Perfil epidemiológico das neoplasias de glândulas salivares diagnosticadas em São Luís-MA / Epidemiologic profile of salivary gland neoplasms diagnosed in São Luís-MA

INTRODUÇÃO E OBJETIVO: As neoplasias de glândulas salivares constituem um grupo de lesões, clínica e morfologicamente diverso, capaz de determinar importantes desafios diagnósticos e terapêuticos. O escopo do trabalho é determinar a frequência relativa e a distribuição das neoplasias de glândulas salivares diagnosticadas no Instituto Maranhense de Oncologia Aldenora Bello (IMOAB). MATERIAL E MÉTODOS: Realizou-se estudo retrospectivo dos casos de neoplasia de glândula salivar diagnosticados no IMOAB, no período de janeiro de 1997 a dezembro de 2007. Dados sobre sexo, idade e localização anatômica foram obtidos em prontuários médicos. Cortes histológicos foram avaliados sob microscopia de luz e os casos foram categorizados segundo a classificação da Organização Mundial da Saúde (OMS)(4). Os dados coletados foram analisados por meio de estatística descritiva. RESULTADOS: Foram identificados 232 casos, dos quais 178 eram neoplasias benignas (76,7 por cento) e 54 (23,3 por cento), malignas. Os três tipos histológicos mais frequentes foram: adenoma pleomórfico (59,5 por cento), tumor de Warthin (13,8 por cento) e carcinoma adenoide cístico (6,9 por cento). A maioria dos casos foi diagnosticada em pacientes do sexo feminino, com proporção homem:mulher de 1:1,3. As neoplasias benignas e malignas apresentaram picos de incidência na quarta e sétima décadas de vida, respectivamente. Com relação à localização anatômica, 154 casos (66,4 por cento) afetaram a parótida, 43 (18,5 por cento) acometeram a glândula submandibular e 35 (15,1 por cento) envolveram glândulas salivares menores. CONCLUSÃO: Em conjunto com outros estudos, os resultados da presente pesquisa sugerem discretas variações na frequência relativa e distribuição das neoplasias de glândulas salivares entre as populações do Brasil e de outras regiões do mundo.

INTRODUCTION AND OBJECTIVE: The salivary gland neoplasms are a clinically and morphologically diverse group of lesions able to determine important diagnostic and therapeutic challenges. The objective of this study is to determine the relative frequency and distribution of salivary gland neoplasms diagnosed at Aldenora Bello Institute of Oncology - Maranhão State (Instituto Maranhense de Oncologia Aldenora Bello [IMOAB]). MATERIAL AND METHODS: It was performed a retrospective analysis of the salivary gland neoplasms diagnosed at IMOAB between January 1997 and December 2007. Data regarding gender, age, and anatomic site were retrieved from medical records. Histological slides were evaluated by light microscopy and cases were categorized according to the World Health Organization classification(4). The collected data were analyzed through descriptive statistics. RESULTS: A total of 232 cases were identified, of which 178 were benign neoplasms (76.7 percent) and 54 (23.3 percent) were malignant. The three most frequent histological types were pleomorphic adenoma (59.5 percent), Warthin's tumor (13.8 percent) and adenoid cystic carcinoma (6.9 percent). Most cases were diagnosed in females, with a male-female ratio of 1:1.3. The benign and malignant neoplasms showed incidence peaks at the 4th and 7th decades of life, respectively. Regarding anatomic site, 154 cases (66.4 percent) affected the parotid gland, 43 (18.5 percent) affected the submandibular gland and 35 (15.1 percent) involved minor salivary glands. CONCLUSION: In association with other studies, the present results suggest slight variations in the relative frequency and distribution of salivary gland neoplasms between Brazilian and worldwide populations.

Acute Sialadenitis in Children and Adolescents: CT Findings and Clinical Manifestations according to Glandular Involvement

PURPOSE: This study was designed to compare the CT findings and clinical manifestations in children and adolescents with acute sialadenitis according to the involved salivary glands. MATERIALS AND METHODS: The study included fifty children and adolescents (34 boys, 16 girls) with acute sialadenitis that was diagnosed during the past five years. All of the subjects were divided into three groups: group I (parotid gland involvement, n = 16), group II (submandibular gland involvement, n = 20) and group III (involvement of both glands, n = 14). We analyzed the presence of an abscess, sialolith, bilaterality, cellulitis and lymphadenopathy on CT scans. The analyzed clinical data were age, sex, lymphadenopathy, pain, swelling, presence of a mass, tonsillitis, treatment period and surgical treatment if it was performed. RESULTS: The presence of an abscess, sialolith, cellulitis, swelling, age, presence of a palpable mass and treatment period were statistically significant factors for the patients in the three groups. An abscess was combined only in group I patients. There was a high rate of sialolith in group II patients and cellulitis in group III patients as seen on CT scans. Swelling in group II patients and group III patients and the presence of a palpable mass in group I patients were identified as clinical manifestations. Age was younger in group I patients (mean age, 5.3 years) than in group II patients (mean age, 12.9 years) and group III patients (mean age, 15.2 years). The treatment period was longer for group I patients. CONCLUSION: For acute sialadenitis in children and adolescents, age, presence of an abscess, sialolith, cellulitis, swelling, presence of a palpable mass and treatment period were different according to the involved salivary glands.