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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
  Table of Contents    
ORIGINAL ARTICLE  
Year : 2015  |  Volume : 19  |  Issue : 1  |  Page : 47-52
 

Primary malignant epithelial salivary gland tumors in an Iranian population: A retrospective study of 81 cases


1 Department of Oral and Maxillofacial Pathology, Member of Social Determinants of Oral Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Private Practitioner, Dentist, Graduated From Yazd University, Yazd, Iran

Date of Submission26-May-2014
Date of Acceptance24-Mar-2015
Date of Web Publication19-May-2015

Correspondence Address:
Babak Rafiei
Tape Television, Jahad Sazandegi Street, #274, Lane 12, First Dead End Street, Shiraz
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-029X.157201

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   Abstract 

Background: Salivary gland tumors of epithelial origin are rare lesions. Few epidemiologic studies on prevalence of such condition in Iranian population have been published. This study with the aim of determining the relative frequency of epithelial salivary tumors was performed in Yazd city from 2001 to 2012. Materials and Methods: Cases diagnosed as primary malignant epithelial salivary gland tumor were collected from the Pathology Department of main hospitals and Health Department of Medical Science Yazd University from 2001-2012. Histopathologic type, tumor location, age, gender and whether patients were native or non-native were analyzed. Results: Eighty-one cases of primary malignant epithelial salivary gland tumors were recorded. Male to female ratio was 1:1.3. The most common malignancy was adenoid cystic carcinoma (35.8%) and the most common effected site was the parotid gland. Mean age for malignancy was 52.57 ΁ 18.25 years. Conclusion: According to the findings of this study, predilection of adenoid cystic carcinoma was more in non-natives as compared to natives (from Yazd). This could suggest the influence of racial and environmental factors on prevalence of such malignancies.


Keywords: Adenoid cystic carcinoma, epithelial origin, salivary gland tumors


How to cite this article:
Tabatabai SH, Tafti MA, Rafiei B. Primary malignant epithelial salivary gland tumors in an Iranian population: A retrospective study of 81 cases. J Oral Maxillofac Pathol 2015;19:47-52

How to cite this URL:
Tabatabai SH, Tafti MA, Rafiei B. Primary malignant epithelial salivary gland tumors in an Iranian population: A retrospective study of 81 cases. J Oral Maxillofac Pathol [serial online] 2015 [cited 2021 Mar 2];19:47-52. Available from: https://www.jomfp.in/text.asp?2015/19/1/47/157201



   Introduction Top


Epithelial Salivary gland neoplasms are relatively uncommon accounting for less than 1% of all tumors and 3-10% of all head and neck tumors. [1],[2],[3] According to epidemiological studies, the annual incidence of these tumors is 0.4 to 13.5 cases in 100,000 persons. [4],[5],[6],[7],[8] These neoplasms are a diverse group of benign and malignant neoplasms with different clinical behaviors and histopathological features. [9],[10],[11]

Worldwide reports show differences in incidence, prevalence and histological types of these neoplasms. [11],[12],[13] Tumor location, age and sex distribution of salivary neoplasms varies depending on race and geographical conditions. [9],[10],[11]

Based on our review of the English [14],[15],[16],[17] and Persian literature [18],[19] few scattered reports of epidemiological characteristics of salivary gland tumors in Iranian population exist.

This study examines the prevalence of salivary gland neoplasms of epithelial origin from 2001-2012 in Yazd city. Yazd is a medical hub in the center of Iran, which provides services to many patients from south and southeast neighboring provinces. This offers a mixture of cases with regards to histopathological nature of lesions, anatomical location, age, sex and whether patients were native or non-native. These factors were evaluated for all cases.


   Materials and Methods Top


In this cross-sectional study, data were collected from records available in the Pathology Department of main hospitals and Health Department of Medical Science from 2001-2012. Any diagnosis of primary malignant head and neck salivary gland tumor in major or minor salivary glands with the exception of metastatic tumors were gathered and decoded to protect the identity of patients. Using SPSS 17 software, statistical analysis was performed on histopathological diagnosis, tumor location, age, gender and whether patients were native or non native.


