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Indian Journal of Otolaryngology and... Jun 2023Retinoblastoma, the most common primary intraocular malignant neoplasm in young children, show frequent metastasis to lymph nodes, central nervous system and bones....
Retinoblastoma, the most common primary intraocular malignant neoplasm in young children, show frequent metastasis to lymph nodes, central nervous system and bones. However, retinoblastoma metastasizing to parotid gland is very rare. We here present 2 cases of isolated parotid gland metastasis in two children with unilateral retinoblastoma. Case 1 was a one-year-old child presenting with left globe lesion which was diagnosed as Retinoblastoma. Post chemotherapy, enucleation was done which on histopathology examination showed retinoblastoma with scleral invasion and anterior chamber seeding. On 3 month follow up, patient presented with left parotid swelling. He underwent Fine needle aspiration cytology (FNAC) and Core needle biopsy which confirmed retinoblastoma metastasizing to parotid following which superficial parotidectomy was done as it was a solitary hotspot on PET-CT followed by localized radiotherapy and chemotherapy. While case 2, a 6-year-old child presented with left parotid swelling with a history of undergoing enucleation 3 months earlier in an outside hospital; Enucleation slides were reviewed in addition to patient undergoing FNAC and Biopsy from parotid swelling, all of which were consistent with Retinoblastoma metastasizing to parotid; This patient was lost to follow up; Although rare with only a few case reports in literature, both the pathologist and the clinician should be aware of retinoblastoma metastasizing to parotid, which when diagnosed and treated promptly has overall better prognosis in the cases reported so far.
PubMed: 37275011
DOI: 10.1007/s12070-022-03287-8 -
Molecules (Basel, Switzerland) Sep 2023Triple-negative breast cancer (TNBC) is a highly aggressive type of breast cancer and has a poor prognosis. As standardized TNBC treatment regimens cause drug resistance...
Triple-negative breast cancer (TNBC) is a highly aggressive type of breast cancer and has a poor prognosis. As standardized TNBC treatment regimens cause drug resistance and tumor recurrence, the development of new TNBC treatment strategies is urgently required. Bufotalin is a bufadienolide isolated from the skin and parotid venom glands of the toad , and has several pharmacological properties, including antiviral, anti-inflammatory, and anticancer activities. However, the anticancer effect and underlying molecular mechanisms of action of bufotalin in TNBC have not been fully studied. In the current study, we investigated the effects of bufotalin on the growth and metastasis of MDA-MB-231 and HCC1937 TNBC cells. Bufotalin potently inhibited the proliferation of both TNBC cell lines by promoting cell cycle arrest and caspase-mediated apoptosis. Furthermore, bufotalin effectively suppressed the migration and invasion of both TNBC cell lines by regulating the expression of key epithelial-mesenchymal transition (EMT) biomarkers, matrix metalloproteinases (MMPs), and integrin α6. Notably, the anticancer effect of bufotalin in TNBC cells was associated with the downregulation of the signal transducer and activator of the transcription 3 (STAT3) signaling pathway. Collectively, our results suggest that the natural compound bufotalin may exert antiproliferative and antimetastatic activities in TNBC cells by modulating the apoptotic pathway and the STAT3/EMT axis.
Topics: Humans; Triple Negative Breast Neoplasms; Epithelial-Mesenchymal Transition; Neoplasm Recurrence, Local; Apoptosis; Bufanolides; Cell Proliferation; Cell Line, Tumor; Cell Movement; STAT3 Transcription Factor
PubMed: 37836626
DOI: 10.3390/molecules28196783 -
Diagnostics (Basel, Switzerland) Nov 2020Our purpose is to evaluate the performance of magnetic resonance (MR) radiomics analysis for differentiating between malignant and benign parotid neoplasms and, among...
Our purpose is to evaluate the performance of magnetic resonance (MR) radiomics analysis for differentiating between malignant and benign parotid neoplasms and, among the latter, between pleomorphic adenomas and Warthin tumors. We retrospectively evaluated 75 T2-weighted images of parotid gland lesions, of which 61 were benign tumors (32 pleomorphic adenomas, 23 Warthin tumors and 6 oncocytomas) and 14 were malignant tumors. A receiver operating characteristics (ROC) curve analysis was performed to find the threshold values for the most discriminative features and determine their sensitivity, specificity and area under the ROC curve (AUROC). The most discriminative features were used to train a support vector machine classifier. The best classification performance was obtained by comparing a pleomorphic adenoma with a Warthin tumor (yielding sensitivity, specificity and a diagnostic accuracy as high as 0.8695, 0.9062 and 0.8909, respectively) and a pleomorphic adenoma with malignant tumors (sensitivity, specificity and a diagnostic accuracy of 0.6666, 0.8709 and 0.8043, respectively). Radiomics analysis of parotid tumors on conventional T2-weighted MR images allows the discrimination of pleomorphic adenomas from Warthin tumors and malignant tumors with a high sensitivity, specificity and diagnostic accuracy.
