Case 41 :

50-year old female with a small swelling in the floor of the mouth. What is the likely diagnosis?


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Imaging diagnosis:
Sublingual salivary gland adenoma

Salivary gland neoplasms most commonly appear in the sixth decade of life. Patients with malignant lesions typically present after age 60 years, whereas those with benign lesions usually present after age 40 years. Benign neoplasms occur more frequently in women than in men, but malignant tumors are distributed equally between the sexes.
Among salivary gland neoplasms, 80% arise in the parotid glands, 10-15% arise in the submandibular glands, and the remainder occur in the sublingual and minor salivary glands.
Minor salivary gland tumors have a varied presentation depending on the site of origin. Painless masses on the palate or floor of mouth are the most common presentation of minor salivary neoplasm. Laryngeal salivary gland neoplasms may produce airway obstruction, dysphagia, or hoarseness. Minor salivary tumors of the nasal cavity or paranasal sinus can present with nasal obstruction or sinusitis.
Minor salivary gland neoplasms are often difficult to assess on examination, and the use of preoperative CT or MRI is important for determining the extent of tumor, which otherwise is not clinically appreciable. This imaging is particularly valuable for salivary gland neoplasms in the paranasal sinus, where skull-base or intracranial extension may alter resectability of the tumors.


Dr. Sanjeev Mani,
Bandra Holy Family Hospital, Mumbai