-
Head & Neck Sep 2016Myopericytoma is a perivascular tumor of the skin and subcutaneous tissue of the extremities, it is a rare finding in the head and neck, and even rarer is its deep... (Review)
Review
BACKGROUND
Myopericytoma is a perivascular tumor of the skin and subcutaneous tissue of the extremities, it is a rare finding in the head and neck, and even rarer is its deep location.
METHODS
A 38-year-old woman presented with a slowly growing mass at the right carotid triangle. Contrast-enhanced CT scan revealed a moderately enhancing mass. At surgery, the tumor was firmly attached to the common carotid artery, making it necessary to excise a small portion of the vessel wall.
RESULTS
The histopathologic report was myopericytoma. The postoperative course was uneventful, without tumor recurrence.
CONCLUSION
The very few deep located myopericytomas at the head and neck region show a predilection to appear near the great neck vessels with a possibility to require vascular repair, or at the parotid space where they can be multicentric. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2479-E2482, 2016.
Topics: Adult; Carotid Artery, Common; Contrast Media; Female; Follow-Up Studies; Head and Neck Neoplasms; Hemangiopericytoma; Humans; Image-Guided Biopsy; Immunohistochemistry; Neck; Rare Diseases; Risk Assessment; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 27061437
DOI: 10.1002/hed.24455 -
International Journal of Radiation... Jun 2024Radiation therapy (RT) to the head and neck (H&N) region is critical in the management of various pediatric malignancies; however, it may result in late toxicity. This... (Review)
Review
PURPOSE
Radiation therapy (RT) to the head and neck (H&N) region is critical in the management of various pediatric malignancies; however, it may result in late toxicity. This comprehensive review from the Pediatric Normal Tissue Effects in the Clinic (PENTEC) initiative focused on salivary dysfunction and dental abnormalities in survivors who received RT to the H&N region as children.
MATERIALS & METHODS
This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method.
RESULTS
Of the 2,164 articles identified through a literature search, 40 were included in a qualitative synthesis and 3 were included in a quantitative synthesis. The dose-toxicity data regarding salivary function demonstrate that a mean parotid dose of 35 to 40 Gy is associated with a risk of acute and chronic grade ≥2 xerostomia of approximately 32% and 13% to 32%, respectively, in patients treated with chemo-radiation therapy. This risk increases with parotid dose; however, rates of xerostomia after lower dose exposure have not been reported. Dental developmental abnormalities are common after RT to the oral cavity. Risk factors include higher radiation dose to the developing teeth and younger age at RT.
CONCLUSIONS
This PENTEC task force considers adoption of salivary gland dose constraints from the adult experience to be a reasonable strategy until more data specific to children become available; thus, we recommend limiting the parotid mean dose to ≤26 Gy. The minimum toxic dose for dental developmental abnormalities is unknown, suggesting that the dose to the teeth should be kept as low as possible particularly in younger patients, with special effort to keep doses <20 Gy in patients <4 years old.
Topics: Humans; Head and Neck Neoplasms; Xerostomia; Child; Cancer Survivors; Salivary Glands; Parotid Gland; Radiotherapy Dosage; Radiation Injuries; Risk Factors; Age Factors; Tooth Abnormalities; Adolescent; Child, Preschool
PubMed: 34074567
DOI: 10.1016/j.ijrobp.2021.04.023 -
Journal of Cranio-maxillo-facial... Jun 2020Salivary gland tumors are predominantly benign and frequently localized in the parotid gland (P). The treatment consists primarily of surgical removal; however, the... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Salivary gland tumors are predominantly benign and frequently localized in the parotid gland (P). The treatment consists primarily of surgical removal; however, the appropriate extent remains a subject of debate. In suitable tumors, superficial parotidectomy (SP) may be substituted for less invasive partial superficial parotidectomy (PSP) (I C). This systematic review analyzed the available literature, comparing PSP and SP with regards to several postoperative outcome parameters (O).
MATERIALS AND METHODS
Established medical databanks were screened for articles evaluating outcomes of PSP compared with SP, published between 1955 and 2019. These data were assessed by pooled risk and odds ratios via meta-analysis.
RESULTS
11 studies with 1272 patients were included. There was no significant difference in tumor recurrence between PSP and SP (primary outcome). Furthermore, no differences in the occurrence of permanent facial nerve paralysis (FNP), salivary fistula, great auricular nerve analgesia, or hematoma were observed between the groups. However, PSP displayed significantly reduced rates of transient FNP, Frey's syndrome, scar deformity, and xerostomia, as well as shorter surgical time, compared with SP (secondary outcomes).
