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Annals of Palliative Medicine Aug 2022Multiple synchronous neoplasms in the ipsilateral parotid gland are very rare. We intend to analyze the clinical characteristics and treatment results of multiple...
BACKGROUND
Multiple synchronous neoplasms in the ipsilateral parotid gland are very rare. We intend to analyze the clinical characteristics and treatment results of multiple synchronous neoplasms in the ipsilateral parotid gland managed at our hospital.
METHODS
The study included 21 patients of multiple synchronous neoplasms in the ipsilateral parotid gland from January 2010 to December 2020.
RESULTS
Twenty-one cases of multiple synchronous neoplasms in the ipsilateral parotid gland were identified among 994 cases of parotid surgery, with a frequency of 2.1%. Multiple synchronous neoplasms in the ipsilateral parotid gland occurred in all males and one female. Except for one case, all of them involved histopathologic neoplasms. Warthin tumor (n=19, 90.5%) was the most common. Among 21 lesions, there were 9 patients of right parotid gland, 4 patients of left parotid gland, and 4 patients of bilateral parotid gland. The main symptoms were slowly enlarging mass within the parotid gland (n=20), followed by incidental detection (n=1).
CONCLUSIONS
Clinicians should be aware of the possibility of multiple synchronous neoplasms in the ipsilateral parotid gland. Preoperative imaging tests, clinical examinations, and careful palpation during surgery are important for accurate diagnosis and treatment.
Topics: Adenolymphoma; Female; Humans; Male; Neoplasms, Multiple Primary; Parotid Gland; Parotid Neoplasms; Tomography, X-Ray Computed
PubMed: 35815451
DOI: 10.21037/apm-22-307 -
Medical Ultrasonography Sep 2010The purpose of this pictorial essay is to illustrate the ultrasonographic aspects of the most common benign tumors of the parotid gland: pleomorphic adenoma and... (Review)
Review
The purpose of this pictorial essay is to illustrate the ultrasonographic aspects of the most common benign tumors of the parotid gland: pleomorphic adenoma and Warthin's tumor. The gray scale and Doppler ultrasonographic findings of the two tumors are reviewed and exemplified.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Humans; Parotid Neoplasms; Ultrasonography, Doppler
PubMed: 21203603
DOI: No ID Found -
Dento Maxillo Facial Radiology 2016To explore the utility of diffusion tensor imaging (DTI) and acoustic radiation force impulse (ARFI) imaging in the diagnosis of parotid tumours.
OBJECTIVES
To explore the utility of diffusion tensor imaging (DTI) and acoustic radiation force impulse (ARFI) imaging in the diagnosis of parotid tumours.
METHODS
51 patients with parotid tumours were examined with DTI on 3.0-T MRI and ARFI imaging on an ultrasound scanner before surgery. Values of apparent diffusion coefficient (ADC), fractional anisotropy (FA) and shear-wave velocity (SWV) were calculated and analyzed with independent samples Wilcoxon-Mann-Whitney test. Cut-off values, sensitivity and specificity were calculated with receiver-operating characteristic (ROC) curve analysis. The value of combination was calculated through parallel test for the cut-off value of ADC, FA and SWV (combination = 0 or 1); then, ROC analysis was performed with pathological results as the gold standard to calculate the sensitivity and specificity for the combination of the three parameters distinguishing benign and malignant parotid tumours. Pathological diagnosis for every patient was made post-operatively from the tumour tissue taken during operation.
RESULTS
There was a significant difference between benign and malignant tumours in the values of ADC, FA and SWV (p = 0.032, p = 0.011 and p < 0.0001); a significant difference in the values was also found between pleomorphic adenoma and malignant tumour (p = 0.0012, p < 0.0001 and p = 0.0002). The diagnosis cut-off points between benign and malignant tumours for ADC, FA and SWV were 1.02 × 10(-3) mm(2) s(-1), 0.24 and 2.76 m s(-1), respectively; the sensitivity for ADC, FA and SWV was 87.50, 62.50 and 68.75%; the specificity was 45.71, 82.86 and 97.14%. Analysis of the combination of the three parameters increased the sensitivity, specificity, Youden index and area under the ROC curve compared with analysis of each parameter alone for distinguishing benign and malignant tumours.
