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Oral Oncology Oct 2023Parotid lymphoma is a rare disease and proves challenging to differentiate from other masses. In this study, we aimed to analyze the clinical characteristics of parotid...
OBJECTIVES
Parotid lymphoma is a rare disease and proves challenging to differentiate from other masses. In this study, we aimed to analyze the clinical characteristics of parotid lymphoma to identify diagnostic factors to facilitate a diagnosis of parotid lymphoma.
MATERIALS AND METHODS
We retrospectively enrolled 7 patients with parotid lymphoma, which was diagnosed at our hospital from 2012 to 2023.
RESULTS
All participants had a well-defined, homogeneous solid mass; moreover, 5 patients had bilateral multiple lymphadenopathy that was detected on neck computed tomography (CT). Three patients had lymphocyte-related findings in fine-needle aspiration cytology (FNAC).
CONCLUSION
Despite the challenges in diagnosing a parotid lymphoma, CT and FNAC findings can facilitate a differential diagnosis of parotid lymphoma.
Topics: Humans; Parotid Neoplasms; Lymphoma; Retrospective Studies; Sensitivity and Specificity; Parotid Gland
PubMed: 37542798
DOI: 10.1016/j.oraloncology.2023.106525 -
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 -
The Annals of Otology, Rhinology, and... Mar 2021Recent literature suggests that outpatient head and neck surgery is safe and may decrease costs. This study assesses whether outpatient parotidectomy differs in...
OBJECTIVES
Recent literature suggests that outpatient head and neck surgery is safe and may decrease costs. This study assesses whether outpatient parotidectomy differs in complication type and rate from inpatient surgery.
METHODS
Patients who underwent parotidectomy at our institution from 2011 to 2019 were retrospectively reviewed and divided by inpatient or outpatient status. Complications including infection, seroma, salivary fistula, hematoma, and flap necrosis, as well as readmission rates were tabulated. Drain placement, related to tumor size, was also analyzed using a receiver operating curve.
RESULTS
144 patients had available data for analysis. Nine of the 144 patients had complications. Seven of 98 outpatients and two of 46 inpatients had complications. There was no statistically significant difference in complication rate between the two groups ( = .518). Tumor size ≥4.62 cm was associated with drain placement ( = .044).
CONCLUSION
Outpatient parotidectomy is a safe and viable alternative for carefully selected patients.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures; Carcinoma, Mucoepidermoid; Cohort Studies; Facial Nerve Injuries; Female; Hospitalization; Humans; Male; Middle Aged; Otorhinolaryngologic Surgical Procedures; Parotid Diseases; Parotid Neoplasms; Postoperative Complications; Postoperative Hemorrhage; Retrospective Studies; Salivary Gland Calculi; Salivary Gland Fistula; Seroma; Surgical Flaps; Surgical Wound Infection; Young Adult
PubMed: 32672069
DOI: 10.1177/0003489420938101 -
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 -
Otolaryngology--head and Neck Surgery :... Jan 2021Parotid neoplasms are a rare heterogeneous group of tumors with varied clinical presentation and behavior. Here we provide an evidence-based review of the contemporary... (Review)
Review
OBJECTIVE
Parotid neoplasms are a rare heterogeneous group of tumors with varied clinical presentation and behavior. Here we provide an evidence-based review of the contemporary approach to evaluation and surgical management of parotid tumors.
DATA SOURCE
PubMed and Web of Science Databases.
REVIEW METHODS
Searches of the PubMed and Web of Science databases were performed on subjects related to the diagnosis and surgical management of parotid neoplasms. Particular emphasis was placed on the following areas: evaluation of parotid tumors, including imaging workup and the utility of fine-needle aspiration; extent of surgery of the primary lesion, including the extent of parotidectomy as well as oncologic management of the facial nerve; the extent of surgery of involved and at-risk cervical lymphatics; and parotid bed reconstruction. Articles published from 2014 to the present were prioritized, supplementing with information from prior studies in areas where data are lacking.
