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Annals of Palliative Medicine Aug 2022Multiple synchronous neoplasms in the ipsilateral parotid gland are very rare. We intend to analyze the clinical characteristics and treatment results of multiple...
BACKGROUND
Multiple synchronous neoplasms in the ipsilateral parotid gland are very rare. We intend to analyze the clinical characteristics and treatment results of multiple synchronous neoplasms in the ipsilateral parotid gland managed at our hospital.
METHODS
The study included 21 patients of multiple synchronous neoplasms in the ipsilateral parotid gland from January 2010 to December 2020.
RESULTS
Twenty-one cases of multiple synchronous neoplasms in the ipsilateral parotid gland were identified among 994 cases of parotid surgery, with a frequency of 2.1%. Multiple synchronous neoplasms in the ipsilateral parotid gland occurred in all males and one female. Except for one case, all of them involved histopathologic neoplasms. Warthin tumor (n=19, 90.5%) was the most common. Among 21 lesions, there were 9 patients of right parotid gland, 4 patients of left parotid gland, and 4 patients of bilateral parotid gland. The main symptoms were slowly enlarging mass within the parotid gland (n=20), followed by incidental detection (n=1).
CONCLUSIONS
Clinicians should be aware of the possibility of multiple synchronous neoplasms in the ipsilateral parotid gland. Preoperative imaging tests, clinical examinations, and careful palpation during surgery are important for accurate diagnosis and treatment.
Topics: Adenolymphoma; Female; Humans; Male; Neoplasms, Multiple Primary; Parotid Gland; Parotid Neoplasms; Tomography, X-Ray Computed
PubMed: 35815451
DOI: 10.21037/apm-22-307 -
International Journal of Surgical... Apr 2023. Metastasis to parotid gland occurs mostly from skin cancers of the head and neck region. Metastatic neuroendocrine tumors to the parotid gland are rare and not well...
. Metastasis to parotid gland occurs mostly from skin cancers of the head and neck region. Metastatic neuroendocrine tumors to the parotid gland are rare and not well studied so far. In this study, we undertook a retrospective review of secondary neuroendocrine tumors of the parotid diagnosed in our institution. The most common entities, primary tumor locations, their clinical presentations and histopathological features were analyzed. . Cases of secondary neuroendocrine tumors to parotid diagnosed from August 1995 to Jan 2021 were retrieved from our institution's pathology databases, and their clinicopathological features were reviewed. . About 29% (120 of 420 cases) of parotid neoplasms were malignant, including 70 cases of parotid primary malignant tumors and 50 cases of metastases to parotid glands. Among metastatic tumors to the parotid glands, squamous cell carcinoma and melanoma of the head and neck region together accounted for about 78% of the cases. Only 11 of 50 metastatic tumors to the parotid were neuroendocrine carcinomas (22%). The most common primaries were poorly differentiated neuroendocrine carcinoma of lung (5 of 11 cases), including 4 cases of small cell carcinoma and one case of large cell neuroendocrine carcinoma. The second most common secondary tumor was Merkel cell carcinoma (4 of 11 cases, 36%) including one case of direct invasion from overlying skin. Medullary carcinoma of the thyroid comprised the rest of the metastases to the parotid (2 of 11 cases, 18%). . Our results show that metastatic neuroendocrine carcinomas to the parotid gland account for about 22% of all metastatic tumors to the organ. Lung is the most common primary neuroendocrine carcinoma location. It is not uncommon for metastatic neuroendocrine carcinoma to present as the first sign of systemic clinical manifestation. Merkel cell carcinoma is the second most common entity that metastasizes to parotid, followed by medullary carcinoma of the thyroid.
Topics: Humans; Parotid Gland; Carcinoma, Merkel Cell; Neuroendocrine Tumors; Carcinoma, Medullary; Carcinoma, Neuroendocrine; Parotid Neoplasms; Skin Neoplasms
PubMed: 35466730
DOI: 10.1177/10668969221095267 -
Journal of the Egyptian National Cancer... Feb 2023Childhood parotid neoplasms appear to have different characteristics from adults. This point, in addition to the rarity of these tumors, reflects the challenges faced in...
BACKGROUND
Childhood parotid neoplasms appear to have different characteristics from adults. This point, in addition to the rarity of these tumors, reflects the challenges faced in diagnosing and treating parotid neoplasms in children.
