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Current Problems in Diagnostic Radiology 2022Kimura disease is a rare chronic inflammatory disorder mostly reported in males in second to third decades from south-east Asia. Head and neck is the most commonly... (Review)
Review
Kimura disease is a rare chronic inflammatory disorder mostly reported in males in second to third decades from south-east Asia. Head and neck is the most commonly involved region. The usual presentation is painless facial swelling with salivary gland involvement and regional lymphadenopathy. The diagnosis can be suspected on imaging but needs to be proven on histopathology. We describe three histopathology proven cases of Kimura disease and emphasize the specific clinic-radiological findings which can help in early identification of the condition and its differentiation from other diseases with similar presentation. Gray scale Ultrasound, contrast-enhanced ultrasound, and contrast-enhanced Magnetic Resonance Imaging (CE-MRI) were done in all patients and Computed Tomography (CT) was done in one. The salient imaging features were ill-defined solid mass in the subcutaneous location of the facial region which was heteroechoic on Gray scale Ultrasound, heterogeneously hyperintense on T2W MRI and without much diffusion restriction. There was involvement of salivary glands with ipsilateral cervical adenopathy. The lesion showed avid contrast enhancement on contrast-enhanced ultrasound and CE-MRI. We also present a systematic literature review of clinico-radiological features in Kimura disease in the head and neck. The articles with histopathologically proven cases and satisfactory description of imaging findings were included and we have compared the findings in our cases with published literature. In addition, we have included examples of radiological mimics of this disease. Certain imaging findings are highly suggestive and can aid in early diagnosis of Kimura disease which helps in early initiation of treatment with better patient prognosis.
Topics: Angiolymphoid Hyperplasia with Eosinophilia; Humans; Kimura Disease; Magnetic Resonance Imaging; Male; Neck; Tomography, X-Ray Computed
PubMed: 33250297
DOI: 10.1067/j.cpradiol.2020.10.003 -
Journal of Oral Pathology & Medicine :... May 2021Salivary gland tumors are a diverse group of uncommon neoplasms that are rare in pediatric patients. The aim of this study was to evaluate the clinicopathological... (Review)
Review
BACKGROUND
Salivary gland tumors are a diverse group of uncommon neoplasms that are rare in pediatric patients. The aim of this study was to evaluate the clinicopathological profile and survival outcomes of pediatric patients affected by salivary gland tumors.
MATERIALS AND METHODS
An extensive search was carried out using the MEDLINE/PubMed, EMBASE, Scopus databases, and grey literature. The risk of bias was available in all papers included.
RESULTS
A total of 2,830 articles were initially retrieved with 54 remaining for data extraction, resulting in 2,937 cases. This comprised forty-five case series' and nine cohort studies. These tumors were slightly more prevalent in females (57.4%). The patients' age ranged from 0.3 to 19 years old, with a mean age of 13.3 years. Parotid was the most affected site (81.9%), and 99.2% of cases clinically exhibited a swelling. Presence of pain/tenderness was reported in 13.5% of the cases, with an average duration of 12.6 months for the appearance of symptoms. Most of the reported cases were malignant tumors (75.4%), with mucoepidermoid carcinoma the most common tumor of all tumors (44.8%), followed by pleomorphic adenoma (24.1%). Surgery alone was the leading treatment choice in 74.9% cases, and the 5-year overall survival rate of patients was 93.1%. Patients with symptoms (P = .001), local recurrence (P < .001), metastasis (P < .001), and those not undergoing surgery or surgery combined with radiotherapy (P < .001) showed lower survival rates.
CONCLUSION
The pediatric patients present a high frequency of malignant salivary neoplasms and a high overall survival rate.