CONCLUSION
A summary of the literature in these areas is outlined to provide an evidence-based approach to evaluation and management of parotid neoplasms.
IMPLICATIONS FOR PRACTICE
While data are available to help guide many aspects of workup and management of parotid neoplasms, further research is needed to refine protocols for this heterogeneous group of diseases.
Topics: Biopsy, Fine-Needle; Diagnosis, Differential; Diagnostic Imaging; Facial Nerve; Facial Paralysis; Humans; Neck Dissection; Parotid Neoplasms; Postoperative Complications; Plastic Surgery Procedures
PubMed: 32571148
DOI: 10.1177/0194599820932512 -
Annales de Pathologie May 2024First case of radiation-induced parotid leiomyosarcoma.
INTRODUCTION
First case of radiation-induced parotid leiomyosarcoma.
ANATOMO-CLINICAL OBSERVATION
A 50-year-old woman with a history of cervical irradiation for Hodgkin's lymphoma presented with a right parotid tumefaction. Examination noted a deep adherent pretragal mass with peripheral facial palsy. A total parotidectomy with intra-operative examination and cervical curage was performed. Histopathological analysis concluded to a grade 3 parotid leiomyosarcoma according to the National Federation of Cancer Centers. Adjuvant radiotherapy was performed. After 24 months of follow-up, the patient presented bone and liver metastases without local recurrence.
DISCUSSION
This is the first case of radiation-induced leiomyosarcoma and the 12th case of parotid leiomyosarcoma described in the literature. The management associates surgery with adjuvant radiotherapy. Follow-up is by clinical examination, parotid MRI, and annual thoracoabdominal CT scan to search for metastases. Recurrences occur during the first year in 40 to 64% of cases, and distant metastases in 40 to 60% of cases. The 5-year survival rate is between 10 and 30%.
Topics: Humans; Leiomyosarcoma; Parotid Neoplasms; Middle Aged; Female; Neoplasms, Radiation-Induced; Hodgkin Disease; Radiotherapy, Adjuvant
PubMed: 38448265
DOI: 10.1016/j.annpat.2024.02.007 -
Auris, Nasus, Larynx Jun 2020An 18-year-old man had a painless, elastic, firm mass in his left parotid area that gradually increased in size over a period of 6 months. At the time of examination,... (Review)
Review
An 18-year-old man had a painless, elastic, firm mass in his left parotid area that gradually increased in size over a period of 6 months. At the time of examination, the parotid mass was poorly mobile and 46 mm in size. Although fine needle aspiration cytology revealed no malignant findings, we suspected a malignancy because the movement of his left mouth angle was slightly impaired; facial nerve paralysis as a result of tumor invasion was suspected. A superficial parotidectomy was performed. The tumor had a strong adhesion to the subcutaneous tissue and facial nerve. Histologically, multiple, randomly distributed cystic structures containing keratinized lamellae were present. The cystic spaces were lined with stratified squamous epithelium lacking a granular layer, and no skin appendage was observed. We diagnosed this case as a keratocystoma. Keratocystoma of the parotid gland is a rare benign tumor with only 6 cases reported worldwide. This case is the first to describe facial nerve palsy in association with a keratocystoma.
Topics: Adolescent; Adult; Child; Epithelium; Facial Paralysis; Female; Humans; Male; Middle Aged; Parotid Gland; Parotid Neoplasms; Tomography, X-Ray Computed
PubMed: 31230813
DOI: 10.1016/j.anl.2019.05.006 -
The Journal of Laryngology and Otology Sep 2021Parotid incidentalomas on fluorodeoxyglucose positron emission tomography/computed tomography imaging are rare. A systematic review was performed to assess their...
OBJECTIVE
Parotid incidentalomas on fluorodeoxyglucose positron emission tomography/computed tomography imaging are rare. A systematic review was performed to assess their aetiology and association with scanning indication, and to develop an evidence-based algorithm for their management.
