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Soft Tissue Enlargements - Coggle Diagram

- - - - Frey's Syndrome is a common complication of the surgical removal of the parotid gland. When the parasympathetic nerves are severed, they undergo abnormal regeneration and join with the sympathetic nerves that innervate facial sweat glands - thus resulting in facial sweating when salivary glands are stimulated.
      - Papillary Cystadenoma Lymphomatosum (Warthin Tumor):
        -Etiology: Unknown, but studies show strong relationship with smoking.
        -Method of Transmission: N/A
        -Characteristics: Slow-growing, rubbery or firm, painless masses, usually found in tail of parotid gland near angle of mandible. Tendency to appear bilaterally.
        -Dental Implications: Decrease in risk for this tumor can be mentioned as a benefit associated with smoking cessation.
        -Treatment/Prognosis: Surgical removal - parotidectomy with a safety margin is the usual procedure. Prognosis is excellent.
      - Mucoepidermoid Carcinoma:
        -Etiology: Unknown
        -Method of Transmission: N/A
        -Characteristics: Malignant neoplasm found most often in parotid gland, where it manifests as asymptomatic swelling. The longer it is present, more likely patient will complain of pain and facial nerve paralysis or palsy. May also occur in submandibular gland and minor salivary glands, along with bone.
        -Dental Implications: Can be present for several years without being noticed so cancer screenings with palpation should always be done.
        -Treatment/Prognosis: Surgical removal. Lymph nodes in neck may have to be removed if metastasis occurs. Adjusvant therapy often indicated. Prognosis depends on grade of tumor.
      - Acinic Cell Carcinoma:
        -Etiology: Unknown
        -Method of Transmission: N/A
        -Characteristics: Slow-growing hard masses when found in parotid or submandibular glands. Minor salivary gland tumors appear as slow-growing masses on palate, buccal mucosa, or lips most often. Pain can be a symptom no matter where it is located.
        -Dental Implications: DH may be first to recognize tumor during oral exam.
        -Treatment/Prognosis: Involvement of parotid gland results in partial or total removal of gland, depending on location of tumor. Entire submandibular gland removed if found in this location. Minor salivary gland tumors treated with surgical excision of tumor with adequate margin of normal surrounding tissue.
    - - Polymorphous Low-Grade Adenocarcinoma:
        -Etiology: May be associated with various genetic mutations and over-production of specific gene products.
        -Method of Transmission: N/S
        -Characteristics: Hard and soft palate most frequent sites, followed by upper lip and buccal mucosa. Presents as slow-growing, smooth-surfaced, painless mass that may exist for years before discovery. Large tumors may be ulcerated because of trauma. Some may erode into bone.
        -Dental Implications: One of the first signs of palatal growth may be denture feeling uncomfortable.
        -Treatment/Prognosis: Surgical excision with wide margins.
      - Adenoid Cystic Carcinoma:
        -Etiology: Unknown
        -Method of Transmission: N/A
        -Characteristics: Parotid gland tumors present as firm, well-defined masses within gland. Slow-growing and may be tender. Facial nerve involvement may indicate tumor is advanced. Tumors occur on palate most frequently. Often ulcerated and pain reported.
        -Dental Implications: Radiation therapy almost always recommended so all dental procedures should be completed BEFORE radiation. Instruct patient about xerostomia management.
        -Treatment/Prognosis: Surgical excision with wide surgical margins. Removal of underlying bone may be necessary with palatal tumors. Adjuvant therapy radiation therapy recommended.