Topics: Adenoma, Pleomorphic; Adolescent; Adult; Carcinoma, Mucoepidermoid; Child; Child, Preschool; Female; Humans; Infant; Neoplasm Recurrence, Local; Retrospective Studies; Salivary Gland Neoplasms; Survival Rate; Young Adult
PubMed: 33314344
DOI: 10.1111/jop.13151 -
The British Journal of Oral &... Apr 2021The objective of this review was to conduct a systematic review and meta-analysis to compare endoscopic with conventional parotid tumour excision. Online databases... (Meta-Analysis)
Meta-Analysis Review
The objective of this review was to conduct a systematic review and meta-analysis to compare endoscopic with conventional parotid tumour excision. Online databases including MEDLINE, EMBASE, EMCare, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), the World Health Organization International Clinical Trials Registry (ICTRP), and the ISRCTN registry were all searched. All randomised controlled trials and observational studies comparing endoscopic with conventional parotid tumour excision were included. Five studies were identified and analysis was reported in forest plots with 95% confidence intervals. Outcomes of interest included operating time, cosmesis, blood loss, facial nerve injury, Frey syndrome, duration of hospital stay, and tumour recurrence. Endoscopic tumour excision had a comparable operating time to conventional resection with an insignificant mean difference (p=0.08). Scar cosmesis in the endoscopic group was superior (mean difference: 2.95, p<0.05) and it also reported a lower volume of blood loss (mean difference: -31.84, p<0.05). No significant difference was found in the incidence of facial nerve injury or Frey syndrome between the two groups, but overall, fewer miscellaneous complications were observed in the endoscopic cohorts. Endoscopic parotid surgery reported a shorter duration of hospital stay, and tumour recurrence was similar in both treatment arms. Endoscopic parotid gland surgery is an effective alternative to conventional approaches with comparable operating times, reduced blood loss and fewer complications, as well as shorter inpatient stay and improved cosmesis. Further studies are, however, required with longer follow-up periods to assess outcomes between different subtypes of parotid tumour.
Topics: Endoscopy; Humans; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms
PubMed: 33280943
DOI: 10.1016/j.bjoms.2020.08.103 -
Acta Clinica Belgica Feb 2020: Autoimmune diseases include a spectrum of disorders in which immune response to the autoantigens leads to tissue damage or dysfunction. Xerostomia, salivary gland... (Meta-Analysis)
Meta-Analysis
: Autoimmune diseases include a spectrum of disorders in which immune response to the autoantigens leads to tissue damage or dysfunction. Xerostomia, salivary gland dysfunction and lack of saliva are some common symptoms associated with many autoimmune diseases.: In this review study, the meta-analysis technique is used to objectively review the relationship between autoimmune diseases and salivary gland dysfunction. We have searched Medline and Embase and Google Scholar. By Revman 5.3, meta-analysis was performed to investigate the salivary flow rate in both stimulatory and non-stimulatory saliva. The sample size obtained from these studies was 130 people with autoimmune diseases and 100 healthy individuals.: The results showed a significant decrease in the level of non-stimulatory saliva in people with autoimmune diseases.: A complete and comprehensive understanding of the clinical manifestation of systemic diseases is crucial in early diagnosis of diseases and identifying the mechanisms that develop the disease. Other than xerostomia, there is a significant reduction in salivary flow rate in patients with autoimmune diseases. As saliva plays a very important role in oral health and has significant functions, more attention is needed for monitoring and managing of hyposalivation in autoimmune patients.
Topics: Autoimmune Diseases; Humans; Salivary Gland Diseases; Salivary Glands; Scleroderma, Systemic; Xerostomia
PubMed: 30376766
DOI: 10.1080/17843286.2018.1540164 -
Head & Neck Aug 2022Recurrent salivary gland carcinomas (RSCs) are poorly characterized and their clinical features and treatment options have not yet been fully described. The goal of this... (Review)
Review
Recurrent salivary gland carcinomas (RSCs) are poorly characterized and their clinical features and treatment options have not yet been fully described. The goal of this study was to analyze the therapeutic strategies and oncological outcomes of RSC patients through a literature review analysis. This systematic review was performed according to the PRISMA statements. Inclusion criteria for the systematic review were based on the population, intervention, comparison, and outcomes according to (PICO) framework. Two thousand seven hundred and four records were selected and 1817 recurrences were studied. Three hundred and sixty-five patients underwent salvage surgery (20.1%) and their 5-year mortality rate, overall survival and disease-free survival were 35%, 70%, and 42%, respectively. RSCs are aggressive neoplasms with a high rate of distant metastases (28.9%). Salvage surgery can be considered in patients with limited local and/or regional recurrences, even in case of single distant relapse, appearing within the first 3 years of follow-up.
