Case No. 1: 36 year old male
with a left sided parotid mass.

 
The correct answer is "b". Pleomorphic adenomas are the most common benign tumors of the parotid gland.

Classification of Epithelial Salivary Gland Tumors

Benign lesions

  • Mixed tumor (Pleomorphic Adenoma)
  • Papillary Cystadenoma Lymphomatosum (Warthin's Tumor)
  • Oncocytoma (oncocytosis)
  • Monomorphic tumors
  • Sebaceous tumors
  • Papillary ductal adenoma (papilloma)
  • Benign lymphoepithelial lesion
  • Unclassified

Malignant Lesions

  • Metastatic malignancy
  • Carcinoma ex pleomorphic adenoma
  • Malignant mixed tumor
  • Mucoepidermoid carcinoma (low to high-grade)
  • Adenoid cystic carcinoma
  • Acinous cell (acinic) carcinoma
  • Adenocarcinoma
  • Oncocytic carcinoma (malignant oncocytoma)
  • Clear cell carcinoma
  • Primary squamous cell carcinoma
  • Hybrid basal cell adenoma/ adenoid cystic carcinoma
  • Undifferentiated carcinoma
  • Epithelial-myoepithelial carcinoma of intercalated ducts
  • Unclassified

    Pleomorphic adenoma, a benign tumor of the parotid gland,
    is the most frequent of salivary gland tumors accounting
    for 65% of all parotid neoplasms.

    Mucoepidermoid carcinoma is the most common malignant
    salivary gland tumor and accounts for 50% of malignant parotid gland tumors.

    Metastatic skin cancer (squamous cell carcinoma, melanoma)
    should always be part of the differential diagnosis.

    Question #3:

    What is the most important consideration in surgical resection of parotid tumors?

    1. Preserving the Greater Auricular Nerve.
    2. Avoiding transection of the Facial Artery.
    3. Preservation of the Facial Nerve (CN VII).
    4. Conserving as much of the Parotid Gland as possible.