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International Journal of Oral Science Aug 2019The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour. For salivary gland... (Review)
Review
The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour. For salivary gland tumours, conservative and functional salivary surgery, including partial sialoadenectomy as well as anatomical and functional preservation of the facial nerve, great auricular nerve, superficial musculo-aponeurotic system (SMAS), and Stensen's duct, has become increasingly popular. In the present review, we discuss the following aspects of conservative and functional surgery in the treatment of salivary gland tumours: (i) partial superficial parotidectomy (PP) to treat benign parotid gland tumours, (ii) modification of surgical incisions to improve cosmetic results, (iii) modification of the surgical approach to decrease complications, (iv) extracardial dissection to treat benign superficial parotid tumours, (v) partial sialoadenectomy to treat benign submandibular gland tumours, and (vi) I brachytherapy to preserve facial nerves. The majority of the operated parotid or submandibular glands are preserved, and surgical complications are also decreased. Conservative and functional surgery plays a significant role in maintaining normal salivary gland function and in improving patients' quality of life during the treatment of salivary gland tumours and thus should be further promoted.
Topics: Conservative Treatment; Humans; Parotid Gland; Parotid Neoplasms; Quality of Life; Salivary Gland Neoplasms; Submandibular Gland; Submandibular Gland Neoplasms
PubMed: 31413317
DOI: 10.1038/s41368-019-0059-9 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Oct 2021Parotid gland tumors are usually solitary tumors, and multiple tumors of the parotid gland are extremely rare. We present a highly unusual case of bilateral and... (Review)
Review
Parotid gland tumors are usually solitary tumors, and multiple tumors of the parotid gland are extremely rare. We present a highly unusual case of bilateral and simultaneous pleomorphic adenoma and basal cell adenoma of the parotid gland. We review the literature and discuss the clinical manifestations, diagnosis, and treatment of these two rare tumors.
Topics: Adenoma, Pleomorphic; Humans; Parotid Gland; Parotid Neoplasms
PubMed: 34636212
DOI: 10.7518/hxkq.2021.05.018 -
Journal of Oral and Maxillofacial... 2021Documentation of metastatic lesions in the parotid gland diagnosed by fine-needle aspiration cytology (FNAC) is limited in the cytopathology literature. The metastases...
Documentation of metastatic lesions in the parotid gland diagnosed by fine-needle aspiration cytology (FNAC) is limited in the cytopathology literature. The metastases within the parotid masquerades clinically as primary neoplasm of parotid. The authors of present case report intent to highlight the importance of FNAC in the diagnosis of metastases in parotid. These diagnoses enable the search for the locations of unknown primaries. The nodules within the parotid masquerading as primary neoplasm have undergone FNAC in five cases. The cytomorphological interpretation of the smears was performed. The diagnosis on cytology was compared with subsequent histological evaluation of the suggested primary neoplasm. FNAC in the five cases revealed the following cytodiagnosis: metastases of ductal carcinoma (2), melanoma (1), deposits of small cell carcinoma (1) and metastases of clear cell renal cell carcinoma (RCC) (1). There was complete concordance when these cytodiagnoses were compared with histological evaluation from the suggested sites of primaries as well-differentiated ductal carcinoma of the breast (2), melanoma of the scalp (1), small cell carcinoma of the lung (1) and clear cell RCC of the kidney (1). The metastases within the parotid can masquerade as primary neoplasm. The cytomorphological patterns and features of metastases are similar to that of their primary neoplasm. Therefore, FNAC over the nodules within the parotid unsuspected for metastases provides valuable information to search for primary neoplasm.
PubMed: 34349431
DOI: 10.4103/jomfp.JOMFP_267_20 -
Cancer Medicine Jan 2023We analyzed the patterns of lymph node (LN) failure and prognosis in patients with regional recurrent nasopharyngeal carcinoma (rNPC) alone after primary...
OBJECTIVE
We analyzed the patterns of lymph node (LN) failure and prognosis in patients with regional recurrent nasopharyngeal carcinoma (rNPC) alone after primary intensity-modulated radiotherapy (IMRT).