Topics: Disease-Free Survival; Humans; Neoplasm Recurrence, Local; Retrospective Studies; Salivary Gland Neoplasms; Salvage Therapy
PubMed: 35441406
DOI: 10.1002/hed.27062 -
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 -
The Laryngoscope Aug 2023A number of patient-reported outcome measures (PROMs) assess quality of life and symptom severity in patients with salivary gland dysfunction, but many vary in the... (Review)
Review
OBJECTIVE
A number of patient-reported outcome measures (PROMs) assess quality of life and symptom severity in patients with salivary gland dysfunction, but many vary in the extent of validation and domain types addressed. We identified PROMs validated to measure salivary gland function and analyzed key properties.
DATA SOURCES
PubMed, Web of Science, Embase, PsycInfo, and CINAHL.
REVIEW METHODS
A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Validated instruments with >1 item to assess salivary gland-related symptoms were included. PROMs were evaluated for developmental methodology, structure, validity, and reliability using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.
RESULTS
A total of 2059 abstracts were retrieved, and 133 full-text articles were reviewed. Sixteen PROMs assessing xerostomia (n = 7), sialadenitis (n = 4), Sjogren's syndrome (n = 2), Parkinson's-associated sialorrhea (n = 2), and oral systemic sclerosis (n = 1) were identified. Most (n = 15) were developed de novo, one was adapted from a pre-existing questionnaire. Eleven PROMs demonstrated "very good" analysis of internal consistency per COSMIN criteria, and 10 included test-retest data. Regarding content validity, four PROMs were developed with both patient and physician input, but none were rated as "adequate." All included comparisons against other questionnaires (n = 7), salivary flow rate (n = 9), and/or healthy controls (n = 3). The most rigorously developed PROM, the Xerostomia Inventory, was rated adequate in 6 out of 7 domains.
CONCLUSIONS
Several PROMs evaluate salivary function. The abilties of these PROMs to meet design and validation standards were variable, with notable limitations in content validity for all tools. New and updated PROMs assessing obstructive and inflammatory salivary symptoms should utilize patient and provider input.
LEVEL OF EVIDENCE
N/A Laryngoscope, 133:1796-1805, 2023.
Topics: Humans; Quality of Life; Reproducibility of Results; Patient Reported Outcome Measures; Surveys and Questionnaires; Consensus
PubMed: 36606658
DOI: 10.1002/lary.30550 -
Journal of Medicine and Life May 2022This study is a systematic review and meta-analysis to assess the overexpression rate of HER2 in patients with salivary gland tumors. We included peer-reviewed... (Meta-Analysis)
Meta-Analysis Review
This study is a systematic review and meta-analysis to assess the overexpression rate of HER2 in patients with salivary gland tumors. We included peer-reviewed publications from 1995 to 2020, indexed in medical databases, using search terms such as "human epidermal growth factor receptor 2 (HER2)" and "salivary gland tumors", and extracted relevant data. The extracted data were analyzed with RevMan 5.3 software. Intra-and intergroup post hoc analyses of outcome variables were performed using t-tests, and the rates of HER2 positivity among studies were evaluated. 80 studies were included in the analysis. The positive rates of HER2 ranged from 3.3% to 84.0% and 1% to 9% in malignant and benign subtypes, respectively. The highest HER2 overexpression rate among malignant tumors was in salivary ductal carcinomas (SDC), with a 45% positive rate (CI 95%: 21.9-70.3%). Mucoepidermoid carcinoma (MEC) had the highest positive rate of 84% (CI 95%: 74.1-90.0%). Among benign salivary gland tumors, the highest rate was found in myoepithelioma, with a positive rate of 9% (CI 95%: 1.7-33.6%). The highest rate of HER2 overexpression is present in malignant subtypes of salivary gland tumors, more specifically in salivary ductal carcinoma, mucoepidermoid carcinomas, salivary duct carcinoma in situ, and carcinoma ex pleomorphic adenoma.
