Adenomas

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

1. ADENOMAS 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. 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

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

6. INVESTIGATION: FNAC Imaging: Ultrasound CT scan MRI Pleomorphic Adenoma

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

8. Papillary cystadenoma lymphomatosum Warthin tumor Adenolymphoma

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

10. HISTOLOGICAL FINDINGS: Epithelial & lymphoid element Stroma : Lymphoid Germinal center formation Adenolymphoma

11. INVESTIGATION: FNAC Imaging: Ultrasound CT scan MRI MANAGEMENT: Enucleation Superficial parodiectomy Adenolymphoma

12. Most common benign tumour of parotid in children Hemangioma

13. 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

14. INVESTIGATION: MANAGEMENT: 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. 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 )

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

18. 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 )

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