What are the other Names for this Condition? (Also known as/Synonyms)
- Intraductal Papillary Hyperplasia of Salivary Gland
- Salivary Gland Cystadenoma with Papillary Features
- Salivary Gland Papillary Cystadenoma
What is Papillary Cystadenoma of Salivary Gland? (Definition/Background Information)
- Papillary Cystadenoma of Salivary Gland is a histological variant of salivary gland cystadenoma, which is a rare, benign tumor arising either in the major or minor salivary glands. A majority of the tumors are seen in older adults
- The cause of formation of Papillary Cystadenoma of Salivary Gland and its contributing risk factors, if any, are unknown. It is a slow-growing tumor
- Most tumors are solitary, small, and asymptomatic. They typically present as a well-defined, painless nodule, affecting the minor salivary glands (in many cases)
- The diagnosis of Papillary Cystadenoma of Salivary Gland can be confirmed through a tissue biopsy. The treatment is a complete surgical removal of the tumor
- The prognosis of Papillary Cystadenoma of Salivary Gland is generally excellent in most cases, since it is a benign tumor. Rarely, tumor recurrences following surgery, and malignant transformations have been reported
Who gets Papillary Cystadenoma of Salivary Gland? (Age and Sex Distribution)
- Papillary Cystadenoma of Salivary Gland is typically seen in adults in the age range 70-80 years
- Both males and females are affected and a preference for females is noted
- The tumor can affect all races and ethnic groups
What are the Risk Factors for Papillary Cystadenoma of Salivary Gland? (Predisposing Factors)
- The risk factors for Papillary Cystadenoma of Salivary Gland are currently unknown
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Papillary Cystadenoma of Salivary Gland? (Etiology)
Currently, the cause of formation of Papillary Cystadenoma of Salivary Gland is not well-established.
What are the Signs and Symptoms of Papillary Cystadenoma of Salivary Gland?
Papillary Cystadenoma of Salivary Gland can affect both the minor and major salivary glands. However, the tumor is more common in the minor than major salivary gland.
The signs and symptoms of Papillary Cystadenoma of Salivary Gland may include:
- Presence of a firm, rubbery nodule in the mouth that presents no pain
- Often, the tumor is slow-growing and develops over many months and years
- When the minor salivary glands are involved, the tumor may be present on the lips, inner cheek lining, the hard/soft palate, and other oral cavity locations
- The tumor can also affect the major salivary glands. The parotid gland is involved in more number of cases than the submandibular or sublingual salivary gland
- The tumor size is usually below 1 cm; some can grow to larger sizes
- Occasionally, large tumors may cause pain and discomfort
How is Papillary Cystadenoma of Salivary Gland Diagnosed?
The following exams and procedures may be used in the diagnosis of Papillary Cystadenoma of Salivary Gland:
- Evaluation of the individual’s medical history and a through physical examination
- Plain X-ray of the head and neck region
- Ultrasound scan of the affected salivary gland
- CT or CAT scan with contrast of the head and neck may show a nodular mass. This radiological procedure creates detailed 3-dimensional images of structures inside the scanned region
- MRI scans of head and neck region: A magnetic field is used to create high-quality pictures of certain parts of the body, such as tissues, muscles, nerves, and bones. These high-quality pictures may reveal the presence of the tumor
Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include:
- Fine needle aspiration (FNA) biopsy of the tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy may be recommended.
- Salivary gland core biopsy of the tumor
- Salivary gland open biopsy of the tumor
- A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
- Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
- Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis
The differential diagnosis of a papillary cystadenoma may include:
- Intraductal papilloma
- Warthin tumor
- Other salivary gland tumors having papillary features
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Papillary Cystadenoma of Salivary Gland?
Significant complications due to Papillary Cystadenoma of Salivary Gland are generally not noted. In some cases, the following may be observed:
- Discomfort while speaking, eating, etc.
- Surgery to remove the tumor mass may result in facial nerve palsy (surgical complication)
- Post-surgical wound infection
- The tumor is known to recur very infrequently following surgical excision
- Rarely, malignant transformations of the tumor to papillary cystadenocarcinoma has been observed
How is Papillary Cystadenoma of Salivary Gland Treated?
- A complete surgical excision with clear margins is the preferred mode of treatment of Papillary Cystadenoma of Salivary Gland. This can result in a cure
- Post-operative care is important: One must maintain minimum activity levels, until the surgical wound heals
- Follow-up following surgery/treatment is recommended
How can Papillary Cystadenoma of Salivary Gland be Prevented?
- Current medical research has not established a method of preventing the formation of Papillary Cystadenoma of Salivary Gland
- Regular medical screening at periodic intervals following treatment is beneficial
What is the Prognosis of Papillary Cystadenoma of Salivary Gland? (Outcomes/Resolutions)
- The prognosis of Papillary Cystadenoma of Salivary Gland is generally excellent with surgical intervention and complete removal, since it is a benign tumor. The risk of tumor recurrence following surgery is minimal
- A transformation to malignancy has also been reported (in rare cases). In such cases, the prognosis depends on several factors including the health status of the individual and stage of the tumor
Additional and Relevant Useful Information for Papillary Cystadenoma of Salivary Gland:
There are 3 major types of salivary glands and these include the following:
- Parotid glands, found on the sides of the face
- Submandibular glands located at the back of mouth, on both sides of the jaw
- Sublingual glands that are seen under the floor of the mouth
The salivary glands produce saliva that helps in:
- Lubricating the mouth
- Protects the teeth against bacteria
- Digestion of food