Prognosis and predictive factors

Metastasis to the jaws usually indicates widely disseminated disease and a poor prognosis with a 4-year survival of 10% {458}. Two thirds of patients die in less than 1 year {1101}. Depending on lesion type and dissemination, radiotherapy or hormone therapy may be provided. Surgery may occasionally be of value in palliative care.

Metastases to oral soft tissues

Metastasis to soft tissues is much more rare. It affects a similar age group, 40-70 years old, and the commonest sites for primary lesions in males are lung (one third of cases) followed by kidney and skin. The commonest primary site in females is breast {1100}. The commonest site for metastasis is gingiva (55%) because of its fine capillary bed, followed by tongue (30%), though any site may be affected. The predilection for gingiva is mostly lost after teeth are extracted {1100}. Lesions present as soft tissue masses, often ulcerated, resembling traumatic or reactive hyperplastic lesions.

chapter 5

Tumours of the Salivary Glands

Salivary gland tumours can show a striking range of morphological diversity between different tumour types and sometimes within an individual tumour mass. In addition, hybrid tumours, dedifferentiation and the propensity for some benign tumours to progress to malignancy can confound histopathological interpretation. These features, together with the relative rarity of a number of tumours, can sometimes make diagnosis difficult, despite the abundance of named tumour entities. The increasing use of pre-operative fine needle aspiration biopsies also

WHO histological classification of tumours of the salivary glands

Malignant epithelial tumours

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