saliv-malig-slides-070523

saliv-malig-slides-070523 - Malignancies of the Major...

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Malignancies of the Major Malignancies of the Major Salivary Glands Salivary Glands Chad Simon, MD Chad Simon, MD Susan D. McCammon, MD Susan D. McCammon, MD Grand Rounds Presentation Grand Rounds Presentation Department of Otolaryngology Department of Otolaryngology University of Texas Medical Branch at Galveston University of Texas Medical Branch at Galveston May 23, 2007 May 23, 2007
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Introduction Introduction Epidemiology Staging Histologic subtypes Diagnosis Treatment
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Epidemiology Epidemiology Malignant neoplasms of the salivary glands are relatively rare, accounting for approximately 6% of all head and neck malignancies It is estimated that 1 in 100,000 U.S. residents will develop a salivary malignancy at an average age of 56.6 years of age
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Staging Staging AJCC Cancer Staging Manual (sixth edition) Based on tumor size, local extension of tumor, nodal metastasis, and distant metastasis Histologic grade, patient age, and tumor site are important additional factors that should be considered in future staging systems
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TNM TNM TX Primary tumor cannot be assessed T0 No evidence of primary tumor T1 Tumor 2 cm or less in greatest dimension without gross extraparenchymal extension T2 Tumor more than 2 cm but not more than 4 cm in greatest dimension without gross extraparenchymal extension T3 Tumor more than 4 cm and/or tumor having gross extraparenchymal extension T4a Tumor invades skin, mandible, ear canal, and/or facial nerve T4b Tumor invades skull base and/or pterygoid plates and/or encases carotid artery
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TNM TNM NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2a Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in a lymph node more than 6 cm in greatest dimension
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TNM TNM MX Distant metastasis cannot be assessed M0 No distant metastasis M1 Distant metastasis
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Stage Grouping Stage Grouping Stage I T1 N0 M0 Stage II T2 N0 M0 Stage III T3 N0 M0 T1 N1 M0 T2 N1 M0 T3 N1 M0 Stage IVA T4a N0 M0 T4a N1 M0 T1 N2 M0 T2 N2 M0 T3 N2 M0 T4a N2 M0 Stage IVB T4b Any N M0 Any T N3 M0 Stage IVC Any T Any N M1
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Histologic Grade Histologic Grade Histologic grading is applicable only to some types of salivary gland cancer (mucoepidermoid carcinoma, adenocarcinoma not otherwise specified) In most instances, the histologic type defines the grade (i.e. salivary duct carcinoma is high grade, basal cell adenoma is low grade)
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Histological subtypes Histological subtypes Mucoepidermoid carcinoma Adenoid cystic carcinoma Acinic cell carcinoma Carcinoma ex-pleomorphic adenoma Additional rare types
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Mucoepidermoid Carcinoma Mucoepidermoid Carcinoma
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Mucoepidermoid Carcinoma
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