Salivary gland neoplasms represent the most complex and diverse group of tumors encountered by the head and neck oncologists. Their diagnosis and managements are complicated by their relative infrequency, the limited amount of pretreatment information available, and the wide range of biological behaviors seen with the different histopathologic lesions. Proper management of these tumors requires an accurate diagnosis by the pathologist and correct interpretation by the surgeon. The benign mixed tumor is the most common salivary gland neoplasm. Approximately 65 percent of all salivary gland tumors are classified as benign mixed tumor or pleomorphic adenoma. Sixty five sequential benign mixed tumors seen from January 1985 to December 1991 were reviewed for their clinical presentations, diagnostic evaluations, and therapeutic approaches. The age of the patients ranged from 12 to 79 with a mean of 42.4 years. The male to female ratio showed a female preponderance, 18 : 47 (1 : 2.6), with variations for locations. There were 35 (53.8%) parotid, 15 (23.1%) submandibular, and 15 (23.1%) minor salivary tumors. An asymptomatic mass (84.8%) was the most common presentation. Radiological evaluation was made mainly with computed tomography. With fine-needle aspiration, the predictive value of a neoplasm was 65.2%. Major postoperative complications were salivary leakage, facial nerve palsy, wound infection and separation. The incidence of carcinoma in mixed tumors was 10.9% (8 cases). Patients with known or suspected benign mixed tumor should be encourged to undergo surgery early on in their disease to avoid malignant degeneration at a late date.
|