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  3. A thirty-eight-year study of salivary gland tumors in patients at the pathology department of the Mashhad Faculty of Dentistry during the years 1350-1388.

A thirty-eight-year study of salivary gland tumors in patients at the pathology department of the Mashhad Faculty of Dentistry during the years 1350-1388.

Number of pages: 81 File Format: word File Code: 32006
Year: 2012 University Degree: Master's degree Category: Medical Sciences
Tags/Keywords: adenoma - Benign tumors - Carcinoma - Clinical diagnoses - Histopathological - Malignant tumors - Pleomorphic - Salivary gland tumors - salivary glands - tumor
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  • Summary of A thirty-eight-year study of salivary gland tumors in patients at the pathology department of the Mashhad Faculty of Dentistry during the years 1350-1388.

    Dissertation to obtain a doctorate degree in general dentistry

    Abstract

    Background and purpose

    Salivary gland tumors have a relatively low prevalence and constitute about 3% to 10% of head and neck neoplasms. Considering the lack of epidemiological research about these tumors in Mashhad Dental School; The present study was conducted with the aim of determining the characteristics of salivary gland tumors in the patients of the Department of Oral, Maxillofacial Pathology, Faculty of Dentistry, Mashhad University of Medical Sciences during the period of 1350-1388 (38 years). In the Department of Oral, Maxillofacial and Oral Pathology of Mashhad Faculty of Dentistry between 1350-1388, a review was conducted and 165 patients with salivary gland tumors were identified. Variables related to tumors (age, gender, location, type of tumor, clinical diagnoses, histological diagnoses and nature of tumors) were determined and the data were reported with descriptive statistics. Findings About 1.7% of all studied samples include salivary tumors. The prevalence of salivary gland tumors in women was somewhat higher than in men [86 people (52.1%) versus 79 people (47.9%)]. The average age of patients with these tumors was estimated to be 41.62 years and in the range of 8-80 years. Most tumors in the palate (91 cases; 55.2%); lips (16 cases; 9.7%); submandibular glands (15 cases; 9.1%); cheek (13 cases; 7.9%) and parotid (10 cases; 6.1%) were created. 51.5% (85 cases) of benign lesions and 48.5% (80 cases) of them were malignant. Pleomorphic adenoma tumor was the most common tumor with 77 cases (46.7%), followed by mucoepidermoid carcinoma with 33 cases (20.0%) and adenoid cystic carcinoma with 23 cases (13.9%).

    Conclusion

    palate is the most common location of salivary tumors in this study, and it also has the lowest age decade for the occurrence of lesions, along with the lip and central types. Malignant lesions occur significantly in females and in a decade later. The agreement of clinical and histopathological diagnoses in pleomorphic adenoma shows the greatest harmony. (Salivary Gland Tumors); They are a complex group of lesions with different histological types and different clinical behaviors [1]. These lesions are often seen in adults and only about 5% of cases occur in people under 16 years of age. Tumors occur in three pairs of major salivary glands along with hundreds of minor salivary glands in the oral cavity and the oropharyngeal region and in a wide range of neoplasms [2]. The histogenesis of salivary gland tumors is still debated; so that some acinar cells and others consider ductal system precursor cells to be involved in their occurrence [3-5]. Therefore, since 1954, the classification systems of salivary glands have undergone numerous revisions and new lesions have been added to them [6]. Salivary gland tumors cover a wide age range, but usually benign types appear around the age of 40 years and malignant types appear about 10-15 years later [1,7]. Although some studies have shown that the most common sites of salivary gland tumor involvement are the parotid gland, minor glands, submandibular and sublingual glands; In the research conducted in Lagos by Ladeinde et al. (2007) [8]; The most common place of occurrence of tumors is in the minor glands and in the research conducted by Ansari (2007) in Iran as well as the research by Ito et al. (2005) in Brazil; The submandibular gland was reported as the second most common site of tumor occurrence [9,10].

     

    Some believe that most salivary gland tumors are benign and the most common benign tumor is pleomorphic adenoma. Among malignant tumors, mucoepidermoid carcinoma is named as the most common tumor [1,2]. These results have been reported in many studies, but at the same time, in
    some other studies, the prevalence of adenoid cystic carcinoma has been estimated to be higher than other malignant tumors [13,14].

    In terms of the prevalence of tumors by gender; According to the results of some studies; These lesions occur more in women [1,7,15,16]. Of course, in other studies; The prevalence of tumors has been reported equally in both men and women [8,11,17]. Also, Li et al. (2004) showed that benign tumors in women and malignant tumors were more in men [12] and in the research of Masanja et al. (2003); This prevalence was seen more in men [13].

    The manifestations of salivary gland tumors are mainly in the form of painless swelling in the corresponding area, and the increase in the size of the mass may also occur over a long period of time [18,19]. In 6% to 29% of patients, pain is one of the initial symptoms [10,20] and facial nerve involvement also suggests a malignant process. Other symptoms that favor the presence of malignancy are: trismus, cervical adenopathy, numbness, loose teeth and bleeding [21,22]. CT Scan, especially with the use of intravenous contrast, will be useful to evaluate the location and extent of the disease, especially in the case of involvement of the deep parotid lobe and parapharyngeal areas [23]. Of course, MRI is better than CT Scan in diagnosing soft tissue involvement, but it is unable to identify bony landmarks [23].

