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National Journal of Maxillofacial... 2024Distant metastasis to salivary glands is a very rare event. Renal cell carcinoma (RCC) has been known for its high propensity of metastasis to unusual locations and... (Review)
Review
Distant metastasis to salivary glands is a very rare event. Renal cell carcinoma (RCC) has been known for its high propensity of metastasis to unusual locations and salivary glands are one among those sites. Approximately 0.1% of all salivary gland metastatic neoplasms originate from renal malignancies Literature has reported several studies analysing the metastatic tumors to the oral region. However, very little research work has been published to date to analyse solely the RCC metastasizing to the salivary glands. Thus, this review was conducted to examine the published cases of RCC metastasizing to salivary glands in the literature to date and to learn about their characteristics. An electronic search of the published literature was performed without publication year limitation in PubMed/ Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like ('Renal cancer', OR 'Renal carcinoma' OR 'Renal cell cancer' OR 'Renal cell carcinoma'), AND ('Metastasis' OR 'Metastases'), And ('Salivary glands' OR 'Parotid gland' OR 'Submandibular gland' OR 'Sublingual gland'). We also searched all related journals manually. The reference list of all articles was also checked. Our research revealed a total of 83 relevant papers (1965-2022) with 100 patients. Parotid was the most predominant gland affected. 8% of patients died with a mean survival time of 1.3 yr. From this research, it can be concluded that RCC metastasizing to salivary glands is a rare occurrence. Careful evaluation of these cases is needed in order to raise awareness of these lesions and gain a better understanding of their characteristics for clinical as well as global implications.
PubMed: 38690239
DOI: 10.4103/njms.njms_79_23 -
In Vivo (Athens, Greece) 2024First bite syndrome (FBS) is a symptom of severe pain at the beginning of a meal that lessens as the meal progresses. It is a common postoperative complication of...
BACKGROUND/AIM
First bite syndrome (FBS) is a symptom of severe pain at the beginning of a meal that lessens as the meal progresses. It is a common postoperative complication of parapharyngeal space tumors and is rarely reported as the first symptom of parotid carcinoma. The parapharyngeal space is considered a difficult area for approach; hence, preoperative histopathology is often challenging. However, there are hardly any reports on the approach of performing biopsies under computerized tomography (CT) guidance.
CASE REPORT
A 28-year-old woman presented to our hospital with the chief complaint of pain in the left parotid region since the past year. Contrast-enhanced magnetic resonance imaging of the parotid gland revealed a 10-mm high-signal area on T2-weighted images extending from the deep lobe of the left parotid gland to the parapharyngeal space, which could not be visualized on ultrasound. She was suspected to have a malignant tumor because of the presence of a parotid tumor with FBS. Therefore, she underwent CT-guided fine-needle aspiration cytology (FNAC) and was diagnosed with adenoid cystic carcinoma. The patient underwent left parotid tumor resection and left cervical dissection, and her pain during feeding improved postoperatively.
CONCLUSION
In a patient with parotid tumor extending into the parapharyngeal space with FBS as the initial symptom, CT-guided FNAC was successfully used to diagnose parotid carcinoma. Symptoms of pain, including FBS, should be considered in cases of malignancy. CT-guided FNAC is effective for lesions that cannot be visualized by ultrasound, such as those in the parapharyngeal space.
Topics: Humans; Female; Parotid Neoplasms; Adult; Tomography, X-Ray Computed; Biopsy, Fine-Needle; Image-Guided Biopsy; Parotid Gland; Magnetic Resonance Imaging; Cytology
PubMed: 38688641
DOI: 10.21873/invivo.13590 -
In Vivo (Athens, Greece) 2024Warthin's tumor, the second most frequent neoplasia of the parotid gland, is characterized by a proliferation of both epithelial and lymphoid components. In addition to...
BACKGROUND/AIM
Warthin's tumor, the second most frequent neoplasia of the parotid gland, is characterized by a proliferation of both epithelial and lymphoid components. In addition to epithelial and lymphoid cells, various other cell types are implicated to varying degrees in the immune response. Notably, mast cells have long been recognized as a consistent cell population within this tumor. Despite the historical acknowledgment of mast cell presence, their true distribution and significance within Warthin's tumor remain unclear. In this study, we aimed to elucidate the distribution and significance of mast cells in Warthin's tumor.
MATERIALS AND METHODS
Histochemical and immunohistochemical methods were employed for the evaluation of mast cells within tumor specimens.