CONCLUSION
Based on these data, PSP can be recommended as a surgical technique for the treatment of superficially located, small, benign parotid tumors.
Topics: Humans; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Retrospective Studies; Sweating, Gustatory
PubMed: 32362539
DOI: 10.1016/j.jcms.2020.04.002 -
Acta Oto-laryngologica Oct 2021The use of adjuvant radiotherapy remains controversial in the treatment of recurrent pleomorphic adenomas. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The use of adjuvant radiotherapy remains controversial in the treatment of recurrent pleomorphic adenomas.
AIMS/OBJECTIVES
The aim of this study was to provide the highest level of evidence possible by performing a systematic review and meta-analysis of the literature.
MATERIAL AND METHODS
We searched the English-language literature between 1985 and 2019.Inclusion criteria included any study on the treatment and outcome of recurrent pleomorphic adenomas. Exclusion criteria included the use of radiotherapy for residual tumors, case reports, and pleomorphic adenomas not arising from the parotid.
RESULTS
A total of 522 abstracts were studied, data analyzed from 14 studies, on a total of 697 patients. When the data werepooled, the overall risk of further recurrence was 21%. In studies where surgery alone was undertaken this increased to 26% and decreased to 10% in those receiving adjuvant radiotherapy ( = .000). There were 21 recurrences in 159 patients in the radiotherapy group, and 151 recurrences out of 538 patients in the surgery group ( < .0001).
CONCLUSIONS
These data support the use of radiotherapy to decrease the risk of re-recurrence in recurrent pleomorphic adenoma.
SIGNIFICANCE
This study is the highest level of evidence currently available in guiding management of recurrent pleomorphic adenoma.
Topics: Adenoma, Pleomorphic; Humans; Neoplasm Recurrence, Local; Parotid Neoplasms; Radiotherapy, Adjuvant; Secondary Prevention
PubMed: 34622733
DOI: 10.1080/00016489.2021.1980226 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Apr 2019Salivary adenoid cystic carcinoma (SACC) is a common malignant tumor in the oral and maxillofacial region and accounts for approximately 3%-5% of all head and neck...
Salivary adenoid cystic carcinoma (SACC) is a common malignant tumor in the oral and maxillofacial region and accounts for approximately 3%-5% of all head and neck carcinomas. SACC always occurs in the palatal salivary gland and parotid gland. The tumor has the characteristics of strong invasion, perineural invasion, high hematogenous metastasis, and low lymph node metastasis rate. The biological characteristics of SACC determine the specificity of clinical treatment. Thus far, few clinical trials have investigated the efficacy of systemic therapy owing to the rarity of SACC with lung metastasis. Moreover, long-term results are poor, and no consensus on standard treatment has been reached yet. This systematic review aims to provide a retrospective analysis of treatment options and prognosis for SACC with lung metastasis and evidence for future clinical treatment.
Topics: Carcinoma, Adenoid Cystic; Cell Line, Tumor; Humans; Neoplasm Invasiveness; Prognosis; Retrospective Studies; Salivary Gland Neoplasms
PubMed: 31168990
DOI: 10.7518/hxkq.2019.02.015 -
The Journal of Laryngology and Otology Feb 2021This study aimed to provide a systematic review on survival outcome based on Pittsburgh T-staging for patients with primary external auditory canal squamous cell...
OBJECTIVE
This study aimed to provide a systematic review on survival outcome based on Pittsburgh T-staging for patients with primary external auditory canal squamous cell carcinoma.
METHOD
This study was a systematic review in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines performed until January 2018; pertinent studies were screened. Quality of evidence was assessed using the grading of recommendation, assessment, development and evaluation working group system.
RESULTS
Eight articles were chosen that reported on 437 patients with external auditory carcinoma. The 5-year overall survival rate was 53.0 per cent. The pooled proportion of survivors at 5 years for T1 tumours was 88.4 per cent and for T2 tumours was 88.6 per cent. For the combined population of T1 and T2 cancer patients, it was 84.5 per cent. For T3 and T4 tumours, it was 53.3 per cent and 26.8 per cent, respectively, whereas for T3 and T4 tumours combined, it was 40.4 per cent. Individual analysis of 61 patients with presence of cervical nodes showed a poor survival rate.
