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Path: Mouth (Salivary glands (major (parotid, submandibular, sublingual),…

- - - - usually painless swelling
      - pleomorphic adenoma
        
        F>M
        
        encapsulated
        
        commonest in parotid
        
        epithelial elements in mucoid + chondroid stroma (mesenchymal + epithelial element)
        
        tx = wide excision
        
        local recurrence common (in 25% with nucleation) - difficult to excise
        
        malignant transformation rarely occurs in 2% (call carcinoma ex pleomorphic adenoma)
      - Warthin's tumour
        
        10% - not nearly as common
        
        almost exclusively parotid
        
        usually older males + smokers
        
        10% multifocal, 10% bilat
        
        double layer of epithelial cells on a dense lymphoid stroma
        
        oncocytes + secretory cells +/- squamous metaplasia
        
        "adenolymphoma"
        
        NOT A LYMPHOMA
        
        called this because it has an epithelial + lymphoid component
    - - more common in minor glands
      - suggested by rapid growth + pain
      - types
        
        mucoepidermoid: glands + squamous cells
        
        adenoid cystic carc: cribriform (well defined spaces formed by arches of cells) + tubular glands, perineurial invasion possible
        
        acinic cell carc: look like acinar cells
        
        carc ex pleomorphic adenoma
- - - - caused by HPV 6+11
  - - - mostly
      - floor of mouth, tongue, hard palate, base of tongue
      - over 95% = SCC
      - caused by things that irritate squamous mucosa (tobacco, alcohol, betel nuts, HPV16+18, sunlight, pipe smoking)