RESULTS
Our study revealed a notable concentration of mast cells in the epithelial component of Warthin's tumor. Microscopic examination showed predominant lymphoid and epithelial elements with occasional cystic formations. Immunohistochemical analysis identified mast cells in both components, emphasizing their role in the tumor microenvironment. Double immunostaining (mast cell tryptase and CD34) revealed no significant correlation between mast cells and blood vessels. Intraepithelial mast cells (IEMCs) had a significantly higher density in the epithelial component, suggesting a potential association with the tumor's benign nature. The relationship between IEMCs and epithelial cells, especially in the presence of cystic structures, offers valuable insights into the unique features of Warthin's tumor.
CONCLUSION
Our study contributes to the understanding of mast cells in Warthin's tumor, highlighting a substantial concentration within the epithelial component. This knowledge may pave the way for further investigations into the roles of mast cells in the pathogenesis and treatment of Warthin's tumor.
Topics: Mast Cells; Adenolymphoma; Humans; Male; Female; Immunohistochemistry; Middle Aged; Aged; Tumor Microenvironment; Cell Count; Parotid Neoplasms; Adult; Epithelial Cells
PubMed: 38688595
DOI: 10.21873/invivo.13544 -
BMC Surgery Apr 2024We primarily aimed to evaluate whether parotid incidental lesion (PIL) in F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for...
Incidentally found parotid gland lesion in F-FDG PET/CT for staging evaluation of patients with hepatocellular carcinoma: remote possibility of metastatic tumor or second primary salivary gland malignancy.
OBJECTIVES
We primarily aimed to evaluate whether parotid incidental lesion (PIL) in F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for staging evaluation of patients with hepatocellular carcinoma (HCC) would represent a possibility of extrahepatic metastasis or second primary malignancy (SPM). Additionally, we explored the incidence of PIL in HCC patients and examined any associated risk factors.
METHODS
We retrospectively analyzed patients with HCC who underwent F-FDG PET/CT at our institution from 2010 to 2022. The pathological findings of PILs in HCC patients were investigated for confirmatory identification of the risk of HCC metastasis or SPM in parotid gland. Healthy controls received F-FDG PET/CT for health screening were also enrolled to compare the incidence of PILs with HCC patients. Various parameters associated with patient demographics and characteristics of HCC were analyzed to find the related factors of PILs.
RESULTS
A total of 17,674 patients with HCC and 2,090 healthy individuals who had undergone F-FDG PET/CT scans were enrolled in the analyses. Among the 54 HCC patients who underwent pathological confirmation for PILs, benign primary parotid tumor was most commonly observed (n = 43 [79.6%]); however, no malignant lesions were detected, including HCC metastasis. The incidence of PILs was higher in patients diagnosed with HCC compared with the control group (485 [2.7%] vs. 23 [1.1%], p = 0.002). Analysis for the risk factors for PILs revealed that patient age, sex, and positive viral markers were significantly associated with the incidence of PILs in patients with HCC (all p < 0.001).
CONCLUSIONS
Our study demonstrates that PILs are more frequently identified in patients with HCC on F-FDG PET/CT. However, no malignant PIL, including extrahepatic metastasis of HCC, was identified. Therefore, the presence of PIL should not impede or delay the treatment process for patients with HCC. Additionally, we suggested that for future swift and straightforward differential diagnoses of PIL, the development of additional protocols within the PET/CT imaging could be beneficial.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Male; Liver Neoplasms; Female; Middle Aged; Carcinoma, Hepatocellular; Retrospective Studies; Incidental Findings; Aged; Parotid Neoplasms; Radiopharmaceuticals; Neoplasms, Second Primary; Adult; Neoplasm Staging; Salivary Gland Neoplasms; Incidence
PubMed: 38658868
DOI: 10.1186/s12893-024-02422-2 -
Physica Medica : PM : An International... May 2024The purpose of this investigation is to quantify the spatial heterogeneity of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) uptake within...
UNLABELLED
The purpose of this investigation is to quantify the spatial heterogeneity of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) uptake within parotid glands. We aim to quantify patterns in well-defined regions to facilitate further investigations. Furthermore, we investigate whether uptake is correlated with computed tomography (CT) texture features.
METHODS
Parotid glands from [18F]DCFPyL PSMA PET/CT images of 30 prostate cancer patients were analyzed. Uptake patterns were assessed with various segmentation schemes. Spearman's rank correlation coefficient was calculated between PSMA PET uptake and feature values of a Grey Level Run Length Matrix using a long and short run length emphasis (GLRLML and GLRLMS) in subregions of the parotid gland.
RESULTS
PSMA PET uptake was significantly higher (p < 0.001) in lateral/posterior regions of the glands than anterior/medial regions. Maximum uptake was found in the lateral half of parotid glands in 50 out of 60 glands. The difference in SUV between parotid halves is greatest when parotids are divided by a plane separating the anterior/medial and posterior/lateral halves symmetrically (out of 120 bisections tested). PSMA PET uptake was significantly correlated with CT GLRLML (p < 0.001), and anti-correlated with CT GLRLMS (p < 0.001).
