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Indian Journal of Otolaryngology and... Jun 2024Mammary analog secretory carcinoma (MASC) is a relatively rare, low-grade tumor affecting the salivary glands. We report a 62-year-old female who was diagnosed with MASC...
Mammary analog secretory carcinoma (MASC) is a relatively rare, low-grade tumor affecting the salivary glands. We report a 62-year-old female who was diagnosed with MASC of the left parotid gland and underwent left Total conservative parotidectomy with condylectomy and reconstruction with right anterolateral free flap and left facial nerve (frontal branch) reconstruction with a cable graft. As there is no standard treatment protocol developed for the management of MASC, this report focuses on the various management options that have been followed to date.
PubMed: 38883468
DOI: 10.1007/s12070-024-04540-y -
Molecular and Clinical Oncology Aug 2024Lymphoepithelial cysts (LECs) of the salivary glands are relatively rare, benign cystic lesions. Characteristic histopathological features of LEC include presence of...
Lymphoepithelial cysts (LECs) of the salivary glands are relatively rare, benign cystic lesions. Characteristic histopathological features of LEC include presence of well-circumscribed unilocular cysts surrounded by dense lymphoid tissue with lymphoid follicles. These cysts are lined by a combination of squamous, ciliated, columnar and mucous epithelia. Fine-needle aspiration (FNA) cytology is the standard preoperative diagnostic procedure for salivary gland lesions. Although the cytological diagnosis of cystic salivary gland lesions is difficult, the use of Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in the cytodiagnosis of cystic salivary gland lesions has been reported. However, only a few studies have described the cytological features of LEC. To the best of our knowledge, the present study reviewed the cytological features of a case series of LEC and evaluated the application of MSRSGC for the first time. This retrospective study included 13 patients with LEC of the salivary glands who underwent pre-operative FNA followed by surgical resection of the cyst. All the lesions were present in the parotid gland. Cytological analysis revealed no epithelial cell component in eight patients (62.5%) along with a proteinaceous background containing lymphocytes and/or foamy cells. Non-keratinising squamous epithelium was observed in three patients. Amylase crystalloids were noted in two patients. None of the patients were cytodiagnosed with LEC. Eight, three, one and one patients were categorised as MSRSGC I, II, III, and IVa, respectively. The results of the present study demonstrated that cytodiagnosis of LEC was difficult due to the absence of epithelial component in 62.5% of the specimens. However, evaluation of its benignity was not difficult. Thus, it can be summarized that MSRSGC may be useful for cytological evaluation of LECs.
PubMed: 38882218
DOI: 10.3892/mco.2024.2750 -
Ear, Nose, & Throat Journal Jun 2024Canalicular adenoma (CA) is a rare benign tumor of the salivary glands, predominantly affecting elderly females, with a strong predilection for the upper lip. While CA...
Canalicular adenoma (CA) is a rare benign tumor of the salivary glands, predominantly affecting elderly females, with a strong predilection for the upper lip. While CA commonly arises in the minor salivary glands, its occurrence in the parotid gland is exceptionally rare. In this report, we present a unique case of CA in the parotid gland, adding to the scant literature with only 8 documented instances. The patient, a 57-year-old Asian male, presented with a painless swelling in the left parotid gland that had been persisting for 8 years. Clinical examination and imaging studies identified a lobulated mass, prompting surgical intervention. The patient underwent a superficial parotidectomy, and pathological examination of the excised tissue confirmed the diagnosis of CA, with no signs of malignancy. This case illustrates the diagnostic and management challenges associated with CA, particularly given its rare presentation in the parotid gland. Accurate diagnosis is reliant on surgical biopsy, and careful surgical planning is imperative, especially considering the proximity of the facial nerve. Our case underscores the need for heightened awareness of CA's unique presentations, particularly within the Asian population. Given the potential for recurrence, long-term follow-up is essential. Further research is needed to elucidate the biological behavior of CA and to refine management strategies for optimal patient outcomes.
PubMed: 38881446
DOI: 10.1177/01455613241262652 -
International Journal of Surgery Case... Jul 2024Tumours of salivary glands are rare and have various histo-pathological subtypes. Myoepitheliomas were first classified by Sheldon et al. and the criterion to classify...
INTRODUCTION
Tumours of salivary glands are rare and have various histo-pathological subtypes. Myoepitheliomas were first classified by Sheldon et al. and the criterion to classify or diagnose it was first defined by Barnes et al. and Sciubba and Brannon. Myoepithelioma accounts for less than 1 % of all salivary gland tumours, 40 % of these tumours occur in the parotid gland while 21 % occur in the minor salivary glands. A case of myoepithelioma of a minor salivary gland of the cheek is described, emphasizing the problems of the differential diagnosis.