METHODS
A total of 175 patients who were treated with IMRT between 2010 and 2015 and who experienced regional recurrence alone were included. Recurrent LNs were re-located in the initial pretreatment imaging and IMRT plan and failures were classified as in-field or out-field based on target volume delineation. All patients underwent curative salvage treatment. Independent prognostic factors for overall survival (OS) were selected by multivariate Cox analysis.
RESULTS
Level IIb (49.1%, 86/175) was the most frequent recurrence site, followed by level IIa (36%), level III (18.9%), level IVa (12%), the retropharyngeal region (8%), level Va (6.9%), and the parotid region (6.9%). A total of 264 recurrent LNs were recorded: 149 (56.4%) were classified as in-field failure with a prescribed dose ≥66 Gy, 60 (22.7%) with 60 to <66 Gy, 32 (12.1%) with 50 to <60 Gy, and 23 (8.7%) as an out-field failure, which mainly occurred in the parotid region and level Ib. After a median follow-up of 52.8 months, the estimated 5-year OS rate was 66.9%. Multivariate analysis showed that age, plasma Epstein-Barr virus DNA level, extranodal extension, lower neck involvement, and parotid LN recurrence were independent prognostic factors of OS.
CONCLUSIONS
In-field failure represented the main pattern of regional recurrence and out-field failure mainly occurred in the parotid gland and level Ib. Patients with regional rNPC alone had a good prognosis after salvage treatment.
Topics: Humans; Nasopharyngeal Carcinoma; Radiotherapy, Intensity-Modulated; Nasopharyngeal Neoplasms; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Neoplasm Recurrence, Local; Prognosis; Follow-Up Studies; Retrospective Studies; Neoplasm Staging
PubMed: 35822664
DOI: 10.1002/cam4.5020 -
BMC Medical Imaging Nov 2022Imaging of parotid gland tumors is challenging due to the wide variety of differential diagnoses. Malignant parotid tumors can have very similar features to benign ones,...
Imaging of parotid gland tumors is challenging due to the wide variety of differential diagnoses. Malignant parotid tumors can have very similar features to benign ones, such as slow growth and displacement instead of infiltration of neighboring structures. Malignant and benign tumors may therefore not be clinically distinguishable. Correct characterization of parotid tumors (i.e., benign or malignant) determines preoperative treatment planning and is important in optimizing the individualized surgical plan. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluation of suspected parotid gland lesions and differentiation between benign and malignant lesions. Certain conventional MRI features can suggest whether a mass is more likely to be a benign or low-grade malignancy or a high-grade malignancy and adding diffusion-weighted imaging or advanced MRI techniques like perfusion can aid in this distinction. Morphological features seen on MRI, such as low signal on T2-w, infiltrative changes or ill-defined margins, change over time and diffusion restriction can point to the malignant nature of the lesion. MRI is useful for detection and localization of the lesion(s), and associated findings like perineural spread of tumor, lymph node involvement and infiltrative changes of the surrounding tissues. In this pictorial essay, we present selected images of a variety of benign and malignant parotid tumors and emphasize the MRI features that may be useful in their characterization.
Topics: Humans; Parotid Neoplasms; Parotid Gland; Magnetic Resonance Imaging; Diffusion Magnetic Resonance Imaging; Diagnosis, Differential; Retrospective Studies
PubMed: 36344914
DOI: 10.1186/s12880-022-00924-0 -
Ear, Nose, & Throat Journal Nov 2023Apocrine hidrocystoma is a cystic tumor originating from apocrine sweat glands. It is predominantly located in the eyelid margins. Here, we report a case of apocrine...
Apocrine hidrocystoma is a cystic tumor originating from apocrine sweat glands. It is predominantly located in the eyelid margins. Here, we report a case of apocrine hidrocystoma of the parotid gland in a 19-year-old man who was referred to our outpatient clinic with a 5-year history of a gradual swelling in the left parotid region. The patient underwent left superficial parotidectomy. Histological examination confirmed the diagnosis of apocrine hidrocystoma. The case is original by the tumor's location: to the best of our knowledge, this could be the first case in English and French literature reporting an apocrine hidrocystoma affecting the parotid gland. The purpose of this article is to report our case and discuss its clinical and anatomopathological features as well as its differential diagnoses.