PATIENTS AND METHODS
This retrospective study included all children who presented to the Children's Cancer Hospital Egypt (CCHE, 57357) with parotid masses from January 2008 to December 2020.
RESULTS
Twenty-one patients were included. Malignant neoplasms were found in 12 (57.1%) of which mucoepidermoid carcinoma was the most common. Benign neoplasms were found in 6 (28.6%) all of them were pleomorphic adenoma, and non-neoplastic lesions were found in 3 (14.3%). Superficial, deep, or total parotidectomy was performed according to the involved lobes. The facial nerve was sacrificed in three cases because of frank invasion by the tumor. Neck dissection was considered in clinically positive lymph nodes and/or T3/4 masses. Complications occurred in 7 (33.3%) all were of the malignant cases. Adjuvant radiotherapy was restricted to high-risk cases (7 cases). Recurrence occurred in two cases, and one patient died of distant metastasis. Fine needle aspiration cytology (FNAC) showed 88.9% sensitivity and 100% specificity for diagnosing malignant neoplasms. The correlation of radiological and pathological staging was fair (66.74% for overall staging).
CONCLUSIONS
Parotidectomy is the backbone treatment for benign and malignant pediatric parotid tumors. Neck nodal dissection should be considered after preoperative FNAC of suspicious nodes. Adjuvant radiotherapy is considered only in high-risk tumors. Preoperative FNAC of parotid masses and clinically suspicious lymph nodes is highly recommended.
Topics: Adult; Humans; Child; Parotid Neoplasms; Parotid Gland; Retrospective Studies; Biopsy, Fine-Needle; Adenoma, Pleomorphic
PubMed: 36740629
DOI: 10.1186/s43046-023-00161-8 -
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 -
The Pan African Medical Journal 2022Tumors of the parotid gland can be challenging if left untreated. We report three cases of patients with initial clinical and therapeutic manifestations of neglected...
Tumors of the parotid gland can be challenging if left untreated. We report three cases of patients with initial clinical and therapeutic manifestations of neglected parotid tumours in Madagascar: two women and one man aged 42, 47 and 51 years, with tumours that had been developing for 4, 7 and 11 years respectively. One patient was suspected to have malignant tumour due to skin necrosis. The diagnosis was then confirmed by cytopuncture. After obtaining the informed consent, total parotidectomy was performed in all patients. Facial nerve sacrifice with cervical lymph node dissection was established in the patient with a malignant tumour. No intraoperative adverse events were reported. Parotid tumors can become cancerous without proper treatment. Socio-economic factors are involved in delayed consultation. However, early consultation in patients with parotid tumors would prevent management risks.
Topics: Male; Humans; Female; Parotid Neoplasms; Adenoma, Pleomorphic; Parotid Gland; Lymph Node Excision; Risk Management; Retrospective Studies
PubMed: 36915420
DOI: 10.11604/pamj.2022.43.184.29628 -
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 -
Current Oncology Reports Feb 2022This paper analyzed previous research data to identify the most important issues to be considered during treatment of parotid gland cancer (PGC) and reviewed recent... (Review)
Review
PURPOSE OF REVIEW
This paper analyzed previous research data to identify the most important issues to be considered during treatment of parotid gland cancer (PGC) and reviewed recent advancements in techniques in parotid surgery.
RECENT FINDINGS
For successful treatment of PGC, a preoperative surgical plan should be designed with consideration of the histologic characteristics and anatomical complexity of the tumor, and the functional and anatomical integrity of the facial nerve should be carefully inspected during surgery and damage to the nerve minimized. The need for adjuvant radiotherapy should be determined based on intraoperative findings and pathologic findings of the specimen after surgery. Surgery and radiotherapy are the main treatment options for PGC. To optimize treatment outcomes for PGC, the extent of surgery should be decided according to histologic characteristics and extent of tumor resection, and use of adjuvant radiotherapy should be considered based on risk stratification.
Topics: Facial Nerve; Humans; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Radiotherapy, Adjuvant; Retrospective Studies; Robotic Surgical Procedures
PubMed: 35061197
DOI: 10.1007/s11912-021-01167-y -
Computational and Mathematical Methods... 2021To investigate the correlation between sonographic and computed tomography and pathological features of basal cell adenomas (BCAs) of the parotid gland.
PURPOSE
To investigate the correlation between sonographic and computed tomography and pathological features of basal cell adenomas (BCAs) of the parotid gland.
