Clinical Analysis Of Malignant Salivary Gland Tumors Of The Jaws

Objective: To analyze the clinical features, treatment and factors affecting the prognosis of 22 patients with central malignant salivary gland tumors of the jaws at West China Stomatology Hospital of Sichuan University in recent 20 years, provide useful information of the rare tumor to clinicians and researchers, and investigate how to promote diagnosis and treatment.Methods: A retrospective analysis and a follow-up of 22 patients with central malignant salivary gland tumors of the jaws at West China Stomatology Hospital of Sichuan University between 1980 and 2006 were conducted.Results: Among the patients, the mean age was 46.5±14.27(19-74), median age was 47.5, and 68.2% of cases were between 29-59. Male:Female ratio was 1:2.14. There were 9 cases originating from maxillae, and the other 13 cases from mandbles, and 9.1%, 22.7%, 27.3% of cases originated from anterior portions of mandibles, posterior portions of mandibles, angles and rami of mandibles, respectively. All the tumors were malignant in our research, 10 cases(45.5%) were mucoepidermoid carcinoma(MEC), 3 cases(13.6%) were adenoid cystic carcinoma(ACC), 1 case(4.5%) was clear cell carcinoma, 2 cases(9.1%) were musculoepithelial carcinoma, 1 case(4.5%) was epithelio-musculoepithelial carcinoma, 1 case(4.5%) waspleomorphologic adenocarcinoma, 1 case(4.5%) was papillary cystic adenocarcinoma, 2 cases(9.1%) were adenocarcinoma, 1 case(4.5%) was lymphoepithelial carcinoma.Clinical manifestations included swelling of the jaw, pain, tooth mobility, hemorrhagia, uncomfortable mastication, occlusion disorder and paraesthesia of half lower lips. Bone dissolution and polycystic change were seen on X-film, and ill-defined borderline of lesion was seen in 95.5% of cases.8 of 9 cases of maxillary origin received surgery, and 11 of 13 cases of mandibular origin received surgery. 12 cases were only treated by surgery, 5 cases by surgery combined with postoperative chemotherapy, 2 cases by surgery combined with postoperative radiation. Regional extensive resection was adopted in most operations. 19 patients were followed up, and 12 patients survived without relapse.Conclusion:1.Central malignant salivary gland tumors of the jaws occur most in female.2.Clinical manifestations of central malignant salivary gland tumors of the jaws are not typical, and swelling of the jaw, pain, tooth mobility are common. Most patients are in middle-late stage when they see a doctor.3. Bone dissolution and polycystic change are common on X-film, and no obvious border of lesion are seen in most cases.4.A few are pathologically confirmed before surgery by biopy.5.Surgery is the primary treatment, and mostly involve radical resection, neck regional lymphadenectomy is required when necessary, any way removal of enough margin of lesion is essential. Adjuvent therapy includes radiation and chemotherapy.