PubMed: 33153140
DOI: 10.3390/diagnostics10110900 -
Cancer Cytopathology Apr 2022Fine-needle aspiration (FNA) is the preferred diagnostic test for salivary gland lesions. The purpose of the Milan System for Reporting Salivary Gland Cytopathology...
Utility of the Milan System for Reporting Salivary Gland Cytology, with focus on the incidence and histologic correlates of atypia of undetermined significance (AUS) and salivary gland neoplasm of uncertain malignant potential (SUMP): A 3-year institutional experience.
BACKGROUND
Fine-needle aspiration (FNA) is the preferred diagnostic test for salivary gland lesions. The purpose of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is to standardize salivary gland cytology reporting and guide treatment decisions. The objective of the current study was to evaluate the utility and performance of the MSRSGC, with a focus on the cytomorphology of lesions diagnosed as atypia of undetermined significance (AUS) and salivary gland neoplasm of uncertain malignant potential (SUMP).
METHODS
In total, 123 salivary gland FNAs were included in the study. FNA diagnoses for all cases were reviewed and recategorized, as applicable, according to the MSRSGC. Cytohistologic correlation was performed in 51 cases that had available surgical follow-up, and the risk of malignancy (ROM) was calculated.
RESULTS
Most FNA samples were from the parotid gland. The mean patient age was 61.4 years, and the male-to-female ratio was 1.3:1. The ROM was 0% (categories I and II; nondiagnostic and benign nonneoplastic, respectively), 50% (category III; AUS), 0% (category IVA; benign neoplasm), 40% (category IVB; SUMP), 100% (category V; suspicious for malignancy), and 100% (category VI; malignant). Sensitivity, specificity, positive predictive value, and negative predictive value were 100% each. In addition, the primary factors for an AUS diagnosis were identified as low cellularity and/or the presence of lymphocytes. The presence of oncocytes followed by cellular atypia in an otherwise classic pleomorphic adenoma were principal factors for a SUMP diagnosis.
CONCLUSIONS
The authors report an ROM comparable to that reported in the literature, with a sensitivity and specificity of 100%, supporting adaptation of the MSRSGC into the system for reporting salivary gland cytology. In addition, the findings emphasize the need to refine criteria for AUS and SUMP, thereby improving the predictive capability and subsequent management of salivary gland lesions.
Topics: Cytodiagnosis; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands
PubMed: 34875145
DOI: 10.1002/cncy.22538 -
European Radiology Apr 2022To assess the usefulness of combined diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of parotid gland tumors.
OBJECTIVE
To assess the usefulness of combined diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of parotid gland tumors.
METHODS
Seventy patients with 80 parotid gland tumors who underwent DKI and DCE-MRI were retrospectively enrolled and divided into four groups: pleomorphic adenomas (PAs), Warthin tumors (WTs), other benign tumors (OBTs), and malignant tumors (MTs). DCE-MRI and DKI quantitative parameters were measured. The Kruskal-Wallis H test and post hoc test with Bonferroni correction and ROC curve were used for statistical analysis.
RESULTS
WTs demonstrated the highest K value (median 1.89, interquartile range [1.46-2.31] min) but lowest V value (0.20, [0.15-0.25]) compared with PAs (K, 0.34 [0.21-0.55] min; V, 0.36 [0.24-0.43]), OBTs (K, 1.22 [0.27-1.67] min; V, 0.28 [0.25-0.41]), and MTs (K, 0.71 [0.50-1.23] min; V, 0.35 [0.26-0.45]) (all p < .05). MTs had the lower D value (1.10, [0.88-1.29] × 10 mm/s) compared with PAs (1.81, [1.60-2.20] × 10 mm/s) and OBTs (1.57, [1.32-1.89] × 10 mm/s) (both p < .05). PAs had the lower K value (0.12, [0.07-0.18] min) compared with OBTs (0.28, [0.11-0.50] min) (p < .05). The cutoff values of combined K and V, D, and K to distinguish WTs, MTs, and PAs sequentially were 1.06 min, 0.28, 1.46 × 10 mm/s, and 0.21 min, respectively (accuracy, 89% [71/80], 91% [73/80], 78% [62/80], respectively).
CONCLUSION
The combined use of DKI and DCE-MRI may help differentiate parotid gland tumors.
