI
Pleomorphic Adenoma

7. 
 Surgical:
 Enucleation  high recurrence
 Total / superficial parotidectomy
Pleomorphic Adenoma

8. 
 Papillary cystadenoma lymphomatosum
 Warthin tumor
Adenolymphoma

9. 
 Male (5:1)
 Usually arise from tail of parotid
 Characteristic of tumor:
 Rounded
 Encapsulated
 Cystic
 Mucoid / brownish fluid
Adenolymphoma

10. 
 Epithelial & lymphoid element
 Stroma:
 Lymphoid
 Germinal center formation
Adenolymphoma

11. 
 FNAC
 Imaging:
 Ultrasound
 CT scan
 MRI
 Enucleation
 Superficial parodiectomy
Adenolymphoma

12. 
 Most common benign tumour of parotid in children
Hemangioma

13. 
 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

14. 
 Surgical excision: If do not regress spontaneously
Hemangioma

15. 
 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)

16. 
 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)

17. 
 Large dilated spaces
 Formed by endothelial-lined space
Lymphangiomas
(Cystic Hygroma)

18. 
 HPE
 Prenatal Case:
 Ultrasound
 Amniocentesis
 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)

19. 
Thank You