Klassifikation der Tumoren der kleinen Speicheldrüsen*

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Abstract
In 160 human cases, tumors of the minor salivary glands were analyzed using the WHO classification. The age peak of the total collective is 59 yr. Lower age peaks are found in mucoepidermoid tumors (37 yr) and pleomorphic adenomas (49 yr), higher age peaks in carcinomas (62 yr) and monomorphic adenomas (68 years). The sex distribution shows a moderate predominance of females, especially in acini cell tumours, adenoid cystic carcinomas and adenocarcinomas. A predominance of males can only be demonstrated for carcinomas in pleomorphic adenomas. The palate is the most frequent tumor localization; 14% of the tumors are localized in the labial glands (upper lip), 12% in the buccal glands and 5% in the area of the tongue or the floor of the mouth. Malignant tumours make up 47% of the total collection, a distinctly higher frequency than in the major salivary glands (parotid gland: .apprx. 20%). The pleomorphic adenomas are the most frequent tumors of the minor salivary glands, representing 44% of all tumors. The subclassification into stroma-rich and stroma-poor subtypes reveals 65% for the former and 35% for the latter group. The stroma-poor subtype is much more often in minor salivary glands than in the parotid gland (15.5%). This has prognostic importance because carcinomas in pleomorphic adenomas prefer to develop in the stroma-poor subtype of pleomorphic adenomas. The monomorphic adenomas are rarer in the minor salivary glands (9%) than in the parotid gland (10-15%). Salivary duct adenomas are the predominant tumor type. Basal cell adenomas are rare. Cystadenolymphomas or oncocytomas rarely occur in the minor salivary glands. The malignant tumors show the following distribution of frequency: 22% adenoid cystic carcinomas, 10.5% mucoepidermoid tumors, 8% carcinomas in pleomorphic adenomas, 4% adenocarcinomas, 2% other carcinomas and 0.5% acinic cell tumors. The mucoepidermoid tumours show the highest 5-yr survival rate (96% of all malignant tumors of the minor salivary glands). The adenoid cystic carcinomas represent the 2nd most frequent tumor group after the pleomorphic adenomas. The survival rates are unfavorable in long-term studies (65% after 5 yr, 29% after 10 yr). Carcinomas in pleomorphic adenomas have an age peak 13 yr later than the pleomorphic adenomas. Of these, 33% were developed in the stroma-poor subtypes of the pleomorphic adenomas. Other carcinomas are variable differentiated adenocarcinomas (papillary, mucous-producing, cystic, trabecular adenocarcinomas), clear cell carcinomas, salivary duct carcinomas or anaplastic carcinomas. To determine the prognostic behavior of the tumors of minor salivary glands criteria including the localization, age and sex, TNM stage, pathohistologic classification and grading must be considered.

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