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European Annals of Otorhinolaryngology,... Oct 2019Primary liposarcoma is very rare in the parotid gland. To date, only 8 cases of primary parotid liposarcoma have been reported. The aim of this study is to report on a...
INTRODUCTION
Primary liposarcoma is very rare in the parotid gland. To date, only 8 cases of primary parotid liposarcoma have been reported. The aim of this study is to report on a case of primary parotid liposarcoma highlighting the complexity of its treatment and analyze treatment outcomes of other reported cases.
CASE SUMMARY
We report a case of parotid liposarcoma arising in the left parotid gland of a 66 year-old man, causing local morbidity, recurrence, repeated surgical treatment and death 5 months after initial treatment.
DISCUSSION
Parotid liposarcoma is marked by a high probability of local recurrence of up to 70% and is prone to distant metastatic spread, as was the case in our patient. Based on limited experience from published literature, optimal treatment entails radical surgery with negative margins. Postoperative radiotherapy is an option for patients with large high-grade tumors, positive margins and involvement of complex anatomic subsites. High-grade tumors have a worse outcome despite the addition of surgery and postoperative radiotherapy.
Topics: Aged; Fatal Outcome; Humans; Liposarcoma; Male; Neck Dissection; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Rare Diseases; Skin Neoplasms
PubMed: 30876853
DOI: 10.1016/j.anorl.2018.01.013 -
Otolaryngologic Clinics of North America Apr 2016Parotidectomy for parotid cancer includes management of primary salivary cancer, metastatic cancer to lymph nodes, and direct extension from surrounding structures or... (Review)
Review
Parotidectomy for parotid cancer includes management of primary salivary cancer, metastatic cancer to lymph nodes, and direct extension from surrounding structures or cutaneous malignancies. Preoperative evaluation should provide surgeons with enough information to plan a sound operation and adequately counsel patients. Facial nerve sacrifice is sometimes required; but in preoperative functioning nerves, function should be preserved. Although nerve involvement predicts poor outcome, survival of around 50% has been reported for primary parotid malignancy. Metastatic cutaneous squamous cell carcinoma is a high-grade aggressive histology whereby local control for palliation with extended parotidectomy can be achieved; however, overall survival remains poor.
Topics: Carcinoma, Squamous Cell; Facial Nerve; Humans; Lymph Nodes; Lymphatic Metastasis; Parotid Gland; Parotid Neoplasms; Skin Neoplasms; Treatment Outcome
PubMed: 26895698
DOI: 10.1016/j.otc.2015.10.007 -
Folia Morphologica 2022The parotid gland in sheep ends freely in front of the masseter muscle, and paracondylary section of occipital bone and extends deep until pterygoid extends of sphenoid...
BACKGROUND
The parotid gland in sheep ends freely in front of the masseter muscle, and paracondylary section of occipital bone and extends deep until pterygoid extends of sphenoid bone and hyoid bone. The structure of salivary glands in mammals has been thoroughly studied using histological and sialographic method. This study aimed to reveal the detailed anatomic features and race-specific differences of the canal system of the parotid glands in Akkaraman sheep by using the corrosion cast technique.
MATERIALS AND METHODS
Thirteen sheep parotid glands from 7 Akkaraman sheep were used in this study. Parotid glands were removed from their places with ducts. Measurements were made with a calliper from back to front, top to bottom and inside to outside. After dissection of the parotid glands, their volumes were measured according to the 'Archimedes principle'. Also, 13 sheep parotid glands were examined using the polyester resin method.
RESULTS
In the present study, our average metric results were: length of parotid duct was 10.92 ± 1.027 cm, length of parotid gland was 5.87 ± 1.04 cm, volume of parotid gland was 12.50 ± 2.48 cm³, thickness of parotid gland was 0.75 ± 0.36 cm and width of parotid gland was 4.07 ± 0.43 cm. The average weight of the parotid gland of Akkaraman sheep was identified as 25.3 g. Accessory parotid gland was not encountered in the current study.
CONCLUSIONS
It was observed that polyester entered into the parotid duct and filled up until the acinus and made both acinus and secretory ducts well-examined in this study. It was also observed that the parotid gland consisted of lobes and lobules. The average number of lobes was 12. The number of lobules in a lobe varied between 3 and 16, each lobe consisted of an average of 9 lobules. It was found that each lobe has its own lobar duct.
Topics: Animals; Parotid Gland; Salivary Glands; Sheep
PubMed: 34308540
DOI: 10.5603/FM.a2021.0071 -
The Laryngoscope May 2021To apply a novel sialography classification system to identify parotid and submandibular ductal findings following I-131 therapy and to assess correlates to dose and...
OBJECTIVES/HYPOTHESIS
To apply a novel sialography classification system to identify parotid and submandibular ductal findings following I-131 therapy and to assess correlates to dose and duration of symptoms.
STUDY DESIGN
Retrospective single-center case series.
METHODS
Patients who underwent sialography between February 2008 and February 2019 after previously receiving I-131 treatment were identified via a retrospective chart review. Their sialograms were systematically evaluated and scored by applying the Iowa parotid sialogram scale to also include submandibular gland analysis.
