55. Disorders and Tumors of Oral Cavity and Salivary Glands. Stomatitis and
Sialadenitis. Tumors of Salivary Glands. Adenomas. Malignant Tumors.
Stomatitis- The inflammation of the mucous membrane of the mouth. It occurs in the following
conditions:
Aphthous, ulcers (canker sores):
o It is a superficial, painful ulceration of the oral mucosa.
o Due to emotional factors, stress, allergies, hormonal imbalances, GI disturbances
etc. but resolves spontaneously
o Has a greyish base and surrounded by erythema.
o Recurrent ulcers could be due to Behcet syndrome.
Herpetic Stomatitis (oral herpes):
o Occurs in infants and young children
o It is a common sign of herpes simplex virus (HSV-1) infection
o Even after lesion heals virus remains dormant in ganglia of trigeminal nerve and
can become reactivated.
Necrotising Stomatitis:
o Occurs in poorly nourished children, infectious diseases, or emotional stress.
o Lesions can spread onto the oral mucosa and cause cellulitis of the cheek.
Sialadenitis
Inflammation of salivary glands and is usually unilateral.
Usually affects one gland and is common in older ages
Caused by Staph. bacteria but could also be Strep, or viruses such as mumps or HIV.
When it is due to bacterial infection:
o After salivary duct is blocked by salivary stone. When flow of saliva is reduced
(due to dehydration or illness) deposits are formed on walls of the duct.
o There can be deposits of calcium, phosphorus and electrolytes sialolyths
o When ducts are blocked bacteria can move from mouth up the duct into the
gland causing inflammation and swelling.
Acute Causes pain, swelling, redness on skin over the gland and less saliva entering
mouth.
Chronic: gland enlarges after meals and lack of redness.
o Due to conditions that decrease flow, such as ductal fibrosis
, Pleomorphic Adenoma (Mixed)
Benign tumor made up of stromal and epithelial tissue. (Biphasic tumour)
Usually in the parotid gland
Gross: Mobile, painless circumscribed mass.
Cut surface is grey-white and bluish.
Micro: Mixed appearance, epithelial cells
present in stromal matrix.
o Epithelial Component: can form
ducts, acini, tubules and sheets.
Ductal cells are columnar.
Myoepithelial cells are spindle
shaped like smooth muscle cells.
o Stromal part: loose connective
tissue.
Can often reoccur even after many years, because it has irregular margins and often
entire tumor may not be removed.
Usually benign but can sometimes metastasise and turn into carcinoma.
Monomorphic Adenoma
Benign epithelial tumors, without any
mesenchymal-like tissues.
Types:
o Warthin’s Tumour: benign cystic
tumour, arises in the parotid gland.
Consists of lymph node tissue.
o Gross: Encapsulated, round or oval
with a smooth surface.
o Micro: tumour has 2 components:
Epithelial Parenchyma:
glandular and cystic structures
with papillary arrangement and lined with eosinophilic epithelium.
Presence of mucous goblet cells.
Lymphoid stroma: under epithelium in the form of lymphoid tissues, with
germinal centres.
Mucoepidermoid Carcinoma
Sialadenitis. Tumors of Salivary Glands. Adenomas. Malignant Tumors.
Stomatitis- The inflammation of the mucous membrane of the mouth. It occurs in the following
conditions:
Aphthous, ulcers (canker sores):
o It is a superficial, painful ulceration of the oral mucosa.
o Due to emotional factors, stress, allergies, hormonal imbalances, GI disturbances
etc. but resolves spontaneously
o Has a greyish base and surrounded by erythema.
o Recurrent ulcers could be due to Behcet syndrome.
Herpetic Stomatitis (oral herpes):
o Occurs in infants and young children
o It is a common sign of herpes simplex virus (HSV-1) infection
o Even after lesion heals virus remains dormant in ganglia of trigeminal nerve and
can become reactivated.
Necrotising Stomatitis:
o Occurs in poorly nourished children, infectious diseases, or emotional stress.
o Lesions can spread onto the oral mucosa and cause cellulitis of the cheek.
Sialadenitis
Inflammation of salivary glands and is usually unilateral.
Usually affects one gland and is common in older ages
Caused by Staph. bacteria but could also be Strep, or viruses such as mumps or HIV.
When it is due to bacterial infection:
o After salivary duct is blocked by salivary stone. When flow of saliva is reduced
(due to dehydration or illness) deposits are formed on walls of the duct.
o There can be deposits of calcium, phosphorus and electrolytes sialolyths
o When ducts are blocked bacteria can move from mouth up the duct into the
gland causing inflammation and swelling.
Acute Causes pain, swelling, redness on skin over the gland and less saliva entering
mouth.
Chronic: gland enlarges after meals and lack of redness.
o Due to conditions that decrease flow, such as ductal fibrosis
, Pleomorphic Adenoma (Mixed)
Benign tumor made up of stromal and epithelial tissue. (Biphasic tumour)
Usually in the parotid gland
Gross: Mobile, painless circumscribed mass.
Cut surface is grey-white and bluish.
Micro: Mixed appearance, epithelial cells
present in stromal matrix.
o Epithelial Component: can form
ducts, acini, tubules and sheets.
Ductal cells are columnar.
Myoepithelial cells are spindle
shaped like smooth muscle cells.
o Stromal part: loose connective
tissue.
Can often reoccur even after many years, because it has irregular margins and often
entire tumor may not be removed.
Usually benign but can sometimes metastasise and turn into carcinoma.
Monomorphic Adenoma
Benign epithelial tumors, without any
mesenchymal-like tissues.
Types:
o Warthin’s Tumour: benign cystic
tumour, arises in the parotid gland.
Consists of lymph node tissue.
o Gross: Encapsulated, round or oval
with a smooth surface.
o Micro: tumour has 2 components:
Epithelial Parenchyma:
glandular and cystic structures
with papillary arrangement and lined with eosinophilic epithelium.
Presence of mucous goblet cells.
Lymphoid stroma: under epithelium in the form of lymphoid tissues, with
germinal centres.
Mucoepidermoid Carcinoma
