Clinicopathological Patterns of Salivary Gland Neoplasms in Al-Ramadi, Iraq: A Five-Year Retrospective Study

Abstract

Tumors of the salivary glands are rare, making up 1.2% of cancers and 2–5% of head and neck cancers. Approximately 80–85% of all salivary gland tumors arise in the parotid glands, where 70–80% are benign. Pleomorphic adenoma is the most common benign tumor. It is difficult to distinguish neoplastic tumors from non-neoplastic tumors based on clinical findings. Histopathology is considered the gold standard. To determine the frequency and clinicopathological pattern according to age, gender, and histopathological distribution of salivary gland tumors in Al-Ramadi, Iraq, as compared to available literature from Iraq and abroad. Cross sectional study over a five-year duration (January 2020 until December 2024) conducted in Al-Ramadi Teaching Hospitals. 43 cases of major salivary gland neoplasms were studied according to their age, gender, site and histopathologically WHO defined type. Non-neoplastic tumors were not included. There were 25 males and 18 females (ratio of male to female being 1.4:1) ranging from ages 10 to 70 years, with an average age of 37 years. The most affected site is the parotid gland, comprising 67.44%; the submandibular gland is 32.56%. The predominating tumors are the benign ones (74.42%), while the malignant ones comprise 25.58%. Malignancy is 20.7% of the parotid gland, but 35.7% of the submandibular gland is malignant. Pleomorphic adenomas are the commonest among the benign tumors (62.79%). Among the malignant tumors, acinic cell carcinoma (9.30%) and mucoepidermoid carcinoma (6.97%) are the commonest. Conclusion: From the results of our study group, we observe similarities with international trends in regards to the sites and gland involved as well as histology types. However, the increased malignancy rate of the submandibular gland and male predominance of the mucoepidermoid carcinoma require continuous monitoring. Histopathologic classification is very important; and any patient having painless swelling of the salivary gland not due to inflammation should be referred to surgery.