SOME BENIGN AND

MALIGNANT TUMORS OF
SALIVARY GLAND

SUBMITTED TO : DR. SAURABH ROY SUBMITTED BY : RAJSHREE SHRESTHA

DEPARTMENT OF ORAL PATHOLOGY BDS 8TH BATCH
CONTENTS
• Myoepithelioma
• Monomorphic adenoma
• Basal cell adenoma
• Canalicular adenoma
• Oncocytoma
• Polymorphous low grade adenocarcinoma
MYOEPITHELIOMA
• Myoepithelioma is a benign tumor of the oral cavity, arising
predominantly from major and minor salivary glands, and
accounting for 1–1.5% of all glandular tumors.

• Sheldon in 1943 coined the term “myoepithelioma” to describe a

group of tumors, histologically composed of solitary myoepithelial
cells.
CLINICAL FEATURES

• It presents as a asymptomatic,
painless , slowly growing mass.

• Most frequent sites of involvement

are parotid gland and minor
salivary glands of the hard palate.

• Age of peak occurrence is 3rd to 5th

decade with equal gender
distribution.
HISTOPATHOGICAL FEATURES

•  The tumor is composed of neoplastic myoepithelial

cells.
• The neoplastic cells are predominantly spindle-
shaped or plasmacytoid.
• They show four histopathologic subtypes, including
plasmacytoid, epithelioid, spindle and clear cells
which can be associated with mucoid or hyalinized
stroma.
• They may exhibit various growth patterns based on
the arrangement of myoepithelial cells.
MONOMORPHIC ADENOMA
• Monomorphic adenoma is a salivary gland tumor believed to
result from a proliferation of a single type of cell.
• Similar to pleomorphic adenoma except no mesenchymal
component. – predominantly epithelial component present.
• More common in minor salivary glands especially lip region.
• 12% bilateral
• Rare malignant potential
• Types
Basal cell adenoma
Cannalicular adenoma
Myoepithelioma adenoma
Clear cell adenoma
Membranous adenoma
Glycogen rich adenoma
BASAL CELL ADENOMA
• Basal cell adenoma is a neoplasm of a uniform population of
basaloid epithelial cells arranged in solid, trabecular, tubular, or
membranous patterns.
CLINICAL FEATURES

• It tend to occur particularly the parotid gland.

• The tumors are usually painless and are slow growing.
• They occur chiefly in adults, the average age of the patients is
57.7 years with the peak of incidence seen in the sixth decade.
• There is a 2 : 1 female predilection for the occurrence of this
tumor.
• These tumors appear as a firm swelling which may be cystic and
compressible.
• These tumors are clinically indistinguishable from mixed tumors
and their greatest dimension is usually less than 3 cm.
HISTOPATHOLOGY
• Basal cells are fairly uniform and regular; two morphologic forms
can be seen.
• One is a small cell with scanty cytoplasm and round deeply
basophilic nucleus.
• The other cell is large with eosinophilic cytoplasm and an ovoid pale
staining nucleus.
• Basal cell adenomas can be divided on the basis of their
morphologic appearances into four subtypes:
 Solid
 Tubular
 Trabecular
 Membranous
• Solid type.
The most common variant.
The basaloid cells form islands and
cords that have a broad, rounded,
lobular pattern.

• Tubular type.
This pattern exhibits multiple small,
round duct like structures.
least common variant
• Trabecular type.
It has the same cytologic features as the solid type,
but the epithelial islands are narrower and cord
like and are interconnected with one another,
producing a reticular pattern.

• Membranous type.
characterized by the presence of abundant, thick,
eosinophilic hyaline layer that surrounds and
separates the epithelial islands.
 The epithelial islands are arranged in large
lobules and appear to mould to the shape of other
lobules to resemble a jigsaw puzzle pattern.
CANALICULAR ADENOMA
• Canalicular adenoma (CA) is an uncommon benign tumor that
occurs almost exclusively in the minor salivary glands.

CLINICAL FEATURES
• Common in patients of age 34–65 years.
• Slight predilection in females with a ratio of
1.8 : 1
• Mostly occurs in lips, buccal mucosa, hard
palate.
• Presents as a slowly growing, well-
circumscribed, firm nodule which,
particularly in the lip, is not fixed.
HISTOPATHOLOGIC FEATURES

• It is composed of long columns or

cords of cuboidal or columnar cells in
a single layer.

• These single layers of cells are

parallel, forming long canals.
( tram track appearance)

• Larger cystic spaces often are created.

ONCOCYTOMA (Oncocytic adenoma, oxyphilic
adenoma, acidophilic adenoma)
• Rare benign tumor composed of oncocytes with granular eosinophilic
cytoplasm and a large number of atypical mitochondria.

CLINICAL FEATURES
• Predominantly a tumor of older adults, with a peak prevalence in the
eighth decade.
• A slight female predilection has been observed..
• Occur primarily in the major salivary glands, especially the parotid
gland.
• firm, slowly growing, painless mass that rarely exceeds 4 cm in
diameter.
HISTOPATHOLOGIC FEATURES

• Characterized by large cells which have an eosinophilic cytoplasm

and distinct cell membrane and which tend to be arranged in
narrow rows or cords.
• The oncocytes are arranged in sheets or nests and cord.
• Some degree of cellular atypia, nuclear hyperchromatism and
pleomorphism.
• Exhibits few mitotic figures, are closely packed, and there is little
supportive stroma.
• Lymphoid tissue is frequently present, but does not appear to be
an integral part of the lesion
 Figure 2

Figure 1
POLYMORPHOUS LOW-GRADE
ADENOCARCINOMA
• Malignant neoplasm of salivary gland origin.
• It is included in the category of benign salivary neoplasms
because it is usually slowly growing, of long duration, and
painless.
• This tumor occurs almost exclusively in minor salivary glands.
CLINICAL FEATURES
• Frequently occurs in minor salivary glands.
• Average age of patient reported is 59years old
• The female to male ratio is about 2 : 1.
• Presents as a firm, nontender swelling involving the mucosa of the hard
and soft palates (often at their junction), the cheek, or the upper lip.
• Discomfort, bleeding, telangiectasia, or ulceration of the overlying
mucosa may occasionally occur.
HISTOPATHOLOGICAL
FEATURES

• The tumor has a

characteristic pattern with
columns and rows of single
cells infiltrating adjacent
tissues and salivary gland
and extending up to the
overlying epithelium.
• The cells are seen
arranged in linear rows
which appear as if one
following the footsteps
of another.

• The term has been used

interchangeably with
“Indian file” probably
denoting Amerindian
people's way of walking
along a trail as
illustrated.
• The concentric whorling is seen
around small neurovascular
bundles producing a targetoid
appearance.
• This perineural invasion is a characteristic
feature of PLGA.
• One of the most
characteristic features of
PLGA is the nuclear
uniformity.

• The cells are

cytologically bland and
can be cuboidal,
columnar, or spindled
with a mixture being
quite common.
REFERENCES
• Shafer’s Text Book of Oral Pathology 7th edition.
• Neville Oral and Maxillofacial Pathology 3rd edition.
• Articles published by PubMed (https://pubmed.ncbi.nlm.nih.gov/)