• Korean Journal of Head & Neck Oncology
• /
• v.21 no.2
• /
• pp.201-207
• /
• 2005

Purpose: Submandibular gland tumor is rare, less than 6% of head and neck tumor. The purpose of this article is to analysis the clinical experience and treatment outcomes of malignant submandibular gland tumor, suggesting a guideline of management. Methods: We retrospectively evaluated 26 patients who underwent operation for malignant submandibular gland tumor at Severence hospital between 1986 and 2004. Statistical analysis was performed by Kaplan-Meier method, log rank test, Chi-square test, Fisher's exact test using SPSS v12.0 for Windows. Results: They consisted of 18 males and 8 females whose median age was 47 years(range: 20-71). 10 cases of adenocystic carcinoma, 8 cases of carcinoma ex pleomorphic adenoma, 4 cases of mucoepidermoid carcinoma, 1 case each for acinic cell carcinoma, undifferentiated carcinoma, adeno carcinoma, epithelioid hemangioendothelioma. Sialoadenectomy only was performed in 10 cases(36.5%) and sialoadenectomy with neck node dissection was performed in 16 cases(63.5%). Adjuvant radiotherapy was done in 22 cases(84.6%). 10 year disease free survival rate for malignant submandibular gland tumor was 63.1 % and 10 year overall survival rate for malignant submandibular gland tumor was 70.1%. In univariate analysis, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. Conclusion: In this study, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. To prevent recurrence and to improve survival, early diagnosis and aggressive surgery must be considered.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.1
• /
• pp.1-8
• /
• 1991

In attempts to evaluate carcinogenic chemical effect on $Na^+,K^+$-ATPase activity in the rat submandibular gland tumor induced by DMBA, pellet from DMBA powder was inserted into the right submandibular gland. Both right and left submandibular gland were excised and weighed following the period of experiment. Excised glands were observed microscopically and estimated biochemically. The results were obtained as follows. 1. Swelling and nodular mass in the right submandibular gland region ould be found at 11th week post-implantation with DMBA. 2. The weight and size of the right submandibular gland was markedly increased following the period of the experiment. 3. Epithelial dysplasia and invasive epidermoid carcinoma could be observed at 7th and 11th week after implantation of DMBA, respectively. 4. The rate of tumor induction in the right submandibular gland was about 76% at 17th week following implantation of DMBA. 5. DMBA caused markedly depressed $Na^+,K^+$-ATPase activity as well as the activity ratio in the rgiht submandibular gland following the period of experiment.

• Korean Journal of Head & Neck Oncology
• /
• v.37 no.2
• /
• pp.81-85
• /
• 2021

Lymphoepithelial carcinoma is an extremely rare malignant tumor, especially those localized at the head and neck region. The histological prototype of lymphoepithelial carcinoma is undifferentiated nasopharyngeal carcinoma. Herein, we report a case of a tumor localized in the left submandibular gland in a 20-year-old male. The tumor mass was surgically excised with the submandibular gland, and the specimen was pathologically confirmed to be lymphoepithelial carcinoma.

• 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.

• Korean Journal of Head & Neck Oncology
• /
• v.33 no.2
• /
• pp.35-38
• /
• 2017

Neurilemmomas are benign tumors originating from Schwann cells, and may occur in various nerves; however, they rarely originate from the lingual nerve. When a lingual nerve neurilemmoma develops in the submandibular space, it can be challenging to diagnose it preoperatively, and this tumor can be misdiagnosed as a usual submandibular gland tumor owing to the rarity and a lack of knowledge about lingual nerve neurilemmomas. Therefore, it is important to consider neurilemmoma in the differential diagnosis in cases where the characteristics of the tumor do not correspond with the typical findings of submandibular gland tumors, in order to avoid inadvertent sacrifice of the nerve because of incorrect diagnosis of a salivary gland tumor. Herein, we report a lingual nerve neurilemmoma in the submandibular space, along with a literature review, to highlight the clinical significance and improve understanding of this type of tumor.

• Imaging Science in Dentistry
• /
• v.31 no.2
• /
• pp.117-120
• /
• 2001

A 66-year-old man visited author's institute complaining of the swelling on the submandibular gland area. Clinically, the exophytic mass penetrated the skin of the submandibular area. On MRI, the lesion occupied the left submandibular space and extended downward, protruding exterior to the subcutaneous fat layer, but the center of the lesion was located on the side of the skin and the growth exterior to the skin was prominent. Demarcation of the lesion and the submandibular gland was unclear. Histopathologically the epithelial nests and keratin production were seen, then the biopsy result was squamous cell carcinoma. The stroma of lesion showed a myxoid characteristic and some ducts showed metaplasia of the ductal cells, which suggested the gland-origin carcinoma. However, lots of keratin production and carcinomatous change of cells continuous to the normal epithelium of the skin, the skin-origin carcinoma invading into the submandibular gland area could not be excluded.

• International Journal of Oral Biology
• /
• v.41 no.2
• /
• pp.97-103
• /
• 2016

Mammals have 3 pairs of major salivary glands i.e., the parotid, submandibular, and sublingual glands. Saliva secretion of these glands is modulated by taste perception. Salivary glands are composed mainly of acinar and ductal cells. Primary saliva is secreted by acinar cells and modified during ductal flow. Recently, of the murine 35 bitter taste receptors, Tas2r108 was expressed at highest levels in the submandibular gland by qPCR. Further, Tas2r108-transfected cells respond to a range of bitter compounds, such as denatonium, quinine, colchicine, diphenidol, caffeine and dapson. The objective of the present study was to characterize the expression of Tas2r108 mRNA in acinar and/or ductal cells of the submandibular gland using in situ hybridization (ISH). Male 42-60 days old DBA2 mice were used in the study. Messenger RNAs were extracted from the submandibular gland for generating digoxigenin (DIG) labeled-cRNA probes. These probes were transcribed in anti-sense and sense orientation using T7 RNA polymerase. Dot blot hybridization was performed using DIG labeled-cRNA probes, in order to estimate integrity and optimal diluting concentration of these probes. Subsequently, ISH was performed on murine submandibular gland to detect Tas2r108 mRNA. Dot blot hybridization data demonstrated that Tas2r108 DIG labeled-cRNA anti-sense probes specifically detected Tas2r108 cDNA. ISH results showed that the anti-sense probes labeled acinar and ductal cells in the submandibular gland, whereas no staining was visible in sense controls. Interestingly, the Tas2r108 expression levels were higher in acinar than ductal cells. These results suggested that Tas2r108 might be more associated with primary saliva secretion than with ductal modification of saliva composition.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.6
• /
• pp.548-552
• /
• 2010

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

• Korean Journal of Head & Neck Oncology
• /
• v.35 no.2
• /
• pp.35-38
• /
• 2019

Oncocytic lipoadenoma is a rare salivary gland tumor composed of adipose tissue and oncocytic epithelial cells in varied proportions. We report a case of an oncocytic lipoadenoma of the submandibular gland, which presented as a submandibular gland mass. The patient was a 65-year-old woman with a right submandibular mass measuring 2 × 2 × 1.6 cm. As a sonographic evaluation and computed tomograph scan gave us the impression of benign submandibular gland tumor such as pleomorphic adenoma, we resected the right side submandibular gland. Grossly, the tumor was well circumscribed with yellow to brown cut surface. Microscopically, the tumor was surrounded by a thin, fibrous capsule and composed of oncocytic epithelial cells admixed with mature adipose tissue. Final diagnosis was an oncocytic lipoadenoma. We discussed here radiologic and pathologic finding of this rare salivary gland tumor.

• 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.