KEY POINTS
• The combined use of DKI and DCE-MRI could facilitate the understanding of the pathophysiological characteristics of parotid gland tumors. • A stepwise diagnostic diagram based on the combined use of DCE-MRI parameters and the diffusion coefficient is helpful for accurate preoperative diagnosis in parotid gland tumors and may further facilitate the clinical management of patients.
Topics: Contrast Media; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Magnetic Resonance Imaging; Parotid Gland; Parotid Neoplasms; Retrospective Studies
PubMed: 34642805
DOI: 10.1007/s00330-021-08312-y -
European Journal of Radiology Jan 2022Parotid tumours (PTs) have a variety of pathological types, and the surgical procedures differ depending on the tumour type. However, accurate diagnosis of PTs from the...
BACKGROUND
Parotid tumours (PTs) have a variety of pathological types, and the surgical procedures differ depending on the tumour type. However, accurate diagnosis of PTs from the current preoperative examinations is unsatisfactory.
METHODS
This retrospective study was approved by the Ethics Committee of our hospital, and the requirement for informed consent was waived. A total of 73 patients with PTs, including 55 benign and 18 malignant tumours confirmed by surgical pathology, were enrolled. All patients underwent diffusion-weighted imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), susceptibility-weighted imaging (SWI), T2-weighted imaging (T2WI), and T1-weighted imaging (T1WI). The signal uniformity and capsule on T2WI, apparent diffusion coefficient (ADC) derived from DWI, semi-quantitative parameter time-intensity curve (TIC) pattern, and quantitative parameters including transfer constant (K), extravascular extracellular volume fraction (V), wash-out constant (K) calculated from DCE-MRI, and intratumoural susceptibility signal (ITSS) obtained from SWI were assessed and compared between benign and malignant PTs. Logistic regression analysis was used to select the predictive parameters for the classification of benign and malignant parotid gland tumours, and receiver operating characteristic (ROC) curve analysis was used to evaluate their diagnostic performance.
RESULTS
Malignant PTs tended to exhibit a type C TIC pattern, whereas benign tumours tended to be type A and B (p < 0.001). Benign PTs had less ITSS than malignant tumours (p < 0.001). Multivariate analyses showed that ADC, V, and ITSS were predictors of tumour classification. ROC analysis showed that the area under the curve (AUC) of ADC, V, ITSS, and ADC combined with V were 0.623, 0.615, 0.826, and 0.782, respectively, in differentiating between malignant and benign PTs. When ITSS was added, the AUCs of ADC, V, and ADC combined with V increased to 0.882, 0.848, and 0.930, respectively.
CONCLUSION
SWI offers incremental diagnostic value to DWI and DCE-MRI in the characterisation of parotid gland tumours.
Topics: Contrast Media; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Magnetic Resonance Imaging; Parotid Gland; Parotid Neoplasms; ROC Curve; Retrospective Studies
PubMed: 34906852
DOI: 10.1016/j.ejrad.2021.110094 -
Journal of Ultrasound Sep 2021Parotid gland oncocytoma (PGO) is a rare benign epithelial tumor that usually occurs in the elderly population. The most common clinical presentation is a painless,... (Review)
Review
Parotid gland oncocytoma (PGO) is a rare benign epithelial tumor that usually occurs in the elderly population. The most common clinical presentation is a painless, slow-growing, non-tender, lobulated, and mobile mass. Histologically, it is composed of monotonous sheets of epithelial cells (oncocytes) with a central scar. The cross-sectional appearance is not specific, and it overlaps with other parotid lesions. On ultrasound (US), oncocytoma appears as an ovoid, well-defined, homogeneous, and hypoechoic lesion. Cystic and hemorrhagic areas as well as intralesional fat may be observed. Doppler analysis shows intratumoral vessels, sometimes with a spoke-wheel pattern. The peak systolic flow is high (up to 100 cm/sec). Furthermore, oncocytoma is avid of FDG on a PET scan, as well as a malignant tumor. Thus, a combined clinical, imaging, and pathologic assessment is essential to establish the most accurate diagnosis and plan the best treatment. US, combined with Doppler techniques, can play an important role in suggesting the diagnosis and confirming it through percutaneous sampling. The purpose of this review is to show the imaging findings in PGO, with special emphasis on the US appearance.
Topics: Adenoma, Oxyphilic; Aged; Cross-Sectional Studies; Humans; Neoplasms, Glandular and Epithelial; Parotid Gland; Parotid Neoplasms; Ultrasonography
PubMed: 32710434
DOI: 10.1007/s40477-020-00511-5 -
Cancer Cytopathology Oct 2022Mucoepidermoid carcinoma (MEC) is the most common salivary gland (SG) malignancy. In this study, the author undertook analysis of a large collection of MEC cytologic...
