Role of High Resolution Sonography in Characterization of Solid Salivary Gland Tumors

Abstract

AIM:The goal of our study was to evaluate the role of high resolution ultrasonography in differentiation of benign and malignant tumors of salivary glands. MATERIAL AND METHODS: This study was carried out in 52 patients with salivary gland tumors, ultrasound and Color Doppler examination were performed in each patient followed by USG guided FNAC/core biopsy. Presumed ultrasound diagnoses were compared with histopathology. RESULTS: 52 tumors were detected by sonography, out of them 32 were benign and 20 were malignant. 81.2%benign tumors had sharp border, but 20% malignant tumors also had sharp borders. Non-homogenous echo pattern was seen in 85% malignant and 46.7% of benign lesions. CONCLUSION: Ultrasound is very useful in identification of salivary gland tumors; however, due to their non-specific imaging features, it is not reliable enough to differentiate between benign and malignant tumors. KEYWORDS: High resolution sonography, Color Doppler, Salivary glands, Pleomorphic adenoma, Benign, Malignant. INTRODUCTION:Salivary gland tumors are not common; they represent 2-4% of all head and neck cancers. Majority of them (80%) are located in the parotid gland, 14% in the submandibular gland and the rest of them in the sublingual glands and in the minor salivary glands. (1) The smaller the gland has the higher the proportion of malignant tumors. The rate of malignancy in the parotid gland is 20-25%; it increases to 40-45% in the submandibular gland and to 51-80% in the sublingual and minor salivary glands. (2) High resolution ultrasonography (HRSG) is first choice of imaging modality as it is widely available, cost effective and capable to image all the three major salivary glands, i. e., parotid, submandibular and sublingual glands. However, for the deep segment of the parotid gland and minor salivary gland tumors, ultrasound may not be enough. In such cases MRI is used, as it provides very precise information on the position, extension and nature of the mass. (3) In USA, MRI is almost the only technique used in cases where a neoplastic enlargement of a salivary gland is suspected. CT is used mostly to detect salivary duct stones. (4) There are various sonographic features which can predict malignancy like irregular margin, non-homogenous echopattern, calcification, regional enlarged lymph nodes, internal composition and absence of distal acoustic enhancement. (5) therefore, our intention of the study was to evaluate role of ultrasound to differentiate between benign and malignant tumors.

Sonoelastographic evaluation of salivary gland lesions with clinicopathological association

“…The conventional sonographic features (USG-CD) of malignant salivary-gland lesions consist of irregular form, poorly demarcated outline, heterogeneous echotexture, mixed consistency of lesion and echo pattern, and mixed/central vascularity pattern [34][35][36][37]. Whereas not a single parameter is sufficient for adequate diagnostic assessment, so we prepared overall findings for USG-CD while in the case of USG-Color Doppler-Elastography (USG-CD-Elasto), scores of eSie touch, VTQ (kPa), and VTIQ (m/s) were used to prepare overall findings.…”