PRESENTATION OF THE CASE
A 40-year-old female reported to the department with a complaint of a cheek bite on her right side for a few months. The physical examination showed a presence of lobulated whitish mucosa on the right buccal mucosa at the level of the occlusal plane, on palpation it revealed a non-painful mass approximately 1.5 cm in radius, mobile to bimanual palpation. An excisional biopsy was performed under local anaesthesia. Microscopic and immunohistochemistry confirmed the tumour to be a myoepithelioma of a minor salivary gland with the absence of definitive features of malignancy.
DISCUSSION
Due to their infrequency and multiplicity of histopathology, myoepitheliomas present difficulties in diagnosis. Cellular varieties can be misdiagnosed as malignancies. A key to determining diagnostic criteria for myoepitheliomas is to study cellular morphology, cytoplasmic filament expression, and ultrastructural features of the tumour and apply this information to defining myoepitheliomas.
CONCLUSION
Myoepitheliomas are rare tumours, utilization of immunohistochemical staining and electron microscopy are useful tools for the diagnosis of myoepitheliomas to ensure proper treatment and follow-up.
PubMed: 38875824
DOI: 10.1016/j.ijscr.2024.109849 -
Radiology Case Reports Aug 2024The primary malignant melanoma of the parotid is a rare and complex clinical entity, posing numerous diagnostic challenges due to the absence of melanin in the tumor and...
The primary malignant melanoma of the parotid is a rare and complex clinical entity, posing numerous diagnostic challenges due to the absence of melanin in the tumor and its histological similarities with other poorly differentiated lesions. Accurate diagnosis often requires advanced imaging techniques and immunohistochemical procedures to identify specific melanoma markers. Therapeutically, total parotidectomy with simultaneous cervical dissection is frequently recommended, although approaches combining surgery, chemotherapy, radiotherapy, or even immunotherapy are also being explored. Despite these advancements, malignant parotid melanoma continues to be associated with a grim prognosis, emphasizing the importance of ongoing research to improve therapeutic options and understanding of this rare pathology.
PubMed: 38872741
DOI: 10.1016/j.radcr.2024.05.005 -
Academic Radiology Jun 2024to develop a deep learning radiomics graph network (DLRN) that integrates deep learning features extracted from gray scale ultrasonography, radiomics features and...
RATIONALE AND OBJECTIVES
to develop a deep learning radiomics graph network (DLRN) that integrates deep learning features extracted from gray scale ultrasonography, radiomics features and clinical features, for distinguishing parotid pleomorphic adenoma (PA) from adenolymphoma (AL) MATERIALS AND METHODS: A total of 287 patients (162 in training cohort, 70 in internal validation cohort and 55 in external validation cohort) from two centers with histologically confirmed PA or AL were enrolled. Deep transfer learning features and radiomics features extracted from gray scale ultrasound images were input to machine learning classifiers including logistic regression (LR), support vector machines (SVM), KNN, RandomForest (RF), ExtraTrees, XGBoost, LightGBM, and MLP to construct deep transfer learning radiomics (DTL) models and Rad models respectively. Deep learning radiomics (DLR) models were constructed by integrating the two features and DLR signatures were generated. Clinical features were further combined with the signatures to develop a DLRN model. The performance of these models was evaluated using receiver operating characteristic (ROC) curve analysis, calibration, decision curve analysis (DCA), and the Hosmer-Lemeshow test.
RESULTS
In the internal validation cohort and external validation cohort, comparing to Clinic (AUC=0.767 and 0.777), Rad (AUC=0.841 and 0.748), DTL (AUC=0.740 and 0.825) and DLR (AUC=0.863 and 0.859), the DLRN model showed greatest discriminatory ability (AUC=0.908 and 0.908) showed optimal discriminatory ability.
CONCLUSION
The DLRN model built based on gray scale ultrasonography significantly improved the diagnostic performance for benign salivary gland tumors. It can provide clinicians with a non-invasive and accurate diagnostic approach, which holds important clinical significance and value. Ensemble of multiple models helped alleviate overfitting on the small dataset compared to using Resnet50 alone.
PubMed: 38871552
DOI: 10.1016/j.acra.2024.05.023 -
The Journal of Craniofacial Surgery Jun 2024Myxoid liposarcoma (MLPS) of the parotid gland is very rare, and only a few cases have been reported worldwide. It can be difficult to diagnose this disease when there...
Myxoid liposarcoma (MLPS) of the parotid gland is very rare, and only a few cases have been reported worldwide. It can be difficult to diagnose this disease when there is only a single lesion in the patient's body. A 56-year-old man was diagnosed with an MLPS in the left calf and was treated with wide resection. Two months after the surgery, a painless mass appeared in the man's left parotid gland area. Both fine-needle aspiration biopsy before surgery and intraoperative frozen sections suggested that the tumor was likely to be a pleomorphic adenoma. Both parotid ultrasound and CT indicated the same result. However, this mass was confirmed to be metastasis of MLPS through immunohistochemistry and multicolor fluorescence in situ hybridization. The authors report a case in which an MLPS metastasized to the parotid gland; this type of lesion is extremely rare and highly worthy of consideration because the authors misdiagnosed it.
