Salivary Gland Neoplasms
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SALIVARY GLAND DISORDERS (HT HOFFMAN, SECTION EDITOR)
Salivary Gland Neoplasms Anne C. Kane 1
&
William R. Ryan 2 & David Cognetti 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To give an overview of diagnosis and treatment of salivary gland neoplasms and highlight the contribution of recent literature. Recent Findings The newly adapted Milan classification system for cytologic diagnosis provides risk of malignancy and clinical management strategies for parotid neoplasms with high PPV and NPV. Reconstruction for partial parotidectomy and total parotidectomy defects continues to advance toward greater cosmesis and facial symmetry. Summary New diagnostic advances will aid in clinical decision making and patient management. Surgically based therapy continues to be favored in both benign and malignancy lesions. Management of the neck is important in high grade salivary malignancy and reconstruction of defects should be considered in order to improve cosmetic outcomes. Keywords Salivary gland tumor . Parotid malignancy . Parotid reconstruction . Salivary gland cytology
Introduction Salivary gland tumors are relatively rare neoplasms which make up approximately 3–5% of all head and neck tumors and 0.5% of all malignancies [1]. Salivary gland tumor classification includes differentiation between major and minor salivary glands as well as benign versus malignant pathology. Most clinicians use the 80/20 rule for salivary gland neoplasms: 80% are benign, 80% occur in the parotid gland, and 80% are pleomorphic adenomas. However, there is some variation of these incidences in the literature [2]. Historically, surgery was considered for every salivary gland tumor. Advances in fine needle aspiration biopsy and radiographic imaging have led to recommendations for preThis article is part of the Topical collection on Salivary Gland Disorders * Anne C. Kane [email protected] William R. Ryan [email protected] David Cognetti [email protected] 1
Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA
2
Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, USA
operative evaluation with imaging and biopsy to guide treatment planning. Analyses within the literature have suggested that ultrasonography, CT, and MRI are all feasible methods in diagnosing salivary tumors without significant differences in diagnostic accuracy [1]. Fine needle aspiration is recommended for diagnosis and to help drive treatment recommendation. It can help to determine recommendations for observation versus excision. For malignant lesions, fine needle aspiration cytology (FNAC) also allows appropriate pre-operative counseling and planning regarding extent of resection, facial nerve management, the need for elective neck dissection, the potential role of postoperative radiation treatment, and the urgency of surgical scheduling. Ultrasound guidance, particularly for submandibular and p
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