Close

Salivary Gland Cancer

Determining the Type of Salivary Gland Cancer

After diagnosing you with salivary gland cancer, your doctor will need to determine what type of cancer it is. Your doctor may be able to tell you the GRADE of the cancer (low-grade, intermediate-grade or high-grade) from your biopsy results. If there happens to be a lot of cells in the biopsy, you might even have an indication of what type of cancer it is. If your doctor is having a difficult time telling you what type of cancer it is, he or she might ask for a second opinion and send some pieces off to a specialist who deals more frequently with these types of tumors.

In any case, since the first treatment for essentially all salivary gland cancers is removal by surgery, at some point the pathologist will get a good look at the tumor under a microscope and you will hopefully know what type of salivary gland cancer you have.

Salivary gland cancer types are among the most difficult to diagnose for a number of reasons:28Spiro et al. Stage means more than grade in adenoid cystic carcinoma. The American Journal of Surgery 1992; 164(6): 623-628.

  • These tumors are extremely rare.
  • The classification system is complex.
  • Some tumors can have features that make it difficult to differentiate benign from malignant.
  • A single tumor mass can have a whole range of characteristics and can even have two different types of tumors within it (including benign and malignant).
  • Just as there is great variation in configurations of cells within a tumor, special stains called immunostains are also quite variable within a group of similar tumors.

After a thorough analysis, a salivary gland cancer will fit into one of these tumor types as defined by the World Health Organization. The six most common ones are in bold.19Agulnik M, McGann CF, Mittal BB, Godon SC, Epstein JB. Management of salivary gland malignancies: current and developing therapies. Oncol Rev (2008) 2:86–94.

ALL THE DIFFERENT TYPES OF SALIVARY GLAND TUMORS

Cancerous Epithelial Tumors Cancerous Soft Tissue Tumors
Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Acinic cell carcinoma
Adenocarcinoma, NOS
Carcinoma ex pleomorphic adenoma
Squamous cell carcinoma
Polymorphous low-grade
Adenocarcinoma
Epithelial-myoepithelial carcinoma
Clear cell carcinoma, NOS
Basal cell adenocarcinoma
Sebaceous carcinoma
Sebaceous lymphadenocarcinoma
Cystadenocarcinoma
Low-grade cribriform
Mucinous adenocarcinoma
Oncocytic carcinoma
Salivary duct carcinoma
Myoepithelial carcinoma
Carcinosarcoma
Metastasizing pleomorphic adenoma
Small cell carcinoma
Large cell carcinoma
Lymphoepithelial carcinoma
Sialoblastoma
Haemangiopericytoma
Malignant schwannoma
Fibrosarcoma
Malignant fibrous histiocytoma
Rhabdomyosarcoma
Angiosarcoma
Synovial sarcoma
Kaposi sarcoma
Leiomyosarcoma
Liposarcoma
Alveolar soft part sarcoma
Epithelioid sarcoma
Extraosseous chondrosarcoma
Osteosarcoma
Malignant haemangioendothelioma
Blood and Lymphatic Tumors Metastatic Tumors
Hodgkin lymphoma
Diffuse large B-cell lymphoma
Extranodal marginal zone B-cell lymphoma
A cancer that has spread to the salivary gland from another site

WHO Histological Classification of Tumors of the Salivary Glands, 2005

References

1 Eveson JW, Auclair PL, Gnepp DR, et al. Tumors of the salivary glands: introduction. In: Barnes EL, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumours: pathology & genetics. Head and neck tumours. Lyon: IARCPress; 2005.

2 Califano J, Eisele DW. Benign salivary gland neoplasms. Otolaryngologic clinics of North America 1999;32:861.

3 Rubino C, De Vathaire F, Dottorini M, et al. Second primary malignancies in thyroid cancer patients. British Journal of Cancer 2003;89:1638-44.

4 Holm LE, Hall P, Wiklund K, et al. Cancer risk after iodine-131 therapy for hyperthyroidism. Journal of the National Cancer Institute 1991;83:1072-7.

5 Hall P, Holm L, Lundell G, et al. Cancer risks in thyroid cancer patients. British Journal of Cancer 1991;64:159.

6 Johansen C, Boice Jr JD, McLaughlin JK, Olsen JH. Cellular telephones and cancer—a nationwide cohort study in Denmark. Journal of the National Cancer Institute 2001;93:203-7.