   Results Top


From 2001-2012, 15,391 cases of malignancies were reported in the city of Yazd. Of those, 81 (0.52%) cases were primary salivary gland neoplasms of epithelial origin. The Most common tumor was adenoid cystic carcinoma (35.8%), followed by mucoepidermoid carcinoma (27.16%) [Table 1].
Table 1: Histopathological diagnosis and relative frequency of Primary epithelial malignant salivary gland tumors according to age


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Age of patients ranged from 10-100 years with the mean age of 52.57 ± 18.25 years. Peak incidence for salivary gland tumors was between fourth and sixth decades of life and adenoid cystic carcinoma was most prevalent in this age group (55.2%) [Table 1].

With regards to gender distribution, 43.3% were male and 56.8% were female. The male to female ratio was 1:1.3. The Most common tumor reported in males was mucoepidermoid carcinoma (13.58%) and in females was adenoid cystic carcinoma (23.45%) [Figure 1].
Figure 1: Relative frequency of four most common primary epithelial malignant salivary gland tumors according to gender

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As to anatomical location, 54.3% of cases developed in parotid gland, 32.1% were in minor salivary glands, 11.1% in submandibular gland and 2.5% formed in sublingual gland. In minor salivary glands, palate was the most common site (38.5%), followed by sino-nasal tract (19.2%) and finally floor of the mouth (15.3%) [Figure 2].
Figure 2: Relative frequency of primary epithelial malignant salivary gland tumors according to anatomical location

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Most common malignant tumor of parotid gland, submandibular gland, minor salivary gland were mucoepidermoid carcinoma (36.36%), adenoid cystic carcinoma (77.77%) and acinic cell carcinoma (50%), respectively. In sublingual gland, both adenoid cystic carcinoma and primary squamous carcinoma were equally prevalent [Table 2].
Table 2: Relative frequency of primary epithelial malignant salivary gland tumors according to types of salivary glands


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Adenoid cystic carcinoma occurred most frequently in minor salivary glands (44.8% of cases). mucoepidermoid carcinoma was more prevalent in the parotid gland (72.7% of cases) and all of acinic cell carcinomas were found in the parotid gland (100% of cases). This was the same for polymorphous low grade adenocarcinomas which were all found in minor salivary glands (100% of cases) [Table 3].
Table 3: Relative frequency of salivary glands according to types of primary epithelial malignant salivary gland tumors


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Among the patients, 65.5% were native (from Yazd) and 34.5% were non-native, mostly from neighboring provinces of Kerman and Hormozgan [Figure 3]. The relative frequency of adenoid cystic carcinoma to mucoepidermoid carcinoma as the most common malignant tumors in natives was 1 to 1.1 and in non-natives was 1.8-1, respectively.
Figure 3: Relative frequency of primary epithelial malignant salivary gland tumors according to province of origins

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   Discussion Top


Primary salivary gland neoplasms with epithelial origin comprised 0.52% of all malignancies. This finding is consistent with studies done by Mendenhal et al., (0.52%) and Speight et al., (0.52%) and somewhat lower than Hashemi Pour's et al., results (0.66%). [7],[15],[20] The higher reported frequency in Hashemi Pour's study is possibly due to the inclusion of the non-epithelial malignant tumors and metastatic tumors as a part of salivary malignant tumors database. [15]

Although the overall incidence of salivary gland malignancies compared to other salivary gland diseases is low, [3],[21] they are an important part of oral cancers after squamous cell carcinoma. [22],[23],[24],[25],[26],[27],[28]

The mean age and standard deviation for this study was 52.57 ± 18.52 years and most of salivary gland tumors were seen in patients between 40 and 60 years of age. In this age group, adenoid cystic carcinoma was the most common tumor. The mean age for the patients with malignant salivary gland tumors in Hashemi Pour et al., study, in Kerman, was 47.33 years. [15] In Varges et al., study, in Brazil, the mean age for such tumors was 48.8 years. [3] Based on study of Oti et al., in Africa, the mean age was 53.5 years and similarly Fonseca et al. result was 54 years for the same types of tumors. These results suggest that these malignant tumors are formed in late fourth decade to early fifth decade of life.

Comparison of the mean age of patients showed that minimum age belonged to Small cell undifferentiated carcinoma (10 years) and maximum age belonged to salivary duct carcinoma (80 years). Additionally, acinic cell carcinoma occurred in older population (60.14 years) compared to adenoid cystic carcinoma (49.55 years) and mucoepidermoid carcinoma (49.4 years).