CONCLUSION
Uptake of PSMA PET is heterogeneous within parotid glands, with uptake biased towards lateral/posterior regions. Uptake within parotid glands was strongly correlated with CT texture feature maps.
Topics: Humans; Parotid Gland; Positron Emission Tomography Computed Tomography; Glutamate Carboxypeptidase II; Male; Ligands; Antigens, Surface; Prostatic Neoplasms; Biological Transport; Aged; Middle Aged; Lysine; Urea
PubMed: 38657425
DOI: 10.1016/j.ejmp.2024.103366 -
BMC Cancer Apr 2024To develop a deep learning(DL) model utilizing ultrasound images, and evaluate its efficacy in distinguishing between benign and malignant parotid tumors (PTs), as well...
BACKGROUND
To develop a deep learning(DL) model utilizing ultrasound images, and evaluate its efficacy in distinguishing between benign and malignant parotid tumors (PTs), as well as its practicality in assisting clinicians with accurate diagnosis.
METHODS
A total of 2211 ultrasound images of 980 pathologically confirmed PTs (Training set: n = 721; Validation set: n = 82; Internal-test set: n = 89; External-test set: n = 88) from 907 patients were retrospectively included in this study. The optimal model was selected and the diagnostic performance evaluation is conducted by utilizing the area under curve (AUC) of the receiver-operating characteristic(ROC) based on five different DL networks constructed at varying depths. Furthermore, a comparison of different seniority radiologists was made in the presence of the optimal auxiliary diagnosis model. Additionally, the diagnostic confusion matrix of the optimal model was calculated, and an analysis and summary of misjudged cases' characteristics were conducted.
RESULTS
The Resnet18 demonstrated superior diagnostic performance, with an AUC value of 0.947, accuracy of 88.5%, sensitivity of 78.2%, and specificity of 92.7% in internal-test set, and with an AUC value of 0.925, accuracy of 89.8%, sensitivity of 83.3%, and specificity of 90.6% in external-test set. The PTs were subjectively assessed twice by six radiologists, both with and without the assisted of the model. With the assisted of the model, both junior and senior radiologists demonstrated enhanced diagnostic performance. In the internal-test set, there was an increase in AUC values by 0.062 and 0.082 for junior radiologists respectively, while senior radiologists experienced an improvement of 0.066 and 0.106 in their respective AUC values.
CONCLUSIONS
The DL model based on ultrasound images demonstrates exceptional capability in distinguishing between benign and malignant PTs, thereby assisting radiologists of varying expertise levels to achieve heightened diagnostic performance, and serve as a noninvasive imaging adjunct diagnostic method for clinical purposes.
Topics: Humans; Deep Learning; Retrospective Studies; Ultrasonography; Parotid Neoplasms; Male; Middle Aged; Female; Adult; Aged; Young Adult; ROC Curve; Diagnosis, Differential; Adolescent; Aged, 80 and over; Sensitivity and Specificity; Child
PubMed: 38654281
DOI: 10.1186/s12885-024-12277-8 -
Journal of Surgical Case Reports Apr 2024Mucoepidermoid carcinoma is a type of salivary gland cancer that can develop in the context of a parotid gland cyst. This type of tumor is composed of mucous,...
Mucoepidermoid carcinoma is a type of salivary gland cancer that can develop in the context of a parotid gland cyst. This type of tumor is composed of mucous, epidermoid, and intercalated cells, and usually presents as a slow-growing and painless mass. A parotid gland cyst is a condition in which a fluid-filled sac forms in the parotid gland. The tumor can be masked as it develops within the parotid cyst. A 45-year-old female patient presented with a suspect of benign neoplasm of the major salivary gland. She underwent partial right parotidectomy, which upon pathological analysis confirmed the diagnosis of mucoepidermoid microcarcinoma associated with parotid gland cysts. The patient did well and continues under regular follow-up with no further treatment.
PubMed: 38638921
DOI: 10.1093/jscr/rjae230 -
World Journal of Surgical Oncology Apr 2024Basal cell adenoma (BCA) is a rare benign tumor within the salivary glands. Basal cell adenocarcinoma (BCAC), the malignant counterpart of BCA, is also an exceedingly...
BACKGROUND
Basal cell adenoma (BCA) is a rare benign tumor within the salivary glands. Basal cell adenocarcinoma (BCAC), the malignant counterpart of BCA, is also an exceedingly rare tumor with very limited clinical studies conducted. This study aims to investigate the clinical characteristics, demographics, and surgical outcomes of patients diagnosed with BCA and BCAC within the parotid gland.
