Salivary gland carcinomas of the larynx: A national study in Denmark

Department of ENT Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
Auris, nasus, larynx (Impact Factor: 1.14). 03/2012; 39(6):611-4. DOI: 10.1016/j.anl.2012.02.003
Source: PubMed


Salivary gland carcinomas of the larynx are rare. The purpose of this study is to present a national series of laryngeal salivary gland carcinoma patients and to bring a review of recent literature.
By merging The Danish Cancer Registry, The National Pathology Registry and The National Patient Registry all registered patients with laryngeal salivary carcinomas diagnosed from 1990 to 2007 were identified. The histological slides were reviewed and data concerning age, sex, symptoms, topography, histology, treatment and outcome were registered. Based on a supplemented PubMed search a review of literature from 1991 to 2010 was performed.
Six Danish patients with a malignant salivary gland tumor in the larynx were identified resulting in an incidence of 0.001/100,000 inhabitants/year. Four had adenoid cystic carcinoma and two a mucoepidermoid carcinoma. All patients were male. The patients were treated with surgery and/or radiotherapy. Three patients had recurrent disease. One died of the primary disease and one died of other causes. Four are alive with no evidence of disease. Merging of actual study group with patients from recent literature resulted in 83 cases. The male vs. female ratio was 2:1, the most common location was the supraglottic region (52%) and the most predominant histological subtypes were adenoid cystic carcinoma (46%), mucoepidermoid carcinoma (35%) and adenocarcinoma NOS (12%).
Laryngeal salivary gland carcinoma is a rare disease with a male predominance and most often localized in the supraglottic region. Data concerning treatment and outcome are scarce, but primary surgery with utmost focus on free surgical margins is the treatment of choice. Recurrences are observed later than ten years after primary treatment and a long follow up time is advocated.

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    ABSTRACT: Aims: To explore the clinical characteristics and treatment of malignant minor salivary gland carcinomas of the larynx. Methods: Clinical patient information regarding presentation, pathology, treatment and outcome was obtained through a review of patient charts. Results: Malignant minor salivary carcinomas in the larynx were confirmed pathologically in 15 patients (11 males, 4 females) between 2003 and 2010 in our hospital; 6 patients had mucoepidermoid carcinoma (MEC; 40%), 6 had adenoid cystic carcinoma (ACC; 40%) and 3 had adenocarcinoma (20%). The most common tumour location was the subglottis (60%), followed by the supraglottis (33%). In total, 13 patients underwent surgery, of which 10 (77%) had positive/insufficient resection margins. The mean follow-up time was 42.3 months, with a range of 8-129 months. The 3- and 5-year overall survival rates were 46.7 and 20%, respectively. Conclusion: Malignant minor salivary gland carcinoma of the larynx is a rare disease that showed male predominance in our study. The carcinomas were most often localised in the subglottic region, and the most common histological types were ACC and MEC. Wide-margin surgery with postoperative radiotherapy is advocated. The overall prognosis is poor compared to squamous cell carcinomas of the same location and tumour stage.
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