American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which tumor is recognized as the second most common malignant tumor of the salivary gland?

1. Warthin's tumor

2. Pleomorphic adenoma

3. Adenoid cystic carcinoma

4. Mucoepidermoid carcinoma

The correct answer is: Adenoid cystic carcinoma

Adenoid cystic carcinoma is recognized as the second most common malignant tumor of the salivary glands due to its distinct histological characteristics and clinical behavior. This tumor is known for its propensity for perineural invasion, which can lead to significant challenges in treatment and management. Its incidence is notable, particularly in minor salivary glands such as those found in the palate, but it can also appear in larger salivary glands like the parotid and submandibular glands. The tumors often present as slow-growing, painless masses, which can complicate early diagnosis. In contrast, while Warthin’s tumor and pleomorphic adenoma are common salivary gland tumors, they are benign. Warthin’s tumor is specifically associated with the parotid gland and often seen in older males and smokers, whereas pleomorphic adenoma, also known as a benign mixed tumor, represents one of the most frequent benign neoplasms found in the salivary glands. Mucoepidermoid carcinoma is recognized as the most common malignant tumor of the salivary glands, but it ranks ahead of adenoid cystic carcinoma in terms of frequency. The distinction in tumor types underscores the diversity of salivary gland