Topics: Biomarkers, Tumor; Carcinoma, Mucoepidermoid; Humans; Receptor, ErbB-2; Salivary Gland Neoplasms; Salivary Glands
PubMed: 35815077
DOI: 10.25122/jml-2021-0394 -
Iranian Journal of Pathology 2023There is no consensus on the prevalence of salivary gland tumors (SGTs) in Iran. Thus, we systematically reviewed the literature about the prevalence of SGTs in Iran and... (Review)
Review
BACKGROUND & OBJECTIVE
There is no consensus on the prevalence of salivary gland tumors (SGTs) in Iran. Thus, we systematically reviewed the literature about the prevalence of SGTs in Iran and applied the last world health organization (WHO) classification.
METHODS
The systematic literature search was performed in EMBASE, Scopus, PubMed MEDLINE, Google Scholar, Scientific Information Database (SID), and Magiran; we searched for "salivary gland," "tumor," "prevalence," and "Iran" until 1 March 2021. The studies included were written in the English and Farsi languages. The weighted mean prevalence of SGTs was calculated as prevalence (%) * (N/the sum of all N). We used the unpaired Two-sample T-test to compare the weighted means.
RESULTS
A total of 17 studies, including 2870 patients, were selected for the data synthesis. The weighted mean prevalence of benign and malignant tumors was 66% (95% CI: 59-73) and 34% (95% CI: 27-41), respectively. The patients' mean age was reported in 10 out of the 17 studies. The weighted mean age of the patients was 40 (95% CI: 37-42) and 49 (95% CI: 43-55) years for benign and malignant tumors, respectively (=0.01). Pleomorphic adenoma (PA), followed by Warthin's tumor (WT), was the most prevalent benign tumor. Moreover, the most common malignant tumors were mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (AdCC).
CONCLUSION
More than one-third of SGTs in Iran were malignant, which is higher than the reports from Middle Eastern countries. Information about risk factors and the burden of SGTs in Iran is insufficient. Thus, further well-designed longitudinal studies are warranted.
PubMed: 37383154
DOI: 10.30699/IJP.2023.559121.2942 -
Autoimmunity Jun 2022Sjögren's syndrome (SS) is a chronic systemic disease characterised by salivary and lacrimal gland dysfunction with severe implications for the well-being of bearing... (Review)
Review
Sjögren's syndrome (SS) is a chronic systemic disease characterised by salivary and lacrimal gland dysfunction with severe implications for the well-being of bearing individuals. Although its origin has not yet been fully elucidated, it is known that genetic, environmental, and epigenetic factors are important contributors to the pathogenesis of this syndrome. DNA methylation is a relevant, widely studied epigenetic factor that is possibly related to the establishment of SS. The aim of the present study was to perform a systematic review of the literature to compile studies on the contribution of DNA methylation to the pathogenesis of SS. A literature search was performed in 4 databases (PubMed, Web of Science, Lilacs, and Scopus) using previously selected Medical Subject Headings (MESH) descriptors, and article selection considered observational studies only. After a full-text reading of the selected articles, 15 studies were in accordance with the eligibility criteria for data extraction. Methylation detection approaches included global methylation, genome-wide assessment of differentially methylated regions, and site-specific methylation. Fourteen articles reported associations of DNA methylation profiles in SS patients, both globally and in several genes in salivary glands and blood cells. Thus, DNA methylation may contribute to the pathogenesis of SS. The findings reinforce the importance of epigenetic markers in the dynamics of SS and may direct efforts toward the development of new diagnostic and therapeutic approaches.
Topics: DNA Methylation; Humans; Salivary Glands; Sjogren's Syndrome
PubMed: 35403521
DOI: 10.1080/08916934.2022.2062593