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squamous cell carcinoma of salivary glands

Monday 22 September 2014

squamous cell carcinoma of the parotid gland

Definition : The squamous cell carcinoma of submandibular salivary gland is a malignant epithelial tumor of major salivary glands composed of epidermoid cells / squamous cells.

Squamous cell carcinoma involving the parotid gland is an aggressive and rapidly advancing lesion which if not recognized and treated early will result in a high morbidity and mortality.

Primary epidermoid carcinoma of major salivary glands is rare. The major risk factor is a history of radiotherapy of this gland.

Patients with spinocellular carcinoma of major salivary glands are predominantly male.

Clinically, they present with an asymptomatic, poorly encapsulated, nodular tumor. It is fixed to superficial and deep planes. The invasion of the facial nerve or one of its branches is possible, but rare.

Epidemiology

Differential diagnosis

- metastasis of an epidermoid carcinoma

  • It is important to rule out a metastasis of an epidermoid carcinoma from elsewhere on the head and the neck, or (rarely) metastasis from visceral cancer, such as lung cancer.

- salivary gland tumors with squamous cell differentiation

- lymphoepithelial carcinoma

  • Epstein Barr virus associated

Management

Radical excision with preservation of the facial nerve when possible is the treatment of choice. Radical neck dissections are not uniformly employed. Adjunctive treatment with radiotherapy or chemotherapy is recommended. Local or regional recurrence occurs in both parotid (51 %) and submandibular (67 %) cases.

Prognosis

Prognosis is strongly correlated with the stage of the tumor. The 5-year survival usually varies from 50 to 80 percent, but for end-stage disease does not exceed 14 percent.

The clinical outcome is similar between patients with metastatic squamous cell carcinoma and primary squamous cell carcinoma of submandibular salivary gland, regardless of treatment plan.

Case reports

- https://escholarship.org/uc/item/7p46v3q7
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196305/

References

- Taxy JB. Squamous carcinoma in a major salivary gland: a review of the diagnostic considerations. Arch Pathol Lab Med. 2001 Jun;125(6):740-5.

- Li J, Wang BY, Nelson M, Li L, Hu Y, Urken ML, Brandwein-Gensler M. Salivary adenocarcinoma, not otherwise specified: a collection of orphans. Arch Pathol Lab Med. 2004 Dec;128(12):1385-94.

- Shemen LJ, Huvos AG, Spiro RH. Squamous cell carcinoma of salivary gland origin. Head Neck Surg. 1987 Mar-Apr;9(4):235-40.

- Seifert G, Hennings K, Caselitz J. Metastatic tumors to thr parotid and submandibular glands—analysis and differential diagnosis of 108 cases. Pathol Res Pract 1986 Dec;181(6):684-692.

- Nichols RD, Pinnock LA, Szymanowski RT. Metastases to parotid nodes. to the Laryngoscope 1980;90:1324-8.

- Andersen LJ, Therkildsen MH, Ockelmann HH, Bentzen JD, Schiodt T, Hansen HS. Malignant epithelial tumors in the minor salivary glands, the submandibular gland and the sublingual gland: prognostic factors and treatment results. Cancer 1991; 68(11):2431-2437. PubMed

- Spiro RH, Armstrong J, Harrison L, Geller NL, Lin SY, Strong EW. Carcinoma of major salivary glands. Recent trends. Arch Otolaryngol Head Neck Surg. 1989 Mar;115(3):316-21.