CONCLUSIONS
The diagnostic value of the combination of the three parameters for distinguishing benign and malignant parotid tumours is the best; SWV is the preferred indicator. Parameters of DTI and ARFI may reflect the histological characteristics of parotid tumours and predict benignancy and malignancy and could provide quantitative information about the tumour. Combination of DTI with ARFI imaging had obvious advantage for the diagnosis of parotid tumours than each alone.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Adolescent; Adult; Aged; Biopsy; Child; Diagnosis, Differential; Diffusion Tensor Imaging; Elasticity Imaging Techniques; Feasibility Studies; Female; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Parotid Neoplasms; ROC Curve; Sensitivity and Specificity; Young Adult
PubMed: 27351345
DOI: 10.1259/dmfr.20160100 -
Oral Surgery, Oral Medicine, Oral... Oct 2022The objective of this study was to evaluate the value of tumor morphology, long-to-short diameter ratio (L/S), and ultrasound gray-scale ratio (UGSR) in the differential...
OBJECTIVE
The objective of this study was to evaluate the value of tumor morphology, long-to-short diameter ratio (L/S), and ultrasound gray-scale ratio (UGSR) in the differential diagnosis of 3 parotid neoplasms.
STUDY DESIGN
Preoperative ultrasound images of 17 patients with a malignant tumor (MT), 48 patients with pleomorphic adenoma (PA), and 39 patients with adenolymphoma (AL) were analyzed for imaging features and gray-scale histograms. Tumor morphology, L/S, and UGSR of MT, PA, and AL were compared. Receiver operating characteristic analysis of area under the curve (AUC), sensitivity, and specificity were used to measure the differential diagnostic efficacy of L/S, UGSR, and both combined with tumor morphology.
RESULTS
Morphologic features, L/S, and UGSR differed significantly in various pairwise comparisons of the 3 tumor types. Acceptable discrimination was detected between MT and AL with UGSR alone (AUC = 0.771) and between PA and AL with L/S and UGSR combined (AUC = 0.741). The combination of tumor boundary with UGSR yielded excellent discrimination between MT and PA (AUC = 0.853) and between MT and AL (AUC = 0.885), with sensitivity and specificity values greater than 0.800.
CONCLUSIONS
These ultrasound parameters, alone or in combination, can provide a method for accurate presurgical differential diagnosis of parotid tumors.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Diagnosis, Differential; Humans; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity; Ultrasonography
PubMed: 35872087
DOI: 10.1016/j.oooo.2022.05.012 -
Science Progress 2023Warthin tumor (WT)-like mucoepidermoid carcinoma resembles the histologic pattern of WT and pathologists unaware of this possibility may misdiagnose it as WT with... (Review)
Review
Warthin tumor (WT)-like mucoepidermoid carcinoma resembles the histologic pattern of WT and pathologists unaware of this possibility may misdiagnose it as WT with squamous and mucous epithelium metaplasia or WT malignant transfer into mucoepidermoid carcinoma. The present study reported a case of a 41-year-old Chinese female with a solitary mass in the left parotid gland. In this case, microscopic observation revealed prominent lymph node stroma and multiple cystic structures similar to those seen in WT. However, it lacked the two layers of oncocytic epithelial tissue characteristic of WT. Furthermore, fluorescence hybridization detected MAML2 rearrangement in the case. Considering the histological findings, this case was diagnosed as WT-like mucoepidermoid carcinoma. The present case report provides pathological and clinical features to differentiate it from WT malignant transition into mucoepidermoid carcinoma, WT with squamous and mucous epithelium metaplasia and non-sebaceous lymphadenoma-like mucoepidermoid carcinoma. In conclusion, WT-like mucoepidermoid carcinoma as a special subtype of mucoepidermoid carcinoma has special histological characteristics, which required further observations and more case reports to clearly define this variant.