7 Auvinen A, Hietanen M, Luukkonen R, Koskela RS. Brain tumors and salivary gland cancers among cellular telephone users. Epidemiology 2002;13:356.

8 Atula T, Grenman R, Klemi P et al (1998) Human papillomavirus, Epstein-Barr virus, human herpesvirus 8 and human cytomegalovirus involvement in salivary gland tumours. Oral Oncol 34:391–395.

9 Sun EC, Curtis R, Melbye M et al (1999) Salivary gland cancer in the United States. Cancer Epidemiol Biomarkers Prev 8:1095–1100.

10 Horn-Ross PL, Ljung BM, Morrow M. Environmental factors and the risk of salivary gland cancer. Epidemiology 1997:414-9.

11 Perzin KH, Livolsi VA. Acinic cell carcinoma arising in ectopic salivary gland tissue. Cancer 1980;45:967-72.

12 Taylor GD, Martin HF. Salivary gland tissue in the middle ear: A rare tumor. Archives of Otolaryngology—Head & Neck Surgery 1961;73:651.

13 Mehanna H, McQueen A, Robinson M, Paleri V. Salivary gland swellings. BMJ. 2012 Oct 23;345-352.

14 Wierzbicka M, Kopeć T, Szyfter W, Kereiakes T, Bem G. The presence of facial nerve weakness on diagnosis of a parotid gland malignant process. European Archives of Oto-Rhino-Laryngology 2012:1-6.

15 Schmidt RL, Hall BJ, Wilson AR, Layfield LJ. A systematic review and meta-analysis of the diagnostic accuracy of fine-needle aspiration cytology for parotid gland lesions. Am J Clin Pathol 2011;136:45-59.

16 Schmidt RL, Hall BJ, Layfield LJ. A systematic review and meta-analysis of the diagnostic accuracy of ultrasound-guided core needle biopsy for salivary gland lesions. Am J Clin Pathol 2011;136:516-26.

17 Agulnik M, McGann CF, Mittal BB, Gordon SC, Epstein JB. Management of salivary gland malignancies: current and developing therapies. Oncol Rev (2008) 2:86–94.

18 Eveson JW, Auclair PL, Gnepp DR, et al. Tumors of the salivary glands: introduction. In: Barnes EL, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumours: pathology & genetics. Head and neck tumours. Lyon: IARCPress; 2005. p. 220–1.

19 Agulnik M, McGann CF, Mittal BB, Godon SC, Epstein JB. Management of salivary gland malignancies: current and developing therapies. Oncol Rev (2008) 2:86–94.

20 Eveson JW, Auclair PL, Gnepp DR, et al. Tumors of the salivary glands: introduction. In: Barnes EL, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumours: pathology & genetics. Head and neck tumours. Lyon: IARCPress; 2005.

21 Seethala RR. An Update on Grading of Salivary Gland Carcinomas. Head Neck Pathol. 2009 March;3(1): 69–77.

22 Douglas JG, Koh WJ, Austin-Seymour M, Laramore GE: Treatment of salivary gland neoplasms with fast neu- tron radiotherapy. Arch Otolaryngol Head Neck Surg 2003, 129:944–948.

23 Rentschler R, Burgess MA, Byers R. Chemotherapy of malignant major salivary gland neoplasms. A 25‐year review of MD Anderson hospital experience. Cancer 2006;40:619-24.

24 Suen JY, Johns ME. Chemotherapy for salivary gland cancer. The Laryngoscope 2009;92:235-9.

25 Terhaard CHJ et al. Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head & Neck 2004; 26(8):681-693.

26 Iro H,Waldfahrer F. Evaluation of the Newly Updated TNM Classification of Head and Neck Carcinoma with Data From 3247 Patients. Cancer 1998; 83:2201--‐7.

27 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

28 Spiro et al. Stage means more than grade in adenoid cystic carcinoma. The American Journal of Surgery 1992; 164(6): 623-628.

29 Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck in Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

30 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2014. © National Comprehensive Cancer Network, Inc 2014. All rights reserved. Accessed June 18, 2014. To view the most recent and complete version of the guideline, go online to www.NCCN.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.