Search

Fifty cases of oral minor salivary gland adenoid cystic carcinoma (ACC) are analyzed and reported. Oral ACC frequently masquerades as a benign neoplasm, and in the majority of cases there is no pain or ulceration. The most common location is in the palate; a plea is made for incisional biopsy of all oral lesions suspected of salivary gland origin. Survival rates show a progressive decrease with time, and there were no survivors beyond 20 years. In this study, there was a positive correlation between duration of the lesion before diagnosis and the salvage rate, but no correlation was found with the size of the presenting lesion.

A patient with Tangier disease, pulpal calcifications, and bilateral mandibular intrabony lesions (unusual odontomas) is presented. A relationship between Tangier disease and the oral manifestations found in this patient has not been established. Of the 27 known patients with Tangier disease, only 2 have been examined.

Labial salivary glands, like the major salivary glands, are infiltrated with lymphoid cells in Sjogren's syndrome (SS). Studies utilizing biopsy specimens from the lower lips of seventy-six patients, forty-one of whom had Sjogren's syndrome, demonstrated that local synthesis of large amounts of immunoglobulins (IgM and IgG) and rheumatoid factor in salivary glandular tissue is distinctive for Sjogren's syndrome. The presence of rheumatoid factor was demonstrated autoradiographically by interaction between anti-lgG:lgG complexes and labeled immunoglobulins. Rheumatoid factor in the lip was found in eighteen of forty-one (43 per cent) patients with Sjogren's syndrome and in only two of thirty-five (6 per cent) control patients. On repeat biopsy of the lip untreated patients showed progression of lymphoid infiltration and increased immunoglobulin synthesis, whereas two patients treated with cyclophosphamide showed improvement histologically and all treated patients had diminished immunoglobulin synthesis. Sicca symptoms diminished in five of ten patients who were treated with cyclophosphamide for serious complications or other associated diseases, but immunosuppressive therapy cannot yet be recommended for uncomplicated Sjogren's syndrome.

In view of the data obtained in three cases, biopsy of minor salivary glands in the labial mucosa of the lower lip is proposed as an alternative means of establishing the diagnosis of sarcoidosis.