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Indian Journal of Surgical Oncology Jun 2023Mucoepidermoid carcinoma (MEC) is the commonest malignant salivary gland tumor affecting the parotid gland in adults and children. In children and adolescents, there is...
Mucoepidermoid carcinoma (MEC) is the commonest malignant salivary gland tumor affecting the parotid gland in adults and children. In children and adolescents, there is a peak incidence in the second decade. We came across a 6-year-old girl with intermediate-grade MEC parotid gland, which is very unusual below 10 years of age. A global literature search revealed only 3 other similar cases in children below 10 years of age. She presented with a 2-year history of left parotid gradually increasing hard swelling involving the overlying skin and underlying sternocleidomastoid muscle which was confirmed on a contrast-enhanced computed tomography (CECT) scan of the face and neck as well as a core biopsy to be a MEC left parotid. The patient underwent a left radical parotidectomy sacrificing the main trunk of the facial nerve while carefully preserving its distal branches along with a left selective neck dissection (SND) followed by facial reanimation using primary neurorrhaphy. Histopathology confirmed an intermediate-grade MEC pT4aN2bMx with close deep lobe margin warranting adjuvant radiotherapy. Albeit very rare, salivary gland neoplasms may occur in children in the first decade of life. Appropriate planning regarding oncological resection with/without facial reanimation, appropriate rehabilitation followed by adjuvant treatment based on histopathology ensures a good prognosis.
PubMed: 37324292
DOI: 10.1007/s13193-023-01717-9 -
Medicine International 2023Multiple neck pathologies occurring simultaneously are a rare condition. The present study describes an extremely rare case of papillary thyroid carcinoma,...
Multiple neck pathologies occurring simultaneously are a rare condition. The present study describes an extremely rare case of papillary thyroid carcinoma, non-functioning parathyroid carcinoma (PC) and Warthin's tumor of the parotid gland. A 59-year-old male presented with a 3-month history of anterior neck swelling. The neck ultrasound revealed a left-sided thyroid nodule associated with pathological lymph nodes. There was a parotid gland mass. A fine-needle aspiration of the left parotid mass was not diagnostic, although the left thyroid nodule revealed a malignancy with metastasis to the left cervical group lymph nodes. The patient underwent total thyroidectomy, left central and left lateral cervical lymph node dissection. A superficial parotidectomy was also performed. A histopathological examination revealed three different pathologies: Papillary thyroid microcarcinoma, PC and Warthin's tumor. The simultaneous occurrence of a Warthin's tumor, papillary thyroid microcarcinoma and PC is an unusual condition. The concurrent findings of these three pathologies have not yet been reported in the literature, at least to the best of our knowledge. The synchronous findings of PTC, non-functioning PC and Warthin's tumor are extremely rare, yet possible. Surgical intervention remains the most appropriate treatment strategy.
PubMed: 37304572
DOI: 10.3892/mi.2023.86 -
Journal of Oral and Maxillofacial... Aug 2023During the preoperative evaluation of parotid gland tumors, one of the main concerns is to determine the location of the tumors in relation to the facial nerve. This...
PURPOSE
During the preoperative evaluation of parotid gland tumors, one of the main concerns is to determine the location of the tumors in relation to the facial nerve. This study aims to assess the value of ultrasound for determining the location of parotid gland tumors in relation to the facial nerve using Stensen's duct.
METHODS
This is a retrospective cross-sectional study at a single institute. The subjects who underwent preoperative ultrasound and parotidectomy for parotid gland tumors were included. The subjects with incomplete operative records or no reference standard for the location of parotid gland tumor were excluded. The primary predictor was ultrasound tumor location, which was defined as the location of parotid gland tumors determined by preoperative ultrasound as to whether the tumors were superficial or deep to the facial nerve. The operative records were used as the reference standard for the location of parotid gland tumors. The primary outcome was diagnostic performances of preoperative ultrasound in predicting the location of parotid gland tumors, which were calculated by comparing ultrasound tumor location to the reference standard. Covariates were sex, age, type of surgery, tumor size, and tumor histology. Data analysis involved descriptive and analytic statistics; P < .05 was considered statistically significant.
RESULTS
One hundred and two of 140 eligible subjects met inclusion and exclusion criteria. There were 50 male and 52 female, with a mean age of 53.3 years. Ultrasound tumor location was classified as deep in 29 subjects, superficial in 50, and indeterminate in 23. The reference standard was deep in 32 subjects and superficial in 70. Indeterminate ultrasound tumor location results were grouped as either deep or superficial to make every possible cross table in which ultrasound tumor location results were presented as a dichotomy. The mean sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the ultrasound to predict the deep location of parotid tumors were 87.5, 82.1, 70.2, 93.6, and 83.8%, respectively.
