Submandibular Gland Oncocytoma: A Rare Tumor Case Series-Its Diagnosis and Treatment Based on Clinicopathology

Abstract

Aim and objective: Submandibular oncocytomas are rare benign salivary gland neoplasms, normally involves the parotid gland and few instances are stated in the submandibular gland region. As the clinical and histopathological features are overlapping to another salivary gland tumor like pleomorphic adenoma or warthin tumour, they are often misdiagnosed. They are typically found in patients aged 50-70 years with no gender preference. The aim of this paper is to assess the clinicopathological functions, diagnostic standards and treatment of submandibular gland oncocytomas via a series of three case reports.

Method and results: We report a three case series of unilateral submandibular gland oncocytoma with female to male ratio 2:1, Size of tumor ranged from 1.8 to 10 cm, 2 cases have painless swelling and one involved tender mass. FNAC and CT scan confirmed the presence of an oncocytoma. The patient underwent unilateral submandibular gland resection and on follow up no evidence of any recurrence was identified.

Conclusion: Submandibular oncocytomas often present as solitary slow growing painless masses, which are firm on clinical examination. CT followed by fine-needle aspiration cytology (FNAC) would be the preferred diagnostic modalities. Due to its low rate of malignant transformation and recurrence, the best treatment is local resection with follow-up as necessary.

Keywords: FNAC; Onkocytes; Submandibular oncocytomas.

Fig. 1

Submandibular gland oncocytoma (a) well circumscribed mass 10 × 6.5x3 cm at right submandibular region; b Total submandibular gland excision and removal of level I and II lymph nodes (c) FNAC of the mass showing clusters of polygonal eosinophilic epithelial cells with low N/C ratio. d Histology of the submandibular oncocytoma reveals tumor is well circumscribed with a thin capsule and is composed of benign appearing oncocytes

Fig. 2

Imaging and cytopathology of the submandibular oncocytoma. a CT scan showing a well-circumscribed mass at the right submandibular space (b) foci of oncocytes present at the tumor adjacent submandibular tissue, eosinophilic cytoplasm, and round nuclei with prominent nucleoli (c) Excised tumor mass