CONCLUSION
From this review, there was not any significant difference found in the survival outcome between T1 and T2 tumours. A practical classification incorporating nodal status that accurately stratifies patients was proposed.
Topics: Aged; Carcinoma, Squamous Cell; Dura Mater; Ear Canal; Ear Neoplasms; Facial Paralysis; Female; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Parotid Gland; Retrospective Studies; Survival Rate
PubMed: 33568243
DOI: 10.1017/S0022215121000323 -
Otology & Neurotology : Official... Apr 2019To examine the etiology, clinical course, and management of recurrent peripheral facial nerve paralysis.
PURPOSE
To examine the etiology, clinical course, and management of recurrent peripheral facial nerve paralysis.
METHODS
Retrospective review at a single tertiary academic center and systematic review of the literature. Clinical presentation, laboratory and imaging findings, treatment and outcome for all cases of recurrent ipsilateral, recurrent contralateral, and bilateral simultaneous cases of facial paralysis are reviewed.
RESULTS
Between 2000 and 2017, 53 patients [41.5% men, 29 median age of onset (range 2.5 wk-75 yr)] were evaluated for recurrent facial nerve paralysis at the authors' institution. Twenty-two (41.5%) cases presented with ipsilateral recurrences only, while the remaining 31 patients (58.5%) had at least 1 episode of contralateral recurrent paralysis. No cases of bilateral simultaneous facial nerve paralysis were observed. The median number of paretic events for all patients was 3 (range 2-20). The median nadir House-Brackmann score was 4, with a median recovery to House-Brackmann grade 1.5 over a mean recovery time of 61.8 days (range 1-420 d). Diagnostic evaluation confirmed Melkersson-Rosenthal syndrome in four (7.5%) cases, neurosarcoidosis in two (3.7%), traumatic neuroma in one (1.9%), Ramsay Hunt syndrome in one (1.9%), granulomatosis with polyangiitis in one (1.9%), and neoplastic causes in three (5.7%) cases [facial nerve schwannoma (n = 2; 3.7%), metastatic squamous cell carcinoma to the deep lobe of the parotid gland (n = 1; 1.9%)]; ultimately, 77.4% (41) of cases were deemed idiopathic. Facial nerve decompression via a middle cranial fossa approach was performed in three (5.7%) cases without subsequent episodes of paralysis.
CONCLUSION
Recurrent facial nerve paralysis is uncommon and few studies have evaluated this unique population. Recurrent ipsilateral and contralateral episodes are most commonly attributed to idiopathic facial nerve paralysis (i.e., Bell's palsy); however, a subset harbor neoplastic causes or local manifestations of underlying systemic disease. A comprehensive diagnostic evaluation is warranted in patients presenting with recurrent facial nerve paralysis and therapeutic considerations including facial nerve decompression can be considered in select cases.
Topics: Cranial Fossa, Middle; Decompression, Surgical; Facial Nerve; Facial Nerve Diseases; Facial Paralysis; Herpes Zoster Oticus; Humans; Melkersson-Rosenthal Syndrome; Myoclonic Cerebellar Dyssynergia; Neoplasm Recurrence, Local; Retrospective Studies
PubMed: 30870370
DOI: 10.1097/MAO.0000000000002167 -
Neuroradiology Nov 2021This retrospective study aimed to investigate the radiological features of head and neck mammary analogue secretory carcinoma (MASC) and systematically review previous...
PURPOSE
This retrospective study aimed to investigate the radiological features of head and neck mammary analogue secretory carcinoma (MASC) and systematically review previous publications and 11 new cases.
METHODS
We included patients with pathologically proven MASCs with preoperative CT or MRI images, including 11 patients from our hospital and 29 patients from 28 publications extracted after screening 645 abstracts. Two board-certified radiologists reviewed and evaluated all radiological images. The frequency of metastasis during the follow-up period in tumors with well- and ill-defined margins was compared using a Fisher's exact test.
RESULTS
The median age at diagnosis was 52.5 years (range, 7-78 years; 20 males). Of the 40 patients, those in their 50 s were the most common (10/40, 25.0%), and the main tumor site was the parotid gland (27/40, 42.5%). Characteristic radiological features included high intensity on T1WI in the cystic components and tumors frequently showed "papillary and cystic," which showed a projection into the cystic components, or "non-papillary and cystic" morphology, which did not show projection of the solid components. Tumor metastasis was found in 10/35 patients (28.6%) during the follow-up period, with a significant difference in frequency between the tumors with well- and ill-defined margin (well-defined (4/26) vs. ill-defined (6/9); P = 0.0074).
