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Neuroradiology

E2666. Lumps and Bumps of the Face and Neck: Learning an Analytical Approach to Salivary Gland Lesions

Narendra D,  Patel S,  Rubens D,  Bhatt A. University of Rochester Medical Center, Rochester, US

Address correspondence to S. Patel (swapnil_patel@urmc.rochester.edu)

Background Information: Salivary gland neoplasms usually present as solitary painless masses. It is difficult to distinguish benign apart from malignant lesions simply based on clinical evaluation due to the variable growth pattern/behavior of the neoplastic entities. In addition, distinguishing among the subtypes of epithelial carcinoma can prove challenging by histopathology due to the broad spectrum of histologic appearance of each tumor with considerable overlap. Therefore, imaging stands to make an impact in the workup of these lesions, particularly in identifying benign lesions apart from suspicious lesions that require further imaging and tissue sampling. In addition, defining imaging features related to grading the severity of lesion aggressiveness can assist with histopathologic correlation for a more accurate diagnosis, specific to tumor subtype.

Educational Goals/Teaching Points: We illustrate the relevant embryological relationships and anatomical principles relating to salivary glands; review the advantages and specific roles of various modalities in evaluation of salivary gland mass; review the current imaging algorithm approach to workup of salivary gland mass; and highlight and demonstrate modality-specific imaging features to assist in distinguishing benign and malignant lesions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Salivary gland anatomy will be reviewed. Multimodality evaluation of salivary gland neoplasms will be presented including ultrasound, CT, MRI, and sialography. Pertinent imaging findings corroborating histopathological features will be highlighted to distinguish benign apart from malignant lesions.

Conclusion: Salivary gland imaging is invaluable in guiding the clinical management of salivary gland neoplasms. Recognition of modality-specific imaging features improves distinction between benign and malignant lesions, providing a more streamlined workup algorithm and leading to more rapid diagnosis and treatment.