➢ The most frequent salivary gland tumour, pleomorphic adenoma, is also referred to as a benign mixed tumour due to its dual origin from myoepithelial and epithelial components. It makes up to two-thirds of all salivary gland tumours, making it the most prevalent of all. The pathogenesis and presentation of plemorphic adenoma are described in this exercise, which also emphasises the care of the condition by an interprofessional team.
➢ On palpation, the swelling was warm, non-tender, and had a firm consistency. Both the upper skin and the underlying structures were attached to it. Examined facial and ocular movements were normal. An intraoral clinical examination revealed nothing unusual. Consideration was given to a preliminary diagnosis of benign tumour of the left parotid gland.
➢ The most likely differential diagnoses included pleomorphic adenoma, Warthin’s tumour, and neuroma of the facial nerve (nerve sheath tumour). Warthin’s tumour typically affects elderly men who have smoked in the past, does not induce eversion of the ear lobe, is found in the lower parotid (at the angle of the mandible), and occurs in 10-15% of cases bilaterally.
➢ The low incidence rate of benign tumours of nerve sheath origin in the parotid gland (0.2% to 1.5%) makes preoperative diagnosis challenging. Additionally, it seems difficult to preoperatively diagnose a parotid tumour as a neuroma in the absence of facial nerve impairment.
➢ Pleomorphic adenomas are typically found as an asymptomatic tumour during a normal medical examination. Head and neck glands are the source of PA, which typically presents as a mobile, slowly growing, firm swelling without any symptoms that doesn’t irritate the mucosa above it.
➢ When removed, the majority of these tumours are 2–6 cm in size. The overlying skin or mucosa, however, may be viewed as a single, uneven nodular mass in big tumours. The tumor’s weight might range from a few grammes to over 8 kilos. The parotid gland PA is often seen above the angle of the mandible and below the lobule of the ear.
➢ The most typical kind of salivary gland cancer is mucoepidermoid cancer. In the parotid glands, most begin. They less frequently appear in the minor salivary glands inside the mouth or the submandibular glands. Although they occasionally have intermediate or high grades, these malignancies are mostly low grade.
➢ The majority of salivary gland tumours are benign, which means they are not cancerous and won’t spread to other body areas. Almost rare do these tumours pose a threat to life.
➢ There are numerous varieties of benign salivary gland tumours, which go by names such Warthin tumours, oncocytomas, and pleomorphic adenomas. Surgery typically always eliminates benign tumours. Very rarely, if untreated for a long time or if they are not entirely removed and grow back, they may develop into cancer. It is unclear precisely how benign tumours develop into cancer.
➢ There are three levels of mucoepidermoid carcinoma cell types: low, moderate, and high. Squamous epithelial and intermediate cells make up the majority of high-grade tumours, which have weak differentiation. Mucus-secreting and squamous epithelial cells make up the majority of low-grade tumours, which are well differentiated and well-developed.
➢ Tumors with intermediate histologic grades fall somewhere in between. Indicators of prognosis for mucoepidermoid carcinomas of the main and minor salivary glands include histologic tumour grade. The clinical stage, location, grade, and success of the surgery all affect the prognosis.
➢ Although there is debate about the best way to treat mucoepidermoid carcinomas of the larynx, most authors concur that various treatment modalities should be used depending on the histologic grade and tumour subsite.
➢ As with high-grade tumours of the major and minor salivary glands, high-grade tumours are often treated more aggressively, with surgery serving as the main treatment option. Regarding the proper management of low-grade tumours, there is less consensus.
➢ Some have suggested total laryngectomy for subglottic tumours and partial laryngectomy for low-grade supraglottic malignancies. Others have suggested methods that retain laryngeal function as long as tumor-free margins are achieved all around the resection.
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