Paravasal Spread of Malignant Neoplasms of the Major Salivary Glands: Challenges in Radiological Imaging

Objective. To study the possibilities of modern methods of radiation diagnostics in detecting paravasal spread of malignant neoplasms of the salivary glands.

Materials and Methods. The study included 306 patients with suspected neoplasms of the major salivary glands who were examined at the X-ray Computed Tomography Departments of the Scientific and Clinical Center for Radiation Diagnostics and Radiotherapy of the Pavlov University and who were treated at the Maxillofacial Surgery Clinic, Pavlov University, between June 13, 2013, and October 20, 2025 (observation period: 12 years). All patients underwent ultrasound examinations on various devices at the university’s clinics, at the outpatient clinics at the patients’ place of residence, and at various medical centers in Saint Petersburg. Of 306 patients, 294 underwent contrast-enhanced magnetic resonance imaging (MRI) using a 1.5 T Signa HDxt scanner (General Electric), and 61 patients underwent contrast-enhanced multidetector computed tomography (MDCT) supplemented with CT sialography using an Optima CT540 scanner (General Electric).

Results. Patients with suspected salivary gland neoplasms (n=306) were divided into 2 groups: Group 1 – primary patients (n=265) and Group 2 – patients with suspected relapse (n=41). Malignant salivary gland neoplasms in our sample were histologically confirmed in 15 % of primary patients and in 23 % of patients with suspected relapse. Among the 22 histological variants of salivary gland malignancies included in the 5th edition of the WHO classification of histological subtypes of salivary gland tumors (World Health Organization, 2022), the most common in our sample were ac inic cell carcinoma (8550/3) in 25 % of cases, mucoepidermoid carcinoma (8430/3) in 18 % of cases, and carcinoma ex pleomorphic adenoma. (8941/3) in 14 % of cases.

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