In this study, the mean age of patients with adenoid cystic carcinoma was 49.55 years which was similar to Chau's study (50 years). [29] Similarly, other studies have shown that peak incidence of adenoid cystic carcinoma is in the fifth decade of life. [19],[30] Spafford et al., in 1991, noted in their study that the mean age of patients with acinic cell carcinoma is a decade less compared to other parotid malignancies. [31] While in this study acinic cell carcinoma's mean age (60.14 years) occurred almost a decade later than adenoid cystic carcinoma (49.55 years) and mucoepidermoid carcinoma (49.4 years). This difference might be due to the differences in etiological factors of salivary gland tumors such as ionizing radiation, solar radiation, chemotherapy, smoking and vitamin A deficiency; even thought these factors are not well recognized. [28]

Results from this study revealed a higher incidence of malignant salivary gland tumors in females, with a ratio of 1:1.3. Similarly most studies showed that females are more frequently affected. [7],[31],[32],[33],[34] Conversely in Oti et al. study in Ghana, male to female ratio was 1.8-1 and In Hashemi Pour et al., study done in Kerman this ratio was 1.6-1. [15],[35]

Frequency ratio of male to female for adenoid cystic carcinoma and acinic cell carcinoma was 1:1.9 and 1:2.5, whereas for mucoepidermoid carcinoma and polymorphous low-grade adenocarcinoma this ratio was 1:1. Most studies performed in the west show equal gender presentation, whereas results from Africa show salivary gland tumor predilection for females. [7],[34] These different reports of malignant salivary gland tumors incidences between sexes could be due to limitations of females in some societies to seek medical treatment or conversely in other regions females paying more attention to their health. On the other hand these differences could suggest a role of hormones in histogenesis of salivary gland tumors.

Based on the results of this study, the most common salivary gland tumor was adenoid cystic carcinoma (35.8%) and the second most common tumor was mucoepidermoid carcinoma (27.2%). These results are consistent with results obtained in several studies. [8],[30],[36],[37],[38] However, some studies have reported mucoepidermoid carcinoma to be the most common tumor. [12],[15],[18],[29],[39],[40],[41]

Our results showed Acinic cell adenocarcinoma as the third most common tumor (8.64%) whereas in the study done by Stene et al. it was the most common tumor. [42] Fourth common malignant salivary gland tumor in this study was polymorphous low-grade adenocarcinoma (4.93%). Prior to 1991 some cases of this tumor were classified as pleomorphic adenoma or adenocarcinoma not otherwise specified. In addition, because of its similar morphologic features such as cribriform pattern and perineural invasion, the diagnosis may have been wrongly reported as adenoid cystic carcinoma. [25] This may potentially be the reason as to why the incidence of such adenoid cystic carcinoma may be higher in this study keeping in mind that racial and geographical differences may also have influenced the results. [43]

As to the anatomical location, 54.3%, 32.1%, 11, 1% and 2.5% of cases were reported to be in parotid gland, minor salivary glands, submandibular gland and in sublingual gland, respectively. These findings were similar to results of earlier studies done by Cawson and Eeson in 1985, Eeifert et al., in 1986 and Spiro in 1986. [25] In a study conducted by Vuhahala, in Uganda parotid gland, submandibular and minor salivary glands were equally affected. In some studies, palate was the most common site for salivary gland malignancies. [43],[44],[45] These differences could be due to incomplete cancer registration in some communities.

Most common malignant tumors of parotid gland, submandibular gland and minor salivary gland were mucoepidermoid carcinoma (36.36%), adenoid cystic carcinoma (77.77%) and adenoid cystic carcinoma (50%), respectively. In sublingual gland, both adenoid cystic carcinoma and primary squamous carcinoma were equally prevalent. Conversely Oti et al., in Ghana reported adenoid cystic carcinoma as the most common malignancy of parotid gland. [35] In a study done in Brazil by Ito and colleagues, the most common malignancy of parotid gland was mucoepidermoid carcinoma. [8]

Adenoid cystic carcinoma mostly occurred in minor salivary glands (44.8%); mucoepidermoid carcinoma was more prevalent in the parotid gland (72.7%) and all cases of acinic cell carcinoma and polymorphous low grade adenocarcinoma occurred in the parotid gland (100%) and minor salivary gland (100%), respectively. These results are consistent with studies done around the world [14],[16],[46] and also contents listed in text books. [25],[47] Since the results show that some tumors have a tendency to occur in a specific salivary gland, it seems that attention to anatomical locations of lesions can help in diagnosis and classification of malignant salivary gland tumors.

