Oral Salivary Gland Cancer
Determining the Type of Oral Salivary Gland Cancer
Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer. Your doctor and pathologist should specialize in oral cancers because some benign (non-cancerous) lesions can look like cancer on a small biopsy.
After diagnosing you with oral 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 reasons14, Agulnik M, McGann CF, Mittal BB, Gordon SC, Epstein JB. Management of salivary gland malignancies: current and developing therapies. Oncol Rev. 2008;2:86-94.15Eveson 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; 2005:220-1.:
- 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.16WHO histological classification of tumors of the salivary glands. World Health Organization. 2005.
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-gradeadenocarcinoma Epithelial-myoepithelial carcinoma Clear cell carcinoma, NOS Basal cell adenocarcinoma Sebaceous carcinoma Sebaceous lymphadenocarcinoma Cystadenocarcinoma Low-grade cribriform Cystadenocarcinoma 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. 16WHO histological classification of tumors of the salivary glands. World Health Organization. 2005.