CONCLUSIONS
Stensen's duct on ultrasound can be a useful criterion to determine the location of parotid gland tumor relative to the facial nerve.
Topics: Humans; Male; Female; Middle Aged; Parotid Neoplasms; Parotid Gland; Facial Nerve; Salivary Ducts; Retrospective Studies; Cross-Sectional Studies
PubMed: 37301226
DOI: 10.1016/j.joms.2023.05.012 -
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 -
Indian Journal of Otolaryngology and... Jun 2023Papillary thyroid carcinoma (PTC) is the most common differentiated thyroid neoplasm. Common sites of regional and distant metastasis includes lymph nodes, lungs and...
Papillary thyroid carcinoma (PTC) is the most common differentiated thyroid neoplasm. Common sites of regional and distant metastasis includes lymph nodes, lungs and bone. 51 year old female patient who was a known case of PTC with a history of multiple surgeries, radioactive iodine therapy (RAI) and oral chemotherapy presented with a painful right parotid mass. PET scan demonstrated FDG avid lesions in the right parotid gland, cervical lymph nodes and other distant sites. Cytology report showed features of metastatic PTC. Patient underwent extended total parotidectomy with facial nerve resection, skin and masseter muscle resection and extended radical neck dissection. Final histopathology (HPE) report showed metastatic papillary carcinoma thyroid. Patient is currently on oral chemotherapy and on regular follow up. PTC rarely metastasizes to parotid gland and such cases have to be treated with surgery alone or with a combination of surgery and RAI based on tumour burden.
PubMed: 37274996
DOI: 10.1007/s12070-022-03425-2 -
International Journal of Surgery Case... Jun 2023Hydatid cysts are often found in the liver or lungs. As for the parotid localization, it remains exceptional even in endemic areas and presents as a tumor of the parotid...
INTRODUCTION AND IMPORTANCE
Hydatid cysts are often found in the liver or lungs. As for the parotid localization, it remains exceptional even in endemic areas and presents as a tumor of the parotid thus representing a challenge to the practitioner.
CASE PRESENTATION
A 54-year-old male farmer presented with a swelling in the left parotid gland region evolving over the past 2 years. Physical examination revealed a non-tender and mobile swelling in the left parotid region, the overlying skin was normal. Magnetic resonance imaging showed a cystic lesion of the left parotid gland. Fine-needle aspiration cytology (FNAC) yielded a clear fluid with a few benign epithelial cell. A superficial parotidectomy was performed. Histopathological examination confirmed the presence of a hydatid cyst in the parotid gland.
CLINICAL DISCUSSION
Parotid hydatid cyst is exceptional. However, it can be suspected in the context of an isolated parotid cystic mass in an endemic area, even in the absence of any other associated location.
CONCLUSION
Hydatid cysts of the parotid gland have a polymorphic and a specific symptomatology and require surgical removal.
PubMed: 37263004
DOI: 10.1016/j.ijscr.2023.108355 -
Iranian Journal of Otorhinolaryngology May 2023Intravascular papillary endothelial hyperplasia (IPEH) is a papillary hyperplasia of the endothelial vascular cells, also called Masson's tumor. Masson's etiology and...
INTRODUCTION
Intravascular papillary endothelial hyperplasia (IPEH) is a papillary hyperplasia of the endothelial vascular cells, also called Masson's tumor. Masson's etiology and risk factors remain unclear but trauma and vascular pathologic conditions may start the tumor process from its common regions like extremities. Common presentations include swelling and mild pain. Our Radiologic modality of choice is Contrast-enhanced MRI which can help us before operating parotidectomy, the gold standard of tumor treatment. As presented in this study, Parotid Masson's tumor, is a very rare form of Masson's,making it even more exceptional.
CASE REPORT
This paper reports a case of a 29-years-old woman with a mass in herright parotid gland from 17 years ago, which has slowly increased in size during these years. She underwent a total parotidectomy following unsuccessful Fibrovein injections, which caused her inflammation. Embolization was performed before the resection to decrease the risk of its hemorrhage. Postoperative follow-up confirmed the reliability of this treatment method as the patient declared no side effects. Apart from its tough diagnosis, since Masson's tumors, especially the ones that emerge in the parotid, are rare, we decided to introduce this case to deliver more information about the treatment and diagnosis of this rare disease to other colleagues.
CONCLUSIONS
The prognosis of parotid Masson's is admirable following a total resection. The patient had no postoperative complaints with no need for multiple visits after resection.
PubMed: 37251290
DOI: 10.22038/IJORL.2023.58567.3288 -
Oral and Maxillofacial Surgery Mar 2024Warthin tumors (WT) are the second most common benign parotid gland neoplasms. They can occur as synchronous or metachronous lesions in 6-10% of cases. This study aims...