RESULTS
From 337 sialograms, 30 (five submandibular, 25 parotid) underwent analysis. Ductal stenosis was identified in all sialograms and was graded as moderate (>50%-75%) in 7/30 cases and severe (>75%) in 15/30 cases. The distal (main) duct was narrowed in 23/30 cases. No association was identified between degree of ductal stenosis and I-131 dose (P = .39), age (P = .81), or time from I-131 therapy to sialogram (P = .97).
CONCLUSIONS
The Iowa parotid sialogram scale was successfully applied to report abnormalities of the parotid and submandibular ductal system. The most common manifestation of I-131-associated sialadenitis was a severe stenosis within the distal salivary duct. No statistically significant association was found between degree of ductal stenosis and dose of I-131, age, or duration of symptoms.
LEVEL OF EVIDENCE
4 Laryngoscope, 131:E1450-E1456, 2021.
Topics: Adult; Aged; Dose-Response Relationship, Radiation; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Parotid Diseases; Parotid Gland; Radiation Injuries; Radiotherapy Dosage; Retrospective Studies; Salivary Ducts; Sialadenitis; Sialography; Submandibular Gland; Submandibular Gland Diseases; Thyroid Diseases; Young Adult
PubMed: 33200832
DOI: 10.1002/lary.29279 -
Head & Neck Oct 2022It is important to define the accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor (WT). This systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis Review
It is important to define the accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor (WT). This systematic review and meta-analysis evaluated the accuracy of FNAC in the diagnosis of WT in the parotid gland and WT growth rate. For determination of FNAC accuracy, 17 studies, encompassing 1710 cases, were included. Pulled random model estimates of sensitivity, specificity, PPV, and NPV were 93.7% (95%CI: 92.1, 95.3), 97.9% (95%CI: 97, 98.9), 93.3% (95%CI: 91.5, 95.1), and 97.4% (95%CI: 96.4, 98.4), respectively. FNAC is highly reliable for the diagnosis of WT of the parotid. The high PPV value suggests that patients with a cytological diagnosis of WT of the parotid may be assigned to active surveillance.
Topics: Adenolymphoma; Biopsy, Fine-Needle; Humans; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity
PubMed: 35586869
DOI: 10.1002/hed.27099 -
ELife Sep 2021Management of salivary gland hypofunction caused by irradiation (IR) therapy for head and neck cancer remains lack of effective treatments. Salivary glands, especially...
Management of salivary gland hypofunction caused by irradiation (IR) therapy for head and neck cancer remains lack of effective treatments. Salivary glands, especially the parotid gland, actively uptake dietary nitrate and secrete it into saliva. Here, we investigated the effect of dietary nitrate on the prevention and treatment of IR-induced parotid gland hypofunction in miniature pigs, and elucidated the underlying mechanism in human parotid gland cells. We found that nitrate administration prevented IR-induced parotid gland damage in a dose-dependent manner, by maintaining the function of irradiated parotid gland tissue. Nitrate could increase sialin expression, a nitrate transporter expressed in the parotid gland, making the nitrate-sialin feedback loop that facilitates nitrate influx into cells for maintaining cell proliferation and inhibiting apoptosis. Furthermore, nitrate enhanced cell proliferation via the epidermal growth factor receptor (EGFR)-protein kinase B (AKT)-mitogen-activated protein kinase (MAPK) signaling pathway in irradiated parotid gland tissue. Collectively, nitrate effectively prevented IR-induced xerostomia via the EGFR-AKT-MAPK signaling pathway. Dietary nitrate supplementation may provide a novel, safe, and effective way to resolve IR-induced xerostomia.
Topics: Animal Feed; Animals; Diet; Dietary Supplements; Nitrates; Parotid Gland; Radiotherapy; Swine; Swine, Miniature; Xerostomia
PubMed: 34581269
DOI: 10.7554/eLife.70710 -
Medical Ultrasonography May 2022Contrast-enhanced ultrasound (CEUS) appears to be a promising application for the diagnosis of parotid gland tumours. We aimed to systematically review and meta-analyse... (Meta-Analysis)
Meta-Analysis Review
AIM
Contrast-enhanced ultrasound (CEUS) appears to be a promising application for the diagnosis of parotid gland tumours. We aimed to systematically review and meta-analyse the ability of CEUS in distinguishing benign from malignant parotid gland tumours.
MATERIAL AND METHODS
PubMed was searched for relevant studies. Data on area under time intensity curve (AUC) in arbitrary unit (AU), and mean transit time (MTT) in seconds (sec) were analysed using the Cochrane Review Manager Software.
RESULTS
Nine studies met the eligibility criteria comprising a total number of 498 parotid gland tumours (benign, number (n)=423; malignant, n=75). Descriptive evaluation of parotid gland tumours following CEUS administration showed overlap characteristics in benign and malignancies. Two publications assessed AUC and MTT in 72 and 60 parotid gland tumours, respectively. AUC was significantly lower in benign compared to malignant tumours following contrast administration (AUC, mean difference (MD) -266.77 AU, 95% confidence intervals (CI) -433.22, -100.33, p=0.002). No significant different in MTT between benign and malignant tumours (p=0.12). Heterogeneity was statistically significant in AUC (p=0.04) and MTT (p<0.00001).