Topics: Female; Humans; Adult; Parotid Gland; Carcinoma, Mucoepidermoid; In Situ Hybridization, Fluorescence; Adenolymphoma; Metaplasia; Carcinoma, Squamous Cell
PubMed: 37335119
DOI: 10.1177/00368504231179816 -
Brazilian Journal of Otorhinolaryngology 2019Warthin tumors are the second most common benign tumors of the parotid gland. We examined the clinical features of Warthin tumors in our hospital, and analyzed the...
INTRODUCTION
Warthin tumors are the second most common benign tumors of the parotid gland. We examined the clinical features of Warthin tumors in our hospital, and analyzed the consistency within the literatures.
OBJECTIVE
The aim of this study is to analyze the clinical features of Warthin tumors in our 10-year experience of 118 Warthin tumors undergoing surgery at a single institute.
METHODS
From December 2006 to December 2016, 110 patients who underwent surgical treatment for Warthin tumors were identified based on their medical records.
RESULTS
A total of 118 parotid gland operations were performed in 110 patients. Almost 90% of Warthin tumors were found in males, and average patient age was 66.1±6.1 years. The prevalence of smoking history was 89.1% (98/110). Eight patients (7.3%) had bilateral Warthin tumors. Seventy-seven lesions (65.3%) were located in the parotid tail portion, followed by 34 lesions in the superficial lobe (28.8%) and 7 lesions in the deep lobe (5.9%).
CONCLUSION
We determined the appropriate extent of surgery depending on the fine needle aspiration cytology and tumor location by computed tomography scans. Partial facial dysfunction after the operation was detected in 12 cases, and facial nerve function recovered within 3 months. Only one patient experienced a recurrence, and was disease free after the re-operation. We suggest that our treatment algorithm, depending on the location of tumors and the result of fine needle aspiration cytology, can be useful to determine the appropriate extent of surgery for Warthin tumors.
Topics: Adenolymphoma; Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Female; Humans; Male; Middle Aged; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Smoking; Tomography, X-Ray Computed
PubMed: 29807810
DOI: 10.1016/j.bjorl.2018.04.004 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Dec 2022Warthin tumor is a benign salivary gland tumor comprising ductal epithelium and lymphoid stroma. To date, reports about the malignant transformations of intraepithelial...
Warthin tumor is a benign salivary gland tumor comprising ductal epithelium and lymphoid stroma. To date, reports about the malignant transformations of intraepithelial and lymphoid components in Warthin tumor are extremely rare; lymphoid malignant transformation into B-cell lymphoma is particularly rare in combination with T-cell lymphoma. The case of Warthin tumor complicated with T-lymphoblastic lymphoma is reported to emphasize the importance of a careful light microscopic evaluation of lymphoid tissue in Warthin tumor for identifying occult lymphoma presence, reducing misdiagnosis and missed diagnosis, and determining a timely treatment.
Topics: Humans; Adenolymphoma; Parotid Neoplasms; Salivary Gland Neoplasms; Epithelium; Precursor Cell Lymphoblastic Leukemia-Lymphoma
PubMed: 36416328
DOI: 10.7518/hxkq.2022.06.016 -
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 -
Modern Pathology : An Official Journal... Jan 2012Lymphadenomas (LADs) are rare salivary gland tumors. Their clinicopathologic characteristics and etiopathogenesis are poorly understood. We examined 33 LADs in 31...