In this study, 65.5% of patients were natives and 34.5% were non-natives from neighboring provinces of south and southeast of Iran. Based on the results of the study, the incidence of adenoid cystic carcinoma in non-natives was 1.8 times higher than mucoepidermoid carcinoma and in natives, this ratio was 1.1. Likewise, results of Ashkavandi et al., study, in the south of Iran and also Shishegar et al., in Shiraz showed that adenoid cystic carcinoma was the most common malignancy in south of Iran [14],[17] A study done by Atarbashi et al., in Ahvaz located in the south of Iran reported mucoepidermoid carcinoma and adenoid cystic carcinoma, with small differences, as the two most common malignant tumors with 8.03% and 7.14% of cases, respectively. While Rahrotaban et al., in the city of Qazvin located in north of Iran, reported mucoepidermoid carcinoma as the most common salivary malignancy in that region.

Results of the current study suggest that the increased frequency of adenoid cystic carcinoma as compared to mucoepidermoid carcinoma is probably due to presence of non-native patients (predominantly from south and southeast region of Iran) and could confirm the concept that environmental and racial factors affect prevalence of malignant salivary gland tumors.


   Conclusion Top


The most common primary salivary gland malignancy in the present study was adenoid cystic carcinoma and the parotid gland was the most common site of involvement for all salivary gland malignancies. Malignancies were most common in the non-native population. Results of this study suggest the important effects of racial and environmental factors on prevalence of malignant salivary gland tumors.


   Acknowledgements Top


The authors sincerely appreciates the assistance given in data collection by respected authorities in Shahid Sadoughi, Shahid Rahnemon, Shohadaie Kargar, Seied Shohada, Godarz, Mojibian, Mortaz hospitals and Health Department of Yazd Medical Science University. This article is partly taken from the thesis of Dr. Babak Rafiei at Yazd dental school.

 
   References Top

1.
Pons-Vicente O, Almendros-Marqués N, Berini-Aytés L, Gay Escoda C. Minor salivary gland tumors: A clonicopathological study of 18 cases. Med Oral Pathol Oral Cir Bucal 2008;13:582-8.  Back to cited text no. 1
    
2.
Ethunandan M, Davies B, Pratt CA, Puxeddu R, Brennan PA. Primary epithelial submandibular salivary gland tumors -Review of management in a district general hospital setting. Oral Oncol 2009;45:173-6.  Back to cited text no. 2
    
3.
Vargas PA, Gerhard R, Araújo Filho VJ, de Castro IV. Salivary gland tumors in a Brazilian population: A retrospective study of 124 cases. Rev Hosp Clin Fac Med Sao Paulo 2002;57:271-6.  Back to cited text no. 3
    
4.
Li LJ, Li Y, Wen YM, Liu H, Zhao HW. Clinical analysis of salivary gland tumor cases in west china in past 50 years. Oral Oncol 2008;44:187-92.  Back to cited text no. 4
    
5.
Tilakaratne WM, Jayasooriya PR, Tennakoon TM, Saku T. Epithelial salivary tumors in Sri Lanka: A retrospective study of 713 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:90-8.  Back to cited text no. 5
    
6.
Przewozny T, Stankiewicz C. Neoplasms of the parotid gland in northern Poland, 1991-2000: An epidemiologic study. Eur Arch Otorhinolaryngol 2004;261:369-75.  Back to cited text no. 6
    
7.
Speight PM, Barrett AW. Salivary gland tumors. Oral Dis 2002;8:229-40.  Back to cited text no. 7
    
8.
Ito FA, Ito K, Vargas PA, de Almeida OP, Lopes MA. Salivary gland tumors in Brazilian population: A retrospective study of 496 cases. Int J Oral Maxillofac Surg 2005;34:533-6.  Back to cited text no. 8
    
9.
Ma'aita JK, Al-Kaisi N, Al-Tamimi S, Wraikat A. Salivary gland tumors in Jordan: A retrospective study of 221 patients. Croat Med J 1999;40:539-42.  Back to cited text no. 9
    
10.
Jaber MA. Intraoral minor salivary gland tumors: A review of 75 cases in a Libyan population. Int J Oral Maxillofac Surg 2006;35:150-4.  Back to cited text no. 10
    
11.
Eveson JW, Cawson RA. Salivary gland tumours. A review of 2410 cases with particular reference to histological types, site, age and sex distribution. J Pathol 1985;146:51-8.  Back to cited text no. 11
    