METHODS
A retrospective analysis from May 2003 to August 2023 was performed for all patients undergoing parotidectomy for masses. Retrospective data on gender, age, tumor characteristics, and outcomes were collected. Surgical approaches, including negative margin attainment, capsule removal, and histological diagnosis, were also detailed.
RESULTS
The study included 1268 patients who underwent parotidectomy, resulting in 81 cases of BCA and 7 cases of BCAC. BCA patients, with a mean age of 55.1 years, showed diverse age distribution and predominantly presented in the 50s. In BCAC cases, seven female patients exhibited a predominant location in the deep lobes. FNA revealed BCAC in three out of seven cases, and subsequent parotidectomy was performed, resulting in no observed recurrences or metastases.
CONCLUSION
This study reports the largest number of BCA cases from a single institution and provides comprehensive insights into the demographics, tumor characteristics, and clinical outcomes of both BCA and BCAC. Although further research should be conducted, based on clinical follow-up results, appropriately including the capsule in the tumor excision indicates favorable outcomes, especially when the tumor size is not large.
Topics: Humans; Female; Middle Aged; Parotid Gland; Retrospective Studies; Adenocarcinoma; Salivary Gland Neoplasms; Adenoma; Treatment Outcome; Parotid Neoplasms
PubMed: 38637826
DOI: 10.1186/s12957-024-03378-6 -
Scientific Reports Apr 2024Warthin tumor (WT) is a benign tumor usually affecting the parotid gland. The main diagnostic tool remains ultrasound combined with fine-needle aspiration cytology...
Warthin tumor (WT) is a benign tumor usually affecting the parotid gland. The main diagnostic tool remains ultrasound combined with fine-needle aspiration cytology (FNAC). This study aims to examine how reliably FNAC indicates WT for clinical decision making regarding surgical versus conservative management. We included all patients who underwent FNAC from a parotid gland lesion between 2016 and 2018 at our institution, and whose FNAC revealed WT suspicion. The FNACs were divided into three groups based on the cytology report: certain, likely, and possible WT. The patients were divided into two groups based on having had either surgery or follow-up. We sent a questionnaire to patients who had not undergone surgery in order to obtain follow-up for a minimum of four years. Altogether, 135 FNAC samples, from 133 tumors and 125 patients, showed signs of WT. Of the 125 patients, 44 (35%) underwent surgery, and 81 (65%) were managed conservatively. Preoperative misdiagnosis in FNAC occurred in three (7%) surgically treated tumors. Their FNACs were reported as possible WTs, but histopathology revealed another benign lesion. In the conservatively treated group, two patients underwent surgery later during the follow-up. Cytological statements of WT were seldom false, and none were malignant. The majority of the patients were only followed-up and rarely required further treatment. A certain or likely diagnosis of WT in the FNAC report by an experienced head and neck pathologist is highly reliable in selecting patients for conservative surveillance.
Topics: Humans; Parotid Neoplasms; Adenolymphoma; Retrospective Studies; Parotid Gland; Clinical Decision-Making; Sensitivity and Specificity
PubMed: 38632256
DOI: 10.1038/s41598-024-58892-0 -
American Journal of Otolaryngology 2024The aim of the study was to trace the development of surgical therapy in a large cohort, examine its changes at one single institution that has been specializing in... (Comparative Study)
Comparative Study
OBJECTIVE
The aim of the study was to trace the development of surgical therapy in a large cohort, examine its changes at one single institution that has been specializing in salivary gland pathologies over the last 22 years, and to determine the extent to which a possible shift in the surgical therapy of parotid benign tumors towards less radical methods was correlated with a change in the incidence of facial palsy and Frey's syndrome.
STUDY DESIGN
Retrospective clinical study.
METHODS
A retrospective evaluation of the records of all patients treated for benign parotid tumors at a tertiary referral center between 2000 and 2022 was carried out. Surgical methods were classified into four groups: extracapsular dissection, partial superficial parotidectomy, superficial parotidectomy and complete parotidectomy.
RESULTS
A total of 4037 patients were included in the study. Our analysis demonstrated an increase in the total number of parotidectomies for benign lesions from 71 (2000) to 298 (2022), mostly due to the increase in extracapsular dissections (from 9 to 212). The increased performance of less radical surgery was associated with a significantly decreased incidence of perioperative complications.
CONCLUSIONS
Our study showed that the increased performance of less radical surgery was associated with better functional outcomes over the years.
Topics: Humans; Retrospective Studies; Parotid Neoplasms; Male; Female; Middle Aged; Parotid Gland; Dissection; Facial Paralysis; Sweating, Gustatory; Adult; Treatment Outcome; Postoperative Complications; Aged; Incidence
PubMed: 38613928
DOI: 10.1016/j.amjoto.2024.104260