Neoplasias epiteliais de glândulas salivares em crianças e adolescentes: estudo retrospectivo da casuística do Instituto Nacional do Câncer no período de 1996 a 2006

Abstract

The biological behavior of salivary gland neoplasms in children and adolescents has motivated many scientific investigations in other countries. However, there is a relative lack of information on these cases in Brazil. The aim of the present work was to describe demographic, clinical and therapeutic data of the pediatric and hebiatric patients with salivary gland tumors from the Brazilian National Institute of Cancer (INCA), the governmental reference for malignant neoplasms in the country. All of the benign and malignant salivary gland epithelial neoplasms registered in the digital database of the Pathology Department of INCA throughout 1996 to 2006 were retrieved, resulting in an initial sample of 1127 cases. Then, those proceeding from patients under 18-years-old were submitted to histopathological review according to the new WHO criteria for diagnostic confirmation and classification. Information regarding sex, ethnic background and age of the patient, as well as size, evolution, staging, site, histological diagnosis and treatment of the lesion was recovered from their medical files. Forty-two patients diagnosed in the pediatric age were found, resulting in an overall frequency of 3.7% from the entire sample. There were 21 benign (50% of the pediatric cohort) and 21 malignant lesions (50%). Female patients were prevalent, in a proportion of 1.7:1 with male subjects. The majority of the cases were found in the parotid gland (25 cases, 59.5%), followed by the submandibular (9, 26.8%) and minor salivary glands (8, 19.5%). The prevalent benign and malignant tumors were pleomorphic adenoma (21 samples, 51.2% of the pediatric group) and mucoepidermoid carcinoma (16 cases, 36.5%), the fallow up goes from two to 91 months. In conclusion, very few salivary gland neoplasms were found in children and adolescents. The major salivary glands are most affected in these cases. Patients in the second decade of life are more frequently affected, but there is a noteworthy prevalence of malignant lesions in the first decade. Pleomorphic adenoma was the most common lesion, and mucoepidermoid carcinoma was the most frequent malignancy. Surgery was the main therapeutic procedure employed in this population. No recurrences or deaths were observed, suggesting a favorable prognosis for epithelial salivary gland neoplasms in children and adolescents.