    Treatment of salivary gland tumors is mainly surgical, and in the case of malignant tumors, additional surgical and non-surgical treatments may also be indicated [9].

    Salivary tumors examination with Due to their various behaviors and the destructive effects they leave on the oral and maxillofacial system, it is considered one of the most important research methods in oral, maxillofacial pathology [1,2]. Obviously, the first step in this way is proper classification and more awareness of the occurrence rate of each tumor and evaluation of tumors in terms of age, sex, and location of involvement, so that based on the information obtained, an accurate measure of their clinical diagnosis can be prepared for clinicians. Due to the difference in the prevalence and occurrence of these tumors in different societies, it is necessary to carry out special epidemiological investigations in this field in each geographical region. In this research, for the first time in the country, salivary gland tumors were examined over a relatively wide period of 38 years, so that by comparing the results with the statistics obtained in various researches and evaluating their similarities and differences; reached a general summary about the condition of these tumors.

    According to the points presented in a summary view, the reasons for choosing the topic and its importance are as follows:

    - By conducting this research, the frequency of salivary gland tumors in patients at the pathology department of the Faculty of Dentistry, Mashhad University, between the years 1350-1388 was investigated.

    - Salivary gland tumors; Despite the limited prevalence, it has been of great importance in retrospective studies and their frequency has been reported according to different geographical and racial regions.

    - Due to the different behavior of salivary gland tumors, every society needs to conduct its own investigations on these tumors and use them to diagnose and treat patients. There are different investigations on the behavior of salivary gland tumors in different societies.

    - On the other hand, according to the availability of patient files in the Department of Oral, Maxillofacial Pathology, Faculty of Dentistry, Mashhad University of Medical Sciences; It has been possible to conduct research.

  • Contents & References of A thirty-eight-year study of salivary gland tumors in patients at the pathology department of the Mashhad Faculty of Dentistry during the years 1350-1388.

    List:

    Abstract 1

    Chapter One: Introduction

    Statement of the problem. 5

    Research objectives. 5

    A- General purpose. 5

    b- specific goals. 5

    C- The practical purpose of the research. 6

    d- Assumptions or research questions. 6

     

    Chapter Two: Generalities, review of texts and articles

    1- Generalities. 7

    Saliva Functions (Function of Saliva): 7

    Salivary Gland Development: 7

    Saliva Gland Structure 8

    Salivary Gland Tumors. 9

    Benign tumors. 11

    Pleomorphic adenoma (PA) 11

    Clinical presentation. 12

    Histopathological features. 13

    Prognosis and treatment. 13

    Warthin's tumor (PCL) 14

    Clinical profile. 14

    Histopathological characteristics. 15

    Prognosis and treatment. 16

    Oncocytoma 16

    Clinical view. 16

    Histopathological features. 17

    Prognosis and treatment. 17

    Basal tuberculous adenoma (BCA) 17

    Clinical view. 18

    Histopathological characteristics. 18

    Treatment and prognosis. 19

    Canalicular adenoma (Canalicular Adenoma) 19

    Clinical appearance. 19

    Histopathological features. 19

    Prognosis and treatment. 20

    Myoepithelioma (Myoepithelioma) 20

    Clinical view. 20

    Histopathological features. 21

    Prognosis and treatment. 21

    Malignant tumors. 21

    Mucoepidermoid carcinoma (MEC) 21

    Clinical presentation. 22

    Histopathological features. 23

    Prognosis and treatment. 24

    Adenoid cystic carcinoma (ACC) 25

    Clinical view. 25

    Histopathological characteristics. 25

    Prognosis and treatment. 26

    Polymorphous low-grade adenocarcinoma (PLGA) 27

    Clinical presentation. 27

    Histopathological characteristics. 27

    Prognosis and treatment. 28

    Acinic Tuberculosis Adenocarcinoma (ACA) 28

    Clinical presentation. 29

    Histopathological features. 29

    Treatment and prognosis. 30

    Pleomorphic malignant adenoma (Malignant Mixed Tumor) 30

    Clinical appearance. 30

    Histopathological characteristics. 31

    Treatment and prognosis. 32

    2- Review of articles. 33

     

    Chapter three: research materials and methods

    type of study. 48

    Technique of data collection 48

    The studied community. 48

    Sample size, its calculation method and sampling method. 48

    Research variables, their measurement type and scale 48

    Role. 48

    Type. 48

    Scale. 48

    Application definition. 48

    Unit of measurement. 48

    The method of conducting research. 49

    Statistical analysis method. 50

    Ethical considerations. 50

     

    Chapter Four: Research Results

    Research Results. 51

    Sen. 51

    Gender. 53

    Clinical diagnosis. 55

    Histological diagnosis. 56

    The degree of agreement between histological and clinical diagnosis. 56

    Tumor location 57

    Tumor types 57

    Peripheral or centrality of tumors 58

    Position of tumor types (minor or major) 59

    Benign or malignant lesions. 59

    Average age by gender and types of place in major and minor 59

    Chapter five: discussion and conclusion

    Discussion. 67

    Conclusion. 73

    Limitations 74

    Proposals. 74

    Resources. 75

     

     

    Source:

     

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A thirty-eight-year study of salivary gland tumors in patients at the pathology department of the Mashhad Faculty of Dentistry during the years 1350-1388.
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