Benign Salivary Gland Tumours, diagnostics and treatment

Žlijezde slinovnice egzokrine su žlijezde koje proizvode i izlučuju slinu kroz sustav kanala. U usnoj šupljini nalaze se tri para velikih žlijezda slinovnica: parotidna, submandibularna i sublingvalna te velik broj manlih žlijezda slinovnica smještenih u sluznici usana, jezika, nepca, obraza, retromolarnog prostora, ždrijela, grkljana i paranazalnih sinusa. Tumori žlijezda slinovnica mogu se pojaviti u svim velikim i malim žlijezdama slinovnicama, rijetki su i predstavljaju oko 3% tumora usne šupljine. Približno 85% ih nastaje u velikim slinovnicama, od toga 90% u parotidi a 10 % u submandibularnoj žlijezdi. Sublingvalna žlijezda je izuzetno rijetko zahvaćena. Ostalih 15-25% nastaje u malim slinovnicama, prvenstveno nepca. Za razliku od tumora velikih žlijezda slinovnica koji su u 85% slučajeva dobroćudni, gotovo polovina neoplazmi malih slinovnica je zloćudna. Najčešće benigne novotvorine žlijezda slinovnica su pleomorfni adenom (dobroćudni tumor mikstus) te Warthinov tumor (cystadenoma lymphomatosum papillare). Od malignih tumora žlijezda slinovnica najčešći su mukoepidermoidni karcinom, adenoidcistični karcinom, acinus-cell adenokarcinom, planocelularni karcinom te zloćudni tumor mikstus. Dijagnostika bolesti žlijezda slinovnica uključuje anamnezu, klinički pregled, ultrazvučnu tehniku, magnetnu rezonanciju, kompjutoriziranu tomografiju, scintigrafiju, sijalografiju, citološku punkciju, biopsiju i konačnu patohistološku analizu. Liječenje je isključivo kirurško. U slučaju dugotrajnog neliječenja može doći do maligne transformacije ili do pojave recidiva u slučaju nepotpunog odstranjenja.The salivary glands are exocrine glands that produce saliva through a system of ducts. There are three pairs of major salivary glands in the mouth: parotid, submandibular and sublingual, and a large number of minor salivary glands, located in oral mucosa, in tongue, palate, retromolar triangle, pharynx, larynx and paranasal sinuses. Salivary gland tumors can occur in every major salivary gland as well as in minor salivary glands, they are rare and represent about 3% of tumors occuring in oral cavity. Approximately 85% arise in major salivary glands of which 90% in parotid gland and 10% in submadibular gland. Sublingual gland is very rarely affected. The remaining 15- 25% are located in minor salivary glands, most frequently in the palate. Unlike tumors of the major salivary glands which are benign in 85% of cases, almost half of the minor salivary gland tumors are malignant. The most common benign lesions are pleomorphic adenoma (mixed tumor) and Warthin's tumor (papillary cystadenoma lymphomatosum). The most common malignant salivary gland tumors are mucoepidermoid carcinoma, adeniod cystic carcinoma, acinic cell carcinoma, squamos cell carcinoma, and carcinoma ex pleomorphic adenoma. Diagnostics of salivary gland diseases includes examination of the patient, ultrasonography, magnetic resonance imaging, computed tomography, scintigraphy, sialography, fine-needle aspiration cytology, salivary gland biopsy and in the end pathohistological diagnosis. The treatment is exclusively surgical. In case of a long-term nontreatment, it can lead to malignant transformation and relapse if not removed completly