12.
Ellis GL, Auclair PL. Atlas of Tumor Pathology: Tumors of the Salivary Glands. 3 rd ed. Washington: Armed Forces Institute of Pathology; 1996. p. 468.   Back to cited text no. 12
    
13.
Spiro RH. Salivary neoplasms: Overview of a 35-year experience with 2807 patients. Head Neck Surg 1986;8:177-84.  Back to cited text no. 13
    
14.
Shishegar M, Ashraf MJ, Azarpira N, Khademi B, Hashemi B, Ashrafi A. Salivary gland tumors in maxillofacial region: A retrospective study of 130 cases in a southern Iranian population. Patholog Res Int 2011;2011:934350.  Back to cited text no. 14
    
15.
Hashemi Pour MS, Chamani G. Malignant salivary gland tumors in kerman province: A retrospective study. Dent Res J 2007;4:4-10.  Back to cited text no. 15
    
16.
Atarbashi Moghadam S, Atarbashi Moghadam F, Dadfar M. Epithelial salivary gland tumors in Ahvaz, southwest of iran. J Dent Res Dent Clin Dent Prospects 2010;4:120-3.  Back to cited text no. 16
    
17.
Jaafari-Ashkavandi Z, Ashraf MJ, Moshaverinia M. Salivary gland tumors: A clinicopathologic study of 366 cases in southern Iran. Asian Pac J Cancer Prev 2013;14:27-30.  Back to cited text no. 17
    
18.
Rahrotaban S, Masoomi P, Moradi M, Sharifpour V. Frequency of salivary gland tumors in two referral center of Qazvin university of medical sciences. Journal of research in dental and maxillofacial sciences 2010;7:6.  Back to cited text no. 18
    
19.
Pardis S, Karandish M, Lavaee-Mashadi F. The clinic pathologic study of benign and malignant lesions of salivary glands in patients attending Shiraz dental school in 15 years. Zahedan J Res Med Sci 2012;13:52-5.  Back to cited text no. 19
    
20.
Mendenhall WM, Werning JW, Pfister DG. Treatment of head and neck cancer. In: Devita VT Jr, Lawrence TS, Rosenberg SA, editors. Cancer: Principle and Practice of Oncology. 9 th ed. Philadelphia: Lippincott Williams and Wilkins; 2011. p. 729-80.  Back to cited text no. 20
    
21.
Kasangaki A, Kamulegeya A. Neoplasms of the salivary glands: A descriptive restrospective study of 142 cases-Mulago Hospital Uganda. J Contemp Dent Pract 2004;5:16-27.  Back to cited text no. 21
    
22.
Jansisyanont P, Blanchaert RH Jr, Ord RA. Intraoral minor salivary gland neoplasm: A single institution experience of 80 cases. Int J Oral Maxillofac Surg 2002;31:257-61.  Back to cited text no. 22
    
23.
Koivunen P, Suutala L, Schorsch I, Jokinen K, Alho OP. Malignant epithelial salivary gland tumors in north Finland: Incidence and clinical characteristics. Eur Arch Otorhinolaryngol 2002;259:146-9.  Back to cited text no. 23
    
24.
Loyola AM, de Araujo VC, De Sousa SO, De Araujo NS. Minor salivary gland tumors. A retrospective study of 164 cases in a Brazilian population. Eur J Cancer B Oral Oncol 1995;31B: 197-201.  Back to cited text no. 24
    
25.
Neville B, Damm D, Allen C, Bouquot J. Oral and Maxillofacial Pathology. 3 rd ed. Philadelphia: Saunders Elsevier; 2009. p. 453-99.   Back to cited text no. 25
    
26.
Shah JP. Cancer of head and neck. 1st ed. Hamilton (London): BC Decker Inc; 2001. p. 242-5.  Back to cited text no. 26
    
27.
Yu GY, Li ZL, Ma DQ, Zhang Y. Diagnosis and treatment of epithelial salivary gland tumors in children and adolescents. Br J Oral Maxillofac Surg 2002;40:389-92.  Back to cited text no. 27
    
28.
Licitra L, Grandi C, Prott FJ, Schornagel JH, Bruzzi P, Molinari R. Major and minor salivary glands tumors. Crit Rev Oncol Hematol 2003;45:215-25.  Back to cited text no. 28
    