CONCLUSION
MASCs are newly recognized malignant tumors. Characteristic T1WI high intensity on MRI and predominant cystic morphology may reflect its unique histological profile. Ill-defined tumor margin status was related to frequent metastasis. Awareness of these characteristic radiological features can assist radiologists in better detection of this novel entity.
Topics: Biomarkers, Tumor; Humans; Male; Mammary Analogue Secretory Carcinoma; Radiography; Retrospective Studies; Salivary Gland Neoplasms
PubMed: 34427706
DOI: 10.1007/s00234-021-02796-7 -
International Journal of Oral and... Jul 2019The purpose of this study was to compare the complications of patients treated for a benign parotid tumour (BPT) by extracapsular dissection (ECD) vs. partial... (Meta-Analysis)
Meta-Analysis
The purpose of this study was to compare the complications of patients treated for a benign parotid tumour (BPT) by extracapsular dissection (ECD) vs. partial superficial parotidectomy (PSP). A comprehensive literature investigation was conducted by searching electronic databases. A systematic review and meta-analysis of comparative studies were performed to assess ECD and PSP for the treatment of BPTs with fixed-effects models. The outcomes analysed were transient or permanent facial nerve injury, Frey syndrome, recurrence rate, infection, and salivary fistula/sialocele. A total of 1641 patients from seven studies (1120 ECD-treated and 521 PSP-treated patients) were included in this meta-analysis. Transient facial nerve injury (odds ratio (OR)=0.28, 95% confidence interval (CI): 0.11-0.71; p=0.008) and Frey syndrome (OR=0.12, 95% CI: 0.03-0.48; p=0.003) were less prevalent in the ECD group. The rates of permanent facial nerve injury (OR=0.77, 95% CI: 0.35-1.70; p=0.520), recurrence rate (OR=0.17, 95% CI: 0.02-1.75; p=0.14), infection (OR=0.70, 95% CI: 0.07-6.67; p=0.76), and salivary fistula/sialocele (OR=0.40, 95% CI: 0.06-2.66; p=0.350) were similar in both groups. Although there was a trend that ECD showed a reduced risk for complications, the present results are not sufficient to conclude that ECD is more beneficial than PSP.
Topics: Humans; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Retrospective Studies; Sweating, Gustatory
PubMed: 30871850
DOI: 10.1016/j.ijom.2019.01.030 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2017The aim of this study is to systematically assess the clinical outcomes of extracapsular dissection (ECD) and superficial parotidectomy (SP), and to provide evidences... (Meta-Analysis)
Meta-Analysis
The aim of this study is to systematically assess the clinical outcomes of extracapsular dissection (ECD) and superficial parotidectomy (SP), and to provide evidences for the clinical decision for treatment of parotid gland benign tumors. Relevant studies that compared the outcomes of extracapsular dissection and superficial parotidectomy for the parotid benign tumors were searched in Pubmed, CNKI and Wangfang data databases, and Meta-analysis was performed using software RevMan 5.0. Fifteen studies were selected for the Meta-analysis. A total of 2 929 participants were included in those studies, of which 1 796 underwent ECD and 1 133 underwent SP. The recurrence rates for ECD and SP were 1.29% (23 of 1 776 cases) and 1.48% (16 of 1 081 cases), respectively. There were no statistically significant in recurrence rate between ECD and SP. The rates of transient facial nerve paresis for ECD and SP were 5.48% (74 of 1 350) and 22.94% (139 of 606), that of permanent facial nerve paralysis were 0.66% (8 of 1 221) and 2.71% (15 of 554). The incidences of Frey's syndrome in ECD group and SP group were 1.91% (26 of 1 360) and 16.71% (111 of 664), that of fistula in were 0.53% (5 of 946) and 2.96% (10 of 338). ECD could reduce the risk for complications compared with SP. This systematic review with Meta-analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered as an alternative surgical modality for select benign parotid tumor.
Topics: Adenoma, Pleomorphic; Dissection; Evidence-Based Medicine; Humans; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Retrospective Studies
PubMed: 29775003
DOI: 10.13201/j.issn.1001-1781.2017.11.011