A prospective study published in Cureus examined the demographic patterns, histopathology, and short-term outcomes of 50 patients with salivary gland neoplasms treated at a tertiary care center in India. The researchers reported that salivary gland neoplasms represent a rare subset of head and neck neoplasms and aimed to assess clinical features, anatomic distribution, and the diagnostic performance of fine needle aspiration cytology (FNAC) compared with histopathology.
The 18-month study included 50 consecutive patients diagnosed with primary salivary gland neoplasms at Guru Gobind Singh Medical College and Hospital in Faridkot. Patients ranged in age from 1 to 80 years, with a median age of 45. Overall, 38 of 50 neoplasms (76%) were benign and 12 (24%) were malignant.
Benign neoplasms were most frequently diagnosed in the fifth decade of life, whereas malignant neoplasms were more commonly identified between the fourth and sixth decades. Females accounted for 58% of cases overall. Although benign lesions were more common in females and malignant lesions more common in males, the association between sex and histopathologic type was not statistically significant.
On microscopic examination, pleomorphic adenoma was the most common benign neoplasm, accounting for 76% of cases and occurring most frequently in the parotid gland. Among malignant neoplasms, mucoepidermoid carcinoma and adenoid cystic carcinoma were most frequent. Malignant neoplasms occurred most commonly in the submandibular gland (58%), followed by the parotid gland and maxillary sinus (17% each).
All patients presented with swelling. Tenderness and skin fixation were observed only in malignant cases and in a small proportion of patients. The researchers said swelling was the most common symptom in all cases, reinforcing its role as the predominant clinical feature.
FNAC findings were compared with postoperative histopathology, the reference standard. The study found that FNAC and histopathology agreed in 43 of 50 cases. In distinguishing benign from malignant lesions, FNAC demonstrated 100% sensitivity for benign tumors but a specificity of 41.7%, indicating limitations in excluding malignancy.
Surgery was the main treatment modality in all cases. Superficial parotidectomy with facial nerve preservation was the most frequently performed procedure. Adjuvant radiotherapy was administered in 24% of patients, primarily those with high-grade malignancies, positive or close margins, perineural invasion, or nodal involvement.
Postoperative complications occurred in 12% of patients and were procedure specific. Transient facial nerve weakness was most common after superficial parotidectomy, whereas marginal mandibular nerve injury was associated with submandibular gland excision.
The researchers acknowledged limitations, including the small sample size, single-center design, and short follow-up of three months. They concluded that while FNAC remains “a useful, minimally invasive diagnostic tool,” surgical excision continues to be the primary treatment, with radiotherapy reserved for selected malignant cases.
Source: Cureus