BACKGROUND
Mucoepidermoid carcinoma (MEC) is the most common salivary gland (SG) malignancy. In this study, the author undertook analysis of a large collection of MEC cytologic cases.
MATERIALS AND METHODS
Cytopathology files were searched for MEC cases with histopathologic confirmation. Fine-needle aspiration (FNA) smears used standard technique.
RESULTS
Seventy-six cases (63 patients [M:F = 1:1; age range, 23-87 years; mean age, 58 years]) met inclusion criteria. Aspirates were primary (54 [71%]), metastatic (18 [24%]), and locally recurrent (4 [5%]). FNA sites included parotid gland (49 [64%]), regional lymph nodes (11 [14%]), submandibular gland (5 [7%]), inner canthus of eye (2 [3%]), and lung (2 [3%]); and single specimens from palate, jaw, shoulder, paranasal sinus, floor of mouth, ear canal, and effusion. Cytologic diagnoses included MEC (30 cases [39%]), suspicious for MEC (16 [21%]), non-MEC carcinoma (9 [12%]), suspicious for malignancy (SM) (2 [3%], malignant (M) (1 [1%]), SG and/or suspicious SG neoplasm (7 [8%]), atypical (3 [5%]), nonneoplastic (5 [6%]), nondiagnostic (2 [3%]), and benign SG neoplasm (1 [1%]). A total of 26% of low-grade (LG) cases were diagnosed as malignant in contrast to 87% malignant in high-grade (HG) cases. Cytomorphology depended on tumor grade. LG MEC contained intra- and/or extra-cellular mucin and more uniform cell and/or nuclear morphology, whereas cytologic atypia, anisonucleosis, and keratotic cells were more typical of HG tumors.
CONCLUSION
A malignant (M) or suspicious for malignancy (SM) cytologic interpretation was made in 76% of mucoepidermoid carcinoma (MEC) cases. In contrast to high-grade MEC (97% identified as M/SM), only 59% of low-grade (LG) MEC cases were interpreted as such, illustrating the continued diagnostic challenge posed by LG MEC using fine-needle aspiration biopsy.
Topics: Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Carcinoma, Mucoepidermoid; Humans; Middle Aged; Mucins; Salivary Gland Neoplasms; Submandibular Gland; Young Adult
PubMed: 35640091
DOI: 10.1002/cncy.22600 -
The Laryngoscope Feb 2023To design a deep learning model based on multimodal magnetic resonance image (MRI) sequences for automatic parotid neoplasm classification, and to improve the diagnostic...
OBJECTIVE
To design a deep learning model based on multimodal magnetic resonance image (MRI) sequences for automatic parotid neoplasm classification, and to improve the diagnostic decision-making in clinical settings.
METHODS
First, multimodal MRI sequences were collected from 266 patients with parotid neoplasms, and an artificial intelligence (AI)-based deep learning model was designed from scratch, combining the image classification network of Resnet and the Transformer network of Natural language processing. Second, the effectiveness of the deep learning model was improved through the multi-modality fusion of MRI sequences, and the fusion strategy of various MRI sequences was optimized. In addition, we compared the effectiveness of the model in the parotid neoplasm classification with experienced radiologists.
RESULTS
The deep learning model delivered reliable outcomes in differentiating benign and malignant parotid neoplasms. The model, which was trained by the fusion of T2-weighted, postcontrast T1-weighted, and diffusion-weighted imaging (b = 1000 s/mm ), produced the best result, with an accuracy score of 0.85, an area under the receiver operator characteristic (ROC) curve of 0.96, a sensitivity score of 0.90, and a specificity score of 0.84. In addition, the multi-modal paradigm exhibited reliable outcomes in diagnosing the pleomorphic adenoma and the Warthin tumor, but not in the identification of the basal cell adenoma.
CONCLUSION
An accurate and efficient AI based classification model was produced to classify parotid neoplasms, resulting from the fusion of multimodal MRI sequences. The effectiveness certainly outperformed the model with single MRI images or single MRI sequences as input, and potentially, experienced radiologists.
LEVEL OF EVIDENCE
3 Laryngoscope, 133:327-335, 2023.
Topics: Humans; Parotid Neoplasms; Artificial Intelligence; Deep Learning; Sensitivity and Specificity; Magnetic Resonance Imaging; Retrospective Studies
PubMed: 35575610
DOI: 10.1002/lary.30154 -
European Annals of Otorhinolaryngology,... Nov 2022
Topics: Humans; Outpatients; Parotid Gland; Ambulatory Surgical Procedures; Salivary Glands; France; Parotid Neoplasms; Postoperative Complications; Retrospective Studies
PubMed: 34972645
DOI: 10.1016/j.anorl.2021.12.002