METHODS
A literature search was performed on 25 August 2020 using the keywords 'incidentaloma', 'incidental finding', 'parotid', 'parotid gland', 'salivary gland' and 'head and neck'. Articles were reviewed by two authors before their inclusion.
RESULTS
Forty articles were included, totalling 558 incidentalomas. The mean incidence was 0.74 per cent. Lung cancer was the most common imaging indication. The most common aetiologies were cystadenolymphoma, pleomorphic salivary adenoma and metastases. Only cystadenolymphoma (p = 0.015) and pleomorphic salivary adenoma (p = 0.011) were significantly associated with a primary malignancy (lung). The most common further investigations were aspiration cytology, ultrasound imaging and core biopsy, usually prior to parotidectomy.
CONCLUSION
If appropriate, parotid incidentalomas should be followed up with flexible endoscopy, skin examinations, and head and neck examinations. Ultrasound-guided core biopsy provides higher accuracy, avoiding repeat sampling and excision biopsy.
Topics: Fluorodeoxyglucose F18; Humans; Incidence; Incidental Findings; Parotid Gland; Parotid Neoplasms; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals
PubMed: 34308809
DOI: 10.1017/S0022215121002036 -
Head and Neck Pathology Jun 2021Sebaceous lymphadenoma is a rare salivary gland neoplasm most commonly occurring in the sixth to eighth decades of life. Cross sectional imaging typically demonstrates a...
Sebaceous lymphadenoma is a rare salivary gland neoplasm most commonly occurring in the sixth to eighth decades of life. Cross sectional imaging typically demonstrates a multicystic expansile mass, most commonly occurring in the parotid gland, where the radiographic differential diagnosis would include Warthin tumor in this location and age group. Ultimately, the diagnosis is confirmed with the histopathologic findings of tubuloglandular epithelial profiles with sebaceous differentiation and cystic change set within a dense, benign lymphocytic infiltrate. These features are exemplified in this sine qua non radiology-pathology correlation article.
Topics: Aged, 80 and over; Humans; Male; Neoplasms, Glandular and Epithelial; Parotid Neoplasms
PubMed: 33398686
DOI: 10.1007/s12105-020-01266-5 -
International Journal of Clinical... Jul 2021Detailed clinical features other than parotid mass have not been investigated in detail for parotid tumors. Symptoms and signs are useful for the differentiation of... (Review)
Review
BACKGROUND
Detailed clinical features other than parotid mass have not been investigated in detail for parotid tumors. Symptoms and signs are useful for the differentiation of benign versus malignant, and may also be of value to determine the grade of malignancy and histological type as well as the assessment of prognosis.
METHODS
We reviewed symptoms and signs of 965 patients with benign tumors and 200 patients with malignant tumors. Symptoms and signs included pain/tenderness, adhesion to surrounding tissues, and facial nerve palsy. We reviewed the incidence in benign and malignant tumors, in histological type of benign tumors, and in grade and histology of malignant tumors. For each symptom or sign, covariates were analyzed, and their correlation with the prognosis was investigated.
RESULTS
The incidence of symptoms and signs was significantly higher in malignant than benign tumors, and more frequent in higher grade of malignancy. Facial nerve palsy was observed in 18.0% of malignant tumor cases, while none occurred in benign tumor cases. Pain/tenderness was more commonly observed in adenoid cystic carcinoma, while adhesion to surrounding tissues and facial nerve palsy were most frequently noted in salivary duct carcinoma. The prognosis of patients with these symptoms and signs was significantly poor.
CONCLUSION
A detailed investigation of symptoms and signs in parotid gland tumors is the first step that leads to the diagnosis of malignant tumors. Symptoms and signs are also useful for estimating the grade of malignancy and histological type, and they are important information for predicting prognosis.
Topics: Carcinoma, Adenoid Cystic; Facial Paralysis; Humans; Parotid Neoplasms; Retrospective Studies; Salivary Gland Neoplasms
PubMed: 33826026
DOI: 10.1007/s10147-021-01901-3