Lymphadenomas (LADs) are rare salivary gland tumors. Their clinicopathologic characteristics and etiopathogenesis are poorly understood. We examined 33 LADs in 31 patients (17 women and 14 men) aged 11-79 years (median 65 years). There were 22 sebaceous LADs in 21 patients (9 women and 12 men) and 11 non-sebaceous LADs in 10 patients (8 women and 2 men). Two patients had synchronous double tumors. Twenty-six tumors (79%) arose in parotid, three in the neck, and two each in submandibular gland and oral cavity. Extraparotid tumors were seen in 2 of 21 (10%) patients with sebaceous and 4 of 10 (40%) patients with non-sebaceous LADs. Seven of twenty-three (30%) patients had immunosuppressive therapy for unrelated diseases. The tumors were well circumscribed, encapsulated (n=28, 84%) painless masses, varying in size from 0.6 to 6 cm (median 2.2). The cut surfaces were gray-tan to yellow, homogeneous and multicystic (n=24, 72%). The epithelial cells were basaloid, squamous and glandular, forming solid nests, cords, tubules, and cysts. Sebaceous differentiation was restricted to sebaceous lymphadenoma. The epithelial cells expressed basal cell markers (p63, 34BE12, and/or CK5/6, 18/18, 100%) and the luminal glandular cells expressed CK7 (12/12, 100%). Myoepithelial cells were absent (n=10/16, 63%) or focal. The lymphoid stroma was reactive, with germinal centers in 28 (84%). There was no evidence of HPV (0/11), EBV (0/7), and HHV-8 (0/8). Malignant transformation to sebaceous and basal cell adenocarcinoma was seen in one patient each. None of the 11 patients with follow-up (1-8 years) recurred. In summary, sebaceous and non-sebaceous LADs are benign, encapsulated, solid and cystic tumors affecting older adults. Non-sebaceous LADs affect women and extraparotid sites more frequently than sebaceous LADs. Altered immune status may have a role in their etiopathogenesis. Multiple synchronous tumors, origin in buccal mucosa, and malignant transformation may rarely occur.
Topics: Adenocarcinoma; Adenocarcinoma, Sebaceous; Adenolymphoma; Adolescent; Adult; Aged; Biomarkers, Tumor; Cell Transformation, Neoplastic; Child; Epithelial Cells; Female; Herpesvirus 4, Human; Herpesvirus 8, Human; Humans; Immunohistochemistry; Male; Middle Aged; Neoplasms, Multiple Primary; Papillomaviridae; Prognosis; Salivary Gland Neoplasms; Stromal Cells; Time Factors; Tumor Burden; United States; Young Adult
PubMed: 21892186
DOI: 10.1038/modpathol.2011.135 -
Dento Maxillo Facial Radiology Jan 2023To evaluate the diagnostic performance of computed tomography (CT) radiomics analysis for differentiating pleomorphic adenoma (PA), Warthin tumor (WT), and basal cell...
OBJECTIVE
To evaluate the diagnostic performance of computed tomography (CT) radiomics analysis for differentiating pleomorphic adenoma (PA), Warthin tumor (WT), and basal cell adenoma (BCA).
METHODS
A total of 189 patients with PA ( = 112), WT ( = 53) and BCA ( = 24) were divided into a training set ( = 133) and a test set ( = 56). The radiomics features were extracted from plain CT and contrast-enhanced CT images. After dimensionality reduction, plain CT, multiphase-enhanced CT, integrated radiomics signature models and radiomics score (Rad-score) were established and calculated. The receiver operating characteristic (ROC) curve analysis was taken for the assessment of the model performance, and then comparison was conducted among these models. Decision curve analysis (DCA) was adopted to assess the clinical benefits of the models. Diagnostic performances including sensitivity, specificity, and accuracy of the radiologists were evaluated.
RESULTS
Seven, nine, fourteen, and fourteen optimal features were used to constructed plain scan, arterial phase, venous phase, and integrated radiomics signature models, respectively. ROC analysis showed these four models were able to differentiate PA from BCA and WT, with the area under the ROC curve (AUC) values of 0.79, 0.90, 0.87, and 0.94 in the training set, and 0.79, 0.89