CONCLUSION
Descriptive evaluation of parotid gland tumours showed overlap CEUS characteristics. Perfusion related CEUS parameters analysis is promising in differentiating benign parotid tumours from malignancies.
Topics: Contrast Media; Diagnosis, Differential; Humans; Parotid Gland; Parotid Neoplasms; Perfusion; Ultrasonography
PubMed: 34216453
DOI: 10.11152/mu-3119 -
Clinical and Experimental Rheumatology Dec 2023Primary Sjögren's syndrome (pSS) is a chronic, systemic, inflammatory autoimmune disease characterised by lymphocyte proliferation and progressive damage to exocrine... (Review)
Review
Primary Sjögren's syndrome (pSS) is a chronic, systemic, inflammatory autoimmune disease characterised by lymphocyte proliferation and progressive damage to exocrine glands. Salivary gland histopathology based on salivary gland biopsy is relevant for the diagnosis of pSS and therefore broadly applied in clinical practice. Tissue can be obtained from labial salivary glands (LSG) biopsy or from major salivary glands (MSG) biopsy, namely the parotid; in this latter scenario, the procedure can be either an open surgical biopsy or a US guided core needle biopsy.In this review we will: i) present the histopathological findings that may be encountered by pathologists on biopsies from pSS patients; ii) discuss the advantages and disadvantages of the surgical and/or imaging guided procedures to obtain tissues from LSG or MSG; iii) describe the histopathological features of lymphoma of MSG in pSS patients.
Topics: Humans; Sjogren's Syndrome; Salivary Glands; Parotid Gland; Salivary Glands, Minor; Lymphoma; Biopsy
PubMed: 38079343
DOI: 10.55563/clinexprheumatol/fcjoqx -
NMR in Biomedicine Jan 2021Various MRI sequences have shown their potential to discriminate parotid gland tumors, including but not limited to T -weighted, postcontrast T -weighted, and...
Various MRI sequences have shown their potential to discriminate parotid gland tumors, including but not limited to T -weighted, postcontrast T -weighted, and diffusion-weighted images. In this study, we present a fully automatic system for the diagnosis of parotid gland tumors by using deep learning methods trained on multimodal MRI images. We used a two-dimensional convolution neural network, U-Net, to segment and classify parotid gland tumors. The U-Net model was trained with transfer learning, and a specific design of the batch distribution optimized the model accuracy. We also selected five combinations of MRI contrasts as the input data of the neural network and compared the classification accuracy of parotid gland tumors. The results indicated that the deep learning model with diffusion-related parameters performed better than those with structural MR images. The performance results (n = 85) of the diffusion-based model were as follows: accuracy of 0.81, 0.76, and 0.71, sensitivity of 0.83, 0.63, and 0.33, and specificity of 0.80, 0.84, and 0.87 for Warthin tumors, pleomorphic adenomas, and malignant tumors, respectively. Combining diffusion-weighted and contrast-enhanced T -weighted images did not improve the prediction accuracy. In summary, the proposed deep learning model could classify Warthin tumor and pleomorphic adenoma tumor but not malignant tumor.
Topics: Deep Learning; Diffusion Magnetic Resonance Imaging; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; Parotid Gland; Parotid Neoplasms
PubMed: 32886955
DOI: 10.1002/nbm.4408 -
Head & Face Medicine Mar 2021The purpose of this study is to determine the histopathological spectrum and risk of primary malignancy of asymptomatic parotid lesions incidentally discovered on...
BACKGROUND
The purpose of this study is to determine the histopathological spectrum and risk of primary malignancy of asymptomatic parotid lesions incidentally discovered on cross-sectional imaging.
METHODS
Over a 10-year period, 154 patients underwent 163 ultrasound-guided parotid lesion biopsies at our institution. This retrospective chart review included 89 lesions in 87 patients with asymptomatic parotid lesions discovered on cross-sectional imaging studies performed for unrelated clinical indications. The histopathologic findings of all sampled lesions were reviewed. We evaluated the patient demographics and pathological diagnoses of sampled parotid lesions to determine the histopathological spectrum and risk of malignancy.
RESULTS
The average age was 67.5 years and 92 % were males. 25 % of patients had bilateral lesions. The average size of the parotid lesions was 1.5 cm and 91 % were located in the superficial lobe. 92.1 % of lesions were benign with Warthin tumor being the most common diagnosis followed by pleomorphic adenoma. 2.3 % of lesions were primary parotid malignant neoplasms, while 5.6 % were metastatic lesions in patients with known malignancy.
CONCLUSIONS
The incidence of primary parotid malignant neoplasm in asymptomatic incidentally discovered parotid lesions is low. Imaging or clinical follow-up may be considered in patients with incidental parotid lesions who prefer to avoid biopsy.
Topics: Adenolymphoma; Aged; Biopsy; Female; Humans; Male; Parotid Gland; Parotid Neoplasms; Retrospective Studies
PubMed: 33757536
DOI: 10.1186/s13005-021-00262-6