29.
Chau MN, Radden BG. Intra-oral salivary gland neoplasms: A retrospective study of 98 cases. J Oral Pathol 1986;15:339-42.  Back to cited text no. 29
    
30.
Otoh EC, Johnson NW, Olasoji H, Danfillo IS, Adeleke OA. Salivary gland neoplasms in Maiduguri, north-eastern Nigeria. Oral Dis 2005;11:386-91.  Back to cited text no. 30
    
31.
Spafford PD, Mintz DR, Hay J. Acinic cell carcinoma of the parotid gland: Review and management. J Otolaryngol 1991;20:262-6.  Back to cited text no. 31
    
32.
Rahimi M. Salivary gland tumors: A retrospective study of 104 cases. J Mashad Dent School 2000;1-2:80-4.  Back to cited text no. 32
    
33.
Bell RB, Dierks EJ, Homer L, Potter BE. Management and outcome of patients with malignant salivary gland tumors. J Oral Maxillofac Surg 2005;63:917-28.  Back to cited text no. 33
    
34.
Silas OA, Echejoh GO, Manasseh AN, Mandong BM. Patterns of malignant salivary gland tumours in Jos University Teaching Hospital (JUTH), Jos: A ten-year retrospective study. Niger J Med 2009;18:282-5.  Back to cited text no. 34
    
35.
Oti AA, Donkor P, Obiri-Yeboah S, Afriyie-Owusu O. Salivary gland tumours at Komfo Anokye Teaching Hospital, Ghana. Surg Sci J 2012;4:135-9.  Back to cited text no. 35
    
36.
Isacsson G, Shear M. Intraoral salivary gland tumors: A retrospective study of 201 cases. J Oral Pathol 1983;12:57-62.  Back to cited text no. 36
    
37.
Pacheco-Ojeda L, Domeisen H, Narvez M, Tixi R, Vivar N. Malignant salivary gland tumors in Quito, Ecuador. ORL J Otorhinolaryngol Relat Spec 2000;62:296-302.  Back to cited text no. 37
    
38.
Boko E, Napo-Koura G, Kpemissi E, Boko-Bessi L. Tumours of the accessory salivary glands. Epidemiological and anatomopathological aspects. Rev Laryngol Otol Rhinol (Bord) 2004;125:233-7.  Back to cited text no. 38
    
39.
Rivera-Bastidas H, Ocanto RA, Acevedo AM. Intraoral minor salivary gland tumors: A retrospective study of 62 cases in a Venezuelan population. J Oral Pathol Med 1996;25:1-4.  Back to cited text no. 39
    
40.
Bentz BG, Hughes CA, Ludemann JP, Maddalozzo J. Masses of the salivary gland region in children. Arch Otolaryngol Head Neck Surg 2000;126:1435-9.  Back to cited text no. 40
    
41.
Fonseca FP, Carvalho Mde V, de Almeida OP, Rangel AL, Takizawa MC, Bueno AG, et al. Clinicopathologic analysis of 493 cases of salivary gland tumors in a Southern Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:230-9.  Back to cited text no. 41
    
42.
Stene T, Koppang SH. Carcinoma of intra-oral salivary gland. Histopathology 1978;2:19-29.  Back to cited text no. 42
    
43.
Vuhahula EA. Salivary gland tumors in Uganda: Clinical pathological study. Afr Health Sci 2004;4:15-23.  Back to cited text no. 43
    
44.
Poomsawat S, Punyasingh J, Weerapradist W. A retrospective study of 60 cases of salivary gland tumors in a Thai population. Quintessence Int 2004;35:577-81.  Back to cited text no. 44
    
45.
Dhanthai K, Boonadulyarat M, Jaengjongdee T, Jiruedee K. A clinico-pahthologic study of 311 intra-oral salivary gland tumors in Thais. J Oral Pathol Med 2009;38:495-500.  Back to cited text no. 45
    
46.
Toida M, Shimokawa K, Makita H, Kato K, Kobayashi A, Kusunoki Y, et al. Intraoral minor salivary gland tumors: A clinicopathological study of 82 cases. Int J Oral Maxillofac Surg 2005;34:528-32.  Back to cited text no. 46
    
47.
Regezi JA, Sciubba JJ, Richard CK. Jordan. Oral Pathology: Clinical Pathologic Correlations. 4 th ed. Vol. 8. St. Louis: Saunders; 2003. p. 183-216.  Back to cited text no. 47
    


    Figures

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