DIAGNOSTIC DILEMMA IN RARE SALIVARY GLAND TUMOURS: A CASE SERIES

Abstract

Salivary gland neoplasms are uncommon and pose diagnostic challenges due to their diverse morphology. Accurate diagnosis depends on meticulous histopathology supported by immunohistochemistry, making documentation of rare variants clinically relevant. The author presents a series of five rare salivary gland tumors, identified through histopathological evaluation and further confirmed by immunohistochemical analysis.

This case series includes five patients with salivary gland tumors. A 32-year-old male with a three-year history of right parotid swelling underwent parotidectomy and was diagnosed with carcinoma ex pleomorphic adenoma—minimally invasive secretory carcinoma type—with clear surgical margins. A 40-year-old female presented with secretory carcinoma of the left parotid gland, also showing negative margins. Two female patients, aged 74 and 60 years, were diagnosed with salivary duct carcinoma of the left and right submandibular glands, respectively, both demonstrating lymphovascular and perineural invasion. The series also includes a 21-year-old male with a benign pleomorphic adenoma exhibiting squamous metaplasia.Surgical excision remains the primary modality of treatment for these tumors. Postoperative radiotherapy is typically considered when adverse features such as positive margins, extraparotid extension, lymphovascular or perineural invasion, and lymph node metastasis are present.