PURPOSE
Warthin tumors (WT) are the second most common benign parotid gland neoplasms. They can occur as synchronous or metachronous lesions in 6-10% of cases. This study aims to compare the complication rate in 224 patients who underwent extracapsular dissection (ECD) or superficial parotidectomy (SP) for the treatment of a WT.
METHODS
This retrospective study was conducted at the Department of Maxillo-Facial Surgery at the University of Naples "Federico II" from February 2002 to December 2018 on a group of patients who underwent surgical treatment for WT. The type of surgical technique was chosen based on Quer's classification. The complications evaluated were facial nerve palsy, hematoma, Frey's syndrome, and bleeding.
RESULTS
A total of 224 patients treated from 2002 to 2018 for Warthin tumor were included in the study. Two hundred elven had solitary tumors (94.1%) and 13 had multicentric lesions (5.8%), of which 9 cases presented synchronous lesions and 4 cases presented metachronous lesions. Extracapsular dissection (ECD) was performed in 130 patients (58.3% of cases) and superficial parotidectomy (SP) in the other 94 (41.7% of cases).
CONCLUSIONS
We consider both surgical techniques as valid. In our opinion, it is essential to study each case based on Quer's Classification to obtain the best surgical outcome. Based on a lower observed rate of complications such as facial nerve palsy, Frey's syndrome, and bleeding, ECD seems to be the best option for the surgical treatment of Quer Class I lesions.
Topics: Humans; Retrospective Studies; Follow-Up Studies; Adenolymphoma; Sweating, Gustatory; Postoperative Complications; Parotid Neoplasms; Paralysis; Parotid Gland
PubMed: 37191772
DOI: 10.1007/s10006-023-01156-4 -
Children (Basel, Switzerland) Mar 2023Sialoblastoma is an extremely rare embryonal tumor derived from salivary gland primordial cells. Treatment usually consists of surgery alone; however, in some cases,...
Sialoblastoma is an extremely rare embryonal tumor derived from salivary gland primordial cells. Treatment usually consists of surgery alone; however, in some cases, chemotherapy is required and is administered with good response. We present a case of a 5-week-old girl diagnosed with a parotid gland tumor and co-existing nevus sebaceous on the face. Initial tumorectomy was microscopically non-radical and histopathology revealed sialoblastoma. The patient received adjuvant chemotherapy consisting of vincristine, actinomycin, and cyclophosphamide. Due to imaging studies being inconclusive regarding response and possible residual disease, a second surgery (total parotidectomy) was performed. The histopathology results showed fields of necrosis in the parotid gland but no neoplastic cells in the material. The patient remains under watchful observation and there is no evidence of relapse 12 months after the second surgery. The adjuvant chemotherapy regimen with vincristine, actinomycin, and cyclophosphamide is a viable option of treatment in children with sialoblastoma.
PubMed: 37189877
DOI: 10.3390/children10040628 -
Journal of Medical Case Reports May 2023Spinal metastasis from adenoid cystic carcinoma of the salivary gland is extremely rare. We present two interesting cases of spinal metastasis from adenoid cystic...
BACKGROUND
Spinal metastasis from adenoid cystic carcinoma of the salivary gland is extremely rare. We present two interesting cases of spinal metastasis from adenoid cystic carcinoma of the parotid gland. A 29-year-old Persian male and a 48-year-old Persian female presented with parotid gland mass. The two patients received parotidectomy and radiotherapy. The pathological examination result was adenoid cystic carcinoma. Because of intractable back pain, patients were referred to the hospital after 7 years and 9 months, respectively. Both cases underwent spinal surgery. Histopathology confirmed spinal metastasis from adenoid cystic carcinoma of the parotid gland (case 1: T6, T12, and L1; case 2: T12). Anterior corpectomy of T12 and lateral screw fixation at T11 and L1 were done in case 2. Posterior spinal fusions from T2 to L3 and from T10 to L2 were performed in case 1 and case 2, respectively. Both patients showed good clinical improvement. The last follow-up (case 1: 24 months; case 2: 6 months after surgery), plain radiographs and computed tomography scan showed good fusion without instrumental failure and magnetic resonance imaging revealed good decompression of the spinal cord of both cases.
CONCLUSION
Although spinal metastasis from adenoid cystic carcinoma of the parotid gland is extremely rare, it is necessary to be careful in the differential diagnosis.
Topics: Humans; Male; Female; Adult; Middle Aged; Parotid Gland; Parotid Neoplasms; Carcinoma, Adenoid Cystic; Spinal Neoplasms; Spine
PubMed: 37183252
DOI: 10.1186/s13256-023-03926-w