GPR: 2019 - Week 32

From MGH Learn Pathology

Clinical history

59-year-old female with a slowly growing 2.1 cm left parotid mass.

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  • About 2% of all salivary gland tumors.
  • Parotid >> submandibular gland.
  • Mean age: 6th to 8th decade.
  • 20% have history of ionizing radiation 5 or more years earlier.
  • May occur as part of Birt-Hogg-Dube syndrome.

Gross appearance:

  • Well-circumscribed to partially encapsulated.
  • Tan to light brown.
  • Solid, lobulated.
  • May have areas of degeneration or cystic change, variable central scar.

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Pleomorphic adenoma

  • Most common salivary gland tumor (45-76% of all neoplasms).
  • 80-90% occur in parotid gland (2nd most common are the minor salivary glands, particularly palatal).
  • Peak in 4th to 6th decade.

Gross appearance:

  • Well-circumscribed, usually at least partially encapsulated.
  • Solid and homogeneous, grey-white to white-tan.

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Warthin tumor

  • 2nd most common salivary neoplasm (10% of salivary tumors).
  • Almost exclusively involves parotid gland.
  • Peak in 6th to 7th decades.
  • Strong link with cigarette smoking.

Gross Appearance:

  • Well-circumscribed to encapsulated.
  • Tan-brown with multiple cystic spaces containing brown mucoid exudate.
  • Papillary projections can be seen into these cystic spaces.

This week's Gross Pathology Roundup was presented by Andrew Crabbe MD, PhD on 2019-08-05.