METHODS
This retrospective study included 41 patients (43 tumors) with BCAs. The tumors were divided into three types based on their location in the parotid gland and their imaging features. The features of the tumors were analyzed.
RESULTS
Imaging manifestations and corresponding pathological results of most BCAs of the parotid glands resembled those of benign parotid gland tumors. Malignant transformation occurred in membranous BCAs and in those with extensive cribriform structures. Type-II and type-III tumors accounted for 82.93% of the total proportion. Thirteen tumors showed cystic degeneration with 30.23%, among which type-III tumors could easily develop cystic degeneration. These cystic areas might correspond to cystic degeneration or focal necrosis. Cystic change was not dependent on the tumor size. The pathological features of the tumors were correlated to their imaging manifestations.
CONCLUSION
Most BCAs of the parotid glands have imaging manifestations similar to those of benign parotid gland tumors. BCAs with extensive cribriform structures and of the membranous type can show malignant transformation and should be treated with caution in clinical practice.
Topics: Adenoma; Adult; Aged; Aged, 80 and over; Computational Biology; Female; Humans; Immunohistochemistry; Male; Middle Aged; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Tomography, X-Ray Computed; Ultrasonography; Young Adult
PubMed: 34912472
DOI: 10.1155/2021/7906058 -
Clinical & Experimental Metastasis Feb 2024In parotid gland cancer (PGC), cervical lymph node metastasis (LNM) and intra-parotid LNM are known as significant indicators of poor prognosis. However, the topography...
In parotid gland cancer (PGC), cervical lymph node metastasis (LNM) and intra-parotid LNM are known as significant indicators of poor prognosis. However, the topography of LNM in the affected parotid gland and the lymphatic progression of PGC has never been explored in detail. This was a retrospective analysis of data from 423 patients with previously untreated primary PGC (2005 to 2020), excluding patients with squamous cell carcinoma, lymphoma or metastatic disease in the parotid gland. The pattern of LNM was analyzed by neck sub-level and parotid sub-site. Using the conditional probability of neck level involvement, a probability diagram was plotted on several thresholds to visualize the sequential progression of LNM in PGC. The pattern of LNM progression was found to be similar between low- and high-grade pathology, but the incidence differed significantly (8.0% vs. 45.4%). Intra-parotid LNs and level IIa LNs were the most common sites (57.3% and 61.0%) of LNM in PGC, followed by level III (31.7%), Ib (25.6%), IV (22.0%), IIb (20.7%) and Va (20.7%) LNM. In intra-parotid LNs, the incidence of LNM in the deep parotid LNs was relatively low (9.4%); most intra-parotid LNMs were observed in the superficial parotid (90.6%) and peri-tumoral (in contact with the tumor) (31.3%) LNs. LNM to levels Ia, Vb and contra-lateral LNM occurred only in the very late stage. Our results provide detailed information about LNM progression in PGC at the sub-level and can help clinicians decide the treatment extent, including surgery or radiation.
Topics: Humans; Parotid Gland; Lymphatic Metastasis; Retrospective Studies; Neoplasm Staging; Lymph Nodes; Parotid Neoplasms
PubMed: 38079016
DOI: 10.1007/s10585-023-10244-4 -
Diagnostic Cytopathology Dec 2022Tubercular infection of the parotid gland often confuses clinicians, it being a rare entity even in an endemic area. Its similarity in presentation with that of parotid... (Review)
Review
Tubercular infection of the parotid gland often confuses clinicians, it being a rare entity even in an endemic area. Its similarity in presentation with that of parotid neoplasms, nonspecific symptoms, low incidence and non-contributory radiological findings often leads to its misdiagnosis as parotid neoplasm, which in the due course results in parotidectomy. Therefore, FNAC of parotid swelling is helpful to avoid unnecessary surgery and patient discomfort. We report four cases of FNAC of parotid swelling with suspicion of neoplasm/inflammatory lesion and were diagnosed as tuberculosis of the parotid gland. They were advised antitubercular drugs for 6 months and followed up. These case are reported not just to highlight that parotid is a rare site for tuberculosis, but also to ascertain that FNAC can be an easy and fast diagnostic modality for confirmation of tubercular parotitis rather than going through the long way of resection and confirmation on histopathology.
Topics: Humans; Parotid Gland; Tuberculosis; Parotid Neoplasms; Antitubercular Agents; Biopsy, Fine-Needle
PubMed: 35924792
DOI: 10.1002/dc.25023