- Oncocytomas typically occur in older persons and are relatively rare:
- Its a benign tumor composed of oncocytes:
- It is also called oxyphilic adenoma
- Represents 0.1% to 2% of salivary gland neoplasms:
- They are more frequent than oncocytosis and oncocytic carcinoma:
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They are classified according to the World Health Organization (WHO) classification, and histologically there are three distinct types: oncocytosis, oncocytoma and oncocytic carcinoma
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- They are more frequent than oncocytosis and oncocytic carcinoma:
- These tumors are characterized by a high mitochondrial content:
- Which accounts for fluorodeoxyglucose avidity on positron emission tomography scans, similar to Warthin’s tumors.
- Its a benign tumor composed of oncocytes:
- Clinical Features of Oncocytomas:
- Usually there are identified in the parotid gland (78% to 84% cases), but the submandibular gland or minor salivary glands can be involved.
- This tumor might be seen in other organs such as:
- The nasal and thoracic cavities, ovaries, breast, kidney, thyroid, parathyroid, pituitary, larynx and pancreas
- This tumor might be seen in other organs such as:
- Usually there are identified in the parotid gland (78% to 84% cases), but the submandibular gland or minor salivary glands can be involved.
- They often present as solitary slow growing painless masses:
- Which are firm, multilobulated and mobile entities upon clinical examination.
- They are diagnosed between the sixth through the eighth decades of life with a slightly higher incidence in women:
- Mean age at presentation is 60 years.
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- 20% associated with radiation therapy or radiation exposure.
- Rarely bilateral.
- May be multiple.
- Rarely synchronous with Warthin tumor or carcinoma ex pleomorphic adenoma
- May occur in trisomy 7 or in BHD syndrome
- Radiology Description:
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Computed tomography (CT) and magnetic resonance imaging (MRI) are the image modalities of choice,
- Specific MRI features:
- T1 hypointense
- Isointense to normal gland on fat saturated T2 and postcontrast T1
- CT features:
- Enhancing tumor and nonenhancing cystic component
- Specific MRI features:
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- Pathology:
- Well circumscribed with fibrous capsule, solid, tan-red-brown, lobulated, often small, may have cystic spaces
- Microscopic description:
- Eosinophilic or clear cell (glycogen) with sheets, trabeculae, acini or follicular patterns of monotonous large polygonal cells with well defined cell borders, deeply eosinophilic, granular cytoplasm, small round nuclei:
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Oncocytic cells are thought to originate from the transformation of epithelial cells of salivary gland ducts or acini
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- Vascular stroma, may have clear cell change, background of oncocytic nodular hyperplasia, psammoma bodies, tyrosine rich crystals
- No mitotic figures, no elastosis
- Eosinophilic or clear cell (glycogen) with sheets, trabeculae, acini or follicular patterns of monotonous large polygonal cells with well defined cell borders, deeply eosinophilic, granular cytoplasm, small round nuclei:
- Complete surgical excision with a superficial parotidectomy is the treatments of choice.
Rodrigo Arrangoiz MS, MD, FACS a head and neck surgeon / surgical oncologist and is a member of Sociedad Quirúrgica S.C at the America British CowdrayMedical Center in Mexico City:
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He is an expert in the management of salivary gland neoplasms:
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If you have any questions about salivary gland neoplasms please fill free to ask Dr. Arrangoiz
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Training:
• General surgery:
• Michigan State University:
• 2005 al 2010
• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:
• Fox Chase Cancer Center (Filadelfia):
• 2010 al 2012
• Masters in Science (Clinical research for health professionals):
• Drexel University (Filadelfia):
• 2010 al 2012
• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:
• IFHNOS / Memorial Sloan Kettering Cancer Center:
• 2014 al 2016
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Rodrigo Arrangoiz MS, MD, FACS, FSSO 