Topics: Male; Humans; Young Adult; Adult; Hidrocystoma; Parotid Gland; Sweat Gland Neoplasms; Eyelids; Diagnosis, Differential
PubMed: 34219505
DOI: 10.1177/01455613211031028 -
Annals of the Royal College of Surgeons... Jan 2021Parotid masses causing facial palsy are highly indicative of malignancy. A significant number of cases describing benign parotid disease causing facial palsy have been...
INTRODUCTION
Parotid masses causing facial palsy are highly indicative of malignancy. A significant number of cases describing benign parotid disease causing facial palsy have been reported.
MATERIALS AND METHODS
We performed a systematic review of the literature to establish the aetiology, clinical features, investigations and management undertaken during these presentations to assess how these factors differed from malignant presentations and to establish an evidence-based algorithm for their management.
RESULTS
A total of 85 cases were identified from 78 articles. Cystadenolymphomas were the most common histopathological type ( = 0.034). Mean facial palsy recovery duration in neoplastic aetiology was longer than for infective aetiology ( = 0.033). A significant association existed between uncommon infective organisms and development of facial palsy ( = <0.0001).
CONCLUSION
Uncommon benign aetiologies are associated with facial palsy. Investigations and management should be guided by patients' clinical presentations, avoiding excessive treatment. Complete facial palsy recovery rates are high, although not immediate.
Topics: Algorithms; Cystadenoma; Diagnosis, Differential; Evidence-Based Medicine; Facial Paralysis; Humans; Lymphoma; Parotid Gland; Parotid Neoplasms
PubMed: 32969265
DOI: 10.1308/rcsann.2020.0194 -
Otolaryngologia Polska = the Polish... Feb 2020The paper aims to demonstrate the Clinic's and own research in the treatment of major salivary gland tumors.
INTRODUCTION
The paper aims to demonstrate the Clinic's and own research in the treatment of major salivary gland tumors.
MATERIAL AND METHOD
In the years 2013-2019, there were 95 salivary gland surgeries, including 45 performed in women (47.36%) aged between 24 and 82 and in 50 men (52.64%) aged 29 to 86. Diagnostics of major salivary glands included: patient history, otolaryngological examination, ultrasound and fine needle aspiration (BACC) (of tumor), laboratory tests (morphology, CRP) and computed tomography (CT) or magnetic resonance imaging (MRI) to accurately assess salivary glands, location of lesion and lymph nodes prior to elective surgery. Research results: In the analyzed material patients with major salivary gland tumors were most frequently operated on at the age of 61-70 (34.7%) and 51-60 years (23.2%). Most patients with tumors were hospitalized in the last 4 years between 2016-2019, which accounted for 77.8% of all operated cases. Among the operated lesions, benign neoplasms and tumors occurred in 93.7%, of which the most frequent findings in histopathological examination were Warthin tumor in 50.5%, and multiform adenoma in 26.3%. The remaining tumors and benign neoplasms constituted only 16.9% and were observed in isolated cases, including eosinophilic adenoma, lymphoepithelial cyst, myoepithelial adenoma, lipofibrosarcoma, congestive cyst, air cyst, tubular adenoma, basal cell carcinoma, cyst with squamous metaplasia features, vascular malformation. Malignant salivary gland tumors were found in 6.3%, including the following malignant tumors were revealed histopathologically: adenocarcinoma, mucoepidermal carcinoma, acinocellular carcinoma, epithelialmyoepithelial carcinoma, ductal carcinoma.
CONCLUSIONS
The majority of operated salivary gland tumors were benign (93.7%), of which the most common histopathologically were: Warthin tumor (50.5%) and multiform adenoma (26.3%), while malignant tumors occurred in 6.3%. Tumors were localized mainly in the parotid gland in as many as 93.7% cases, of which the most common localization concerned the superficial lobe in 56.8%. The most frequent surgical technique used in the Clinic was extracapsular dissection of the tumor in 88.4%, and other methods were used rarely.