PubMed: 38869293
DOI: 10.1097/SCS.0000000000010418 -
SAGE Open Medical Case Reports 2024Primary lymphoepithelial carcinoma of the salivary glands is an exceptional oncological condition that predominantly emerges within the parotid gland. A significant...
Primary lymphoepithelial carcinoma of the salivary glands is an exceptional oncological condition that predominantly emerges within the parotid gland. A significant prevalence of lymphoepithelial carcinoma has been reported in the Inuit population, along with an associated positive serology for Epstein-Barr virus in these endemic regions. In this paper, we present a case of primary lymphoepithelial carcinoma of the parotid gland in a 68-year-old female patient with a history of diabetes and hypertension residing in a non-endemic area. Histology plays a critical role in the definitive diagnosis, and confirming the primary origin of lymphoepithelial carcinoma after ruling out metastasis from undifferentiated nasopharyngeal carcinoma. The mainstay of treatment is a combination of surgical resection and adjuvant radiotherapy. Inoperable forms are typically managed with chemoradiotherapy.
PubMed: 38868663
DOI: 10.1177/2050313X241260210 -
Ear, Nose, & Throat Journal Jun 2024To provide a comprehensive review of nonsurgical approaches for the management of Warthin's tumors (WTs) and evaluate their safety and efficacy as alternatives to... (Review)
Review
To provide a comprehensive review of nonsurgical approaches for the management of Warthin's tumors (WTs) and evaluate their safety and efficacy as alternatives to surgical intervention. A systematic literature search was conducted in PubMed, Web of Science, Cochrane Library, and Embase databases using specific keywords related to WT and nonsurgical treatments. Studies published before 2012, non-English publications, and mixed methodology articles were excluded. The selection process involved title and abstract screening, followed by a thorough assessment of the remaining articles based on inclusion and exclusion criteria. Data regarding study characteristics, participants, interventions, and outcomes were collected. A total of 1582 records were analyzed, and 6 studies met the inclusion criteria. These studies evaluated different nonsurgical interventions for WT management, including microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy. The findings demonstrated that microwave ablation and radiofrequency ablation led to a significant reduction in tumor size and improved cosmetic appearance. Ultrasound-guided ethanol sclerotherapy also resulted in a notable decrease in tumor size without complications. The included studies supported the safety and efficacy of these nonsurgical options for the treatment of WTs. Nonsurgical approaches, such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy, have emerged as viable alternatives to surgical intervention for the management of WTs. These interventions offer promising outcomes in terms of tumor size reduction and cosmetic improvement. Further research with larger sample sizes and long-term follow-up is warranted to validate these findings and establish standardized protocols for nonsurgical management of WTs.
PubMed: 38864169
DOI: 10.1177/01455613241260969 -
Wounds : a Compendium of Clinical... May 2024Marjolin ulcer (MU) is an aggressive cutaneous malignancy that commonly occurs in those with a chronic wound such as post-burn scar. (Review)
Review
BACKGROUND
Marjolin ulcer (MU) is an aggressive cutaneous malignancy that commonly occurs in those with a chronic wound such as post-burn scar.
CASE REPORT
A 20-year-old male who sustained a flame burn over the scalp at 3 months of age developed a nonhealing ulcer over the burn scar 20 years later, which was treated with adequate surgical margins with adjuvant mold brachytherapy. Two months after completion of that treatment, he developed parotid nodal metastasis with positron emission tomography (PET)-positive bilateral cervical, supraclavicular, right suboccipital, and mesenteric lymph nodes that were treated with concurrent chemoradiation. One month later, the patient developed an ulcerative lesion involving the left parotid region with PET showing infiltration of the parotid gland, but with resolution of other previous sites of uptake. The patient was treated surgically with radical parotidectomy with elective neck dissection and reconstruction with locoregional flap. At 6-month follow-up, the patient developed extensive locoregional recurrence and distant metastasis and was started on oral metronomic therapy. The patient was alive with stable disease at 3-month follow-up after initiation of palliative chemotherapy.
CONCLUSION
Despite timely multimodality therapy, MU may present with a hostile clinical course with a short disease-free interval and early recurrence.
Topics: Humans; Male; Brachytherapy; Burns; Combined Modality Therapy; Neck Dissection; Neoplasm Recurrence, Local; Parotid Neoplasms; Plastic Surgery Procedures; Scalp; Skin Neoplasms; Skin Ulcer; Treatment Outcome; Adult
PubMed: 38861212
DOI: 10.25270/wnds/23138