A digital manual for the early diagnosis of oral neoplasia
Tumours of minor salivary glands
Minor salivary glands are most numerous at the junction of hard and soft palate, buccal mucosa and lips. These glands in the palate, retromolar area and ventral tongue are predominantly mucous, and those in the lateral aspects of tongue, lips and buccal mucosa are seromucous.
Malignant tumours of minor salivary glands are rare and are seen in all age groups. A slight female predilection has been reported . About 40% of the tumours arising from minor salivary glands are malignant . The palate is most commonly affected, followed by the upper lip. Mucoepidermoid carcinoma is the most common histological subtype . The risk factors responsible for the development of these cancers are not well understood. Clinically, they appear as painless, progressive submucosal swelling. The diagnosis is confirmed by incision biopsy. Fine needle aspiration cytology (FNAC) gives varying results. Wide excision is the treatment of choice. Post-operative radiotherapy is indicated in high-grade tumours, especially in adenoid cystic carcinoma, and those with positive resected margins, involvement of nodes and perineural invasion. In selected cases where surgery is not feasible, radical radiotherapy has been tried. The 5-year survival is around 66%, and stage at diagnosis is the most important predictor of survival .
Image
Caption
Figure 1: Carcinoma of the minor salivary gland. Note the swelling on the right side of the floor of mouth which, on histopathological examination, proved to be mucoepidermoid carcinoma.
Figure 2: Adenoid cystic carcinoma in a 30–year-old man. Note the diffuse swelling on the left side of the hard palate with intact mucosa.