Topics: Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Carcinoma; Female; Humans; Male; Middle Aged; Neoplasm Staging; Neoplasms, Multiple Primary; Parotid Gland; Salivary Gland Neoplasms; Salivary Glands; Young Adult
PubMed: 32398385
DOI: 10.5604/01.3001.0013.6605 -
Turkish Journal of Medical Sciences Feb 2020To define the cytomorphologic findings leading to difficulties in diagnosis of Warthin tumors (WTs).
BACKGROUND/AIM
To define the cytomorphologic findings leading to difficulties in diagnosis of Warthin tumors (WTs).
MATERIALS AND METHODS
Forty-eight histopathologically diagnosed WT patients who had fine needle aspiration cytology preoperatively were reevaluated for defining the presence or absence of lymphocytes, oncocytic cell layer, oncocytic cell papillae, granular debris background, mucoid background, macrophages, polymorphonuclear cells, mast cells, squamous-like cells, atypical vacuolated cytoplasmic cells, and giant cells.
RESULTS
Forty-seven tumors were in the parotid gland and one in the submandibular gland. There were 37 (77%) male and 11 (23%) female patients. Cytopathologically in 36 patients the diagnosis was benign neoplasm (WT); in 6, other benign entities; and in 6, suspicious for malignancy. The main characteristic cytomorphologic features of WTs were as follows: 92% lymphoid cells, 83% oncocytic cell layers, and 67% granular debris background. These percentages were 67%, 17%, and 17% in the benign cytology group and 67%, 50%, and 17% in the suspicious for malignancy group, respectively.
CONCLUSION
Absence or lack of main features of WTs with or without presence of squamous-like cells, vacuolated cytoplasmic cells, and inflammatory reaction may cause diagnostic dilemma. The presence of the mast cells accompanied by epithelial tissue was striking for WT diagnosis.
Topics: Adenolymphoma; Biopsy, Fine-Needle; Diagnosis, Differential; Female; Humans; Male; Mast Cells; Parotid Gland; Parotid Neoplasms; Submandibular Gland; Submandibular Gland Neoplasms
PubMed: 31769640
DOI: 10.3906/sag-1901-215 -
Cancer Medicine Oct 2023Optimum management of the N0 neck is unresolved in parotid salivary gland cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis and... (Observational Study)
Observational Study
BACKGROUND
Optimum management of the N0 neck is unresolved in parotid salivary gland cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis and its´ clinical use is increasing for head and neck tumors. The object of this study was to establish whether the technique is applicable to detect distribution of sentinel nodes for parotid tumors.
MATERIALS AND METHODS
Prosepective observational study in 30 patients with benign or low-grade T1-T2N0 malignant tumors in the parotid gland planned for surgical treatment. Distribution of SN was detected with a preoperative ultrasound-guided peritumoral injection with a technetium-99 (Tc-99 m) laballed tracer followed by a SPECT-CT and intraoperative measurement in the neck and parotidal tissue. In patients with cytologically suspected malignant tumor or highly unclerar cytology, SNB was also performed.
RESULTS
Sentinel nodes (SNs) were detected in 26/30 cases. Out of these, 7 presented with only one SN, whereas multiple sentinel nodes where detected in 19 cases. No SNs were found in neck level 1. SN was detected in level 5 independent of tumor location within the parotid gland. An intraparotidal distribution of SNs was more frequent in larger tumors.
CONCLUSIONS
The use of SN-technique in the planning of surgical treatment of parotid tumors seems feasible. It may be of clinical value for patients with parotid cancer to enable a more accurate staging and to detect occult metastasis in the SNs within the parotid as well as in the neck, enabaling the possibility to surgically remove all positive SNs at primary surgery and with reduced surgical morbidity.
Topics: Humans; Parotid Neoplasms; Feasibility Studies; Sentinel Lymph Node Biopsy; Lymphatic Metastasis; Neck; Lymph Nodes; Neoplasm Staging
PubMed: 37776164
DOI: 10.1002/cam4.6612