• Archives of Plastic Surgery
• /
• v.37 no.1
• /
• pp.75-78
• /
• 2010

Purpose: Whereas oral ranula is relatively common and presents as a cyst in the mouth, the plunging ranula is rare and manifests itself as a mass in the neck with or without an associated oral lesion. The purpose of this study is to examine the clinical characteristics of rare bilateral plunging ranula arising from accessory submandibular gland in order to provide our experience for its correct diagnosis and treatment. Methods: A 13-year-old girl manifests as a slow growing painless, non-mobile swelling in the anterior neck. She underwent surgery via a cervical approach. A pseudocyst was extirpated and adjacent accessory gland tissue and related lymph node were removed. Results: The histologic appearance is characteristically of a cyst, devoiding of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophage stuffed with mucin. Pathologic findings represented a form of myxomatous degeneration and lined by condensed connective tissue and granulation tissue. The nature of the accessory gland tissue was same as subligual gland. Although total submandibular or sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods. Conclusion: Usually, unilateral plunging ranula develops commonly because of rupture of sublingual gland duct by trauma and extravasation of salivary secretion to the adjacent tissue. But our case developed because of bilateral congenital accessory submandibular gland. This is thought to be a result from a congenital failure of canalization of the terminal end of the duct. Finally, the correct diagnosis is essential for the most effective treatment, which is excision of the ranula and related accessory salivary gland. We performed excision of accessory submandibular gland and plunging ranula and had a good result without recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.28 no.1
• /
• pp.1-12
• /
• 2006

Pleomorphic adenoma is the most common benign tumor in salivary glands, and occurred in frequency of 60% in parotid gland tumors, and 50% in submandibular gland tumors, and 25% in sublingual gland tumors. Histopathologically, pleomorphic adenoma is composed of epithelial cells and mesenchymal tissues, and called 'mixed tumor' because of morphological divergency. The cell structures of luminal area are composed of polyhedral and cuboidal secretory epithelial cells and modified myoepithelial cells around it, and mesenchymal tissue is composed of some myoepithelial cells and stromal tissue. In stromal tissue, myxoid change, chondroid change, or hyalinization can be seen even if bone tissue. In many studies, tumor cells of pleomorphic adenoma containing modified myoepithelial cell participate in synthesis of glycosaminoglycans. In this study, tissue sample of pleomorphic adenoma of human salivary gland were obtained from 20 surgical specimens, and all specimens were routinely fixed in 10% formalin and embedded. Serial 4-8${\mu}m$ thick sections were cut from paraffin blocks. The histopathologic evaluation was done with light microscopy. And, with immunohistochemical staining, characteristics of glycosaminoglycan were observed. And, for biochemical analysis of glycosaminoglycan, isolation of crude glycosaminoglycan from tumor tissue and immuno-blot analysis were carried out. With transmission electromicroscopy, tumor cells and biologic behavior of pleomorphic adenoma were observed with distribution and expression of glycosaminoglycan in tumor cells, The results were obtained as follows: 1. In immunohistochemical study, chondroitin 4-sulfate is highly postively stained in myxoid stromal tissue, and chondroitin 6-sulfate is highly positively stained in chondroid mesenchymal tissue, both glycosaminoglycans are positively stained in non-luminal cell of ductal area. 2. Dermatan sulfate and keratan sulfate is positively stained in periductal non-luminal tumor cells. 3. In immunohistochemical study, heparan sulfate is weakly stained in luminal cells and non-luminal cells around duct, and chondroid mesenchymal tissue. 4. In transmission electromicroscopic view, the tumor cells are composed of modified myoepithelial cells, and contain many microfilaments and well developed rough endoplasmic reticulum. 5. In Immuno-Blot analysis, the expression of glycosaminoglycans is expressed mostly in chondroitin 6-sulfate and chondroitin 4-sulfate. From the results obtained in this study, tumor cells of pleomorphic adenoma are composed of modified myoepithelial cells, and glycosaminoglycans of chondroitin 4-sulfate and chondroitin 6-sulfate mostly participate in the development of pleomorphic adenoma, but dermatan sulfate, keratan sulfate and heparan sulfate glycosaminoglycans were expressed variably.

• International Journal of Oral Biology
• /
• v.45 no.2
• /
• pp.58-63
• /
• 2020

The salivary glands secrete saliva, which plays a role in the maintenance of a healthy oral environment. Under physiological conditions, saliva secretion within the acinar cells of the gland is regulated by stimulation of specific calcium (Ca²⁺) signaling mechanisms such as increases in the intracellular Ca²⁺ concentration ([Ca²⁺]_i) via storeoperated Ca²⁺ entry, which involves components such as Orai1, transient receptor potential (TRP) canonical 1, stromal interaction molecules, and inositol 1,4,5-triphosphate (IP₃) receptors (IP₃Rs). Homer proteins are scaffold proteins that bind to G protein-coupled receptors, IP₃Rs, ryanodine receptors, and TRP channels. However, their exact role in Ca²⁺ signaling in the salivary glands remains unknown. In the present study, we investigated the role of Homer2 in Ca²⁺ signaling and saliva secretion in parotid gland acinar cells under physiological conditions. Deletion of Homer2 (Homer2^-/-) markedly decreased the amplitude of [Ca²⁺]_i oscillations via the stimulation of carbachol, which is physiologically concentrated in parotid acinar cells, whereas the frequency of [Ca²⁺]_i oscillations showed no difference between wild-type and Homer2^-/- mice. Homer2^-/- mice also showed a significant decrease in amylase release by carbachol in the parotid gland in a dose-dependent manner. These results suggest that Homer2 plays a critical role in maintaining [Ca²⁺]_i concentration and secretion of saliva in mouse parotid gland acinar cells.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.28 no.1
• /
• pp.68-72
• /
• 2006

Mucoepidermoid carcinoma is one of the most common malignant salivary gland neoplasm. It occurs over a wide age range, and is most common in the parotid gland and usually appears as an asymptomatic swelling. Pain or facial nerve palsy may develop. Minor salivary gland tumors also typically appear as asymptomatic swellings, which are sometimes fluctuant and have blue or red color that can be mistaken clinically for a mucocele. Histopathologically the mucoepidermoid carcinoma is composed of a mixture of mucous-producing cells and squamous (epidermoid) cells. Low-grade tumors show prominent cyst formation, minimal cellular atypia, and relatively high proportion of mucous cells. Mucoepidermoid carcinoma of the minor salivary glands are treated usually by assured surgical excision. For low-grade neoplasm, only a modest margin of surrounding normal tissue may need to be removed, but high-grade or large tumors warrant wider resection. Postoperative radiation therapy also may be used for more aggressive tumors. Mucoepidermoid carcinoma of the oral minor salivary glands generally have a good prognosis, because they are mostly low-to intermediate grade tumors. We present a case of mucoepidermoid carcinoma managed with surgical enucleation and postoperative irradiation and a good clinical result with review of literatures.

• The Korean Journal of Cytopathology
• /
• v.8 no.2
• /
• pp.135-142
• /
• 1997

Mucoepidermoid carcinoma is the most common malignant neoplasm of the salivary gland, compring between 30 and 40%. Fine needle apsiration cytology was performed in five patients with mucoepidermoid carcinoma. The patients consisted of three males aged of 42, 48, and 60 years, and two females aged 36, and 56 years. The primary tumor sites were the parotid gland in four patients and the submandibular gland in the rest one. The histologic grades were low in one patient, intermediate in two patients and high in other two. In our experience, the common cytologic findings of low grade subtype were predominent mucous cells with some intermediate cells in an abundant mucinous background. The cytologic findings of intermediate grade subtype were predominant clusters of intermediate cells with or without mucous cells in an abundant mucinous background. And the cytologic findings of high grade subtype were predominant clusters of epidermoid cells with intermediate cells in a bloody background. Cytologic pleomorphism and atypia were more severe in high grade than low and intermediate grade, and nucleoli were more frequently noted in epidermoid cells. In low grade, it is very difficult to decide the benignancy or malignancy of the tumor. In fact, the presence of mucous cells in a mucinous background should rule out any other type of well differentiated carcinoma.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
• /
• v.55 no.3
• /
• pp.173-176
• /
• 2012

Oncocytic neoplasm of the head and neck region accounts for approximately 1% of all salivary gland tumors, but only 5% of oncocytic neoplasm is malignant. Oncocytic carcinoma arising in the submandibular gland is exceedingly rare. We encountered a sixty seven-year-old male patient who presented with multiple mass in the right neck. Fine needle aspiration biopsy revealed a salivary gland tumor of predominantly oncocytic form, and a differential diagnosis included oncocytic adenoma or mucoepidermoid carcinoma. A right submandibular gland resection and modified radical neck dissection were performed. Histologically, the tumor cells showed nuclear pleomorphism, and stromal invasion, which were compatible with oncocytic carcinoma. After surgery, the entire neck region was irradiated. Seventeen months after the initial surgery, multiple metastases to the bone and lung were detected from the incidental pathologic bone fracture of the right humerus; palliative chemotherapy was performed to resolve this. We report a case of oncocytic carcinoma in the submandibular gland with a review of literature.

• Journal of Oral Medicine and Pain
• /
• v.23 no.3
• /
• pp.235-239
• /
• 1998

In Sjogren syndrome, abruptly decreased salivation and delayed lag time reveal that many acini cells are destructed and Lymphocytes infiltration is supposed as the main cause that makes dysfunction of salivation. In this case report, the biopsy of minor salivary glands is very useful diagnostic method of Sjogren's syndrome with sialometry,sialography, salivary gland scan.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.12
• /
• pp.4995-5000
• /
• 2014

Background: Cancer constitutes a key pressure on public health regardless of the economy state in different countries. As a kind of highly malignant epithelial tumor, lacrimal gland adenoid cystic carcinoma can occur in any part of the body, such as salivary gland, submandibular gland, trachea, lung, breast, skin and lacrimal gland. Chemotherapy is one of the key treatment techniques, but drug resistance, especially MDR, seriously blunts its effects. As an element of the 60S large ribosomal subunit, the ribosomal protein L39-L gene appears to be documented specifically in the human testis and many human cancer samples of different origins. Materials and Methods: Total RNA of cultured drug-resistant and susceptible lacrimal gland adenoid cystic carcinoma cells was seperated, and real time quantitative RT-PCR were used to reveal transcription differences between amycin resistant and susceptible strains of lacrimal gland adenoid cystic carcinoma cells. Viability assays were used to present the amycin resistance difference in a RPL39-L transfected lacrimal gland adenoid cystic carcinoma cell line as compared to control vector and null-transfected lacrimal gland adenoid cystic carcinoma cell lines. Results: The ribosomal protein L39-L transcription level was 6.5-fold higher in the drug-resistant human lacrimal gland adenoid cystic carcinoma cell line than in the susceptible cell line by quantitative RT-PCR analysis. The ribosomal protein L39-L transfected cells revealed enhanced drug resistance compared to plasmid vector-transfected or null-transfected cells as determined by methyl tritiated thymidine (3H-TdR) incorporation. Conclusions: The ribosomal protein L39-L gene could possibly have influence on the drug resistance mechanism of lacrimal gland adenoid cystic carcinoma cells.

• International Journal of Oral Biology
• /
• v.40 no.3
• /
• pp.127-133
• /
• 2015

The salivary gland undergoes complex process of growth and differentiation of the branching morphogenesis of ductal system during the prenatal and early postnatal periods which are regulated by various elements in the extracellular matrix. Extracellular matrix metalloproteinase inducer (EMMPRIN) is a cell adhesion molecule. In the present study, localization and expression of EMMPRIN in development and effects of chorda-lingual denervation and cyclosporine A (CsA) treatment on the EMMPRIN expression were investigated. Immunohistochemistry, RT-PCR and Western blot were used to determine expression level. Immunohistochemistry revealed that EMMPRIN was localized specifically in the cytoplasm of ductal cells, not acini of the submandibular gland all the postnatal periods. At prenatal day 18, when the formation of ducts was not definite, no immunoreactivity was observed. Both Western blot and RT-PCR analyses revealed that EMMPRIN expression was maintained up to postnatal day 7, decreased after postnatal day 10. The EMMPRIN expression was upregulated by the surgical denervation of the chorda-lingual nerve in the gland as well as by the CsA treatment. The present study suggests that EMMPRIN is a crucial molecule for maintaining physiological functions of the salivary gland.

• Archives of Plastic Surgery
• /
• v.32 no.5
• /
• pp.653-655
• /
• 2005

Epithelial-myoepithelial carcinoma (EMC) of the salivary gland is a rare tumor that comprises approximately 1% of all salivary gland tumors. It has a distinctive histological appearance comprising ductal structures with an inner epithelial cell component and an outer layer of myoepithelial cells. We report a case of EMC of the parotid gland in a 41- year-old man. He presented left-sided subauricular swelling developed 3-month earlier. Neck CT scans revealed a well-defined mass in the left superficial parotid gland. He underwent superficial parotidectomy and was diagnosed as EMC. He was taken postoperative radiotherapy. There was no evidence of recurrence during a follow-up period of 12 months. A EMC is a low grade malignant tumor which can cause diagnostic confusion during workup and also frequently misdiagnosed as other benign or malignant tumor.