An overview on the histogenesis and morphogenesis of salivary gland neoplasms and evolving diagnostic approaches

Abstract

Salivary gland neoplasms (SGN) remain a diagnostic dilemma due to their heterogenic complex behavior. Their diverse histomorphological appearance is attributed to the underlying cellular mechanisms and differentiation into various histopathological subtypes with overlapping features. Diagnostic tools such as fine needle aspiration biopsy, computerized tomography, magnetic resonance imaging, and positron emission tomography help evaluate the structure and assess the staging of SGN. Advances in molecular pathology have uncovered genetic patterns and onco-genes by immunohistochemistry, fluorescent in situ hybridization, and next–generation sequenc-ing, that may potentially contribute to innovating diagnostic approaches in identifying various SGN. Surgical resection is the principal treatment for most SGN. Other modalities such as radio-therapy, chemotherapy, targeted therapy (agents like tyrosine kinase inhibitors, monoclonal anti-bodies, and proteasome inhibitors), and potential hormone therapy may be applied, depending on the clinical behaviors, histopathologic grading, tumor stage and location, and the extent of tissue invasion. This review delves into the molecular pathways of salivary gland tumorigenesis, high-lighting recent diagnostic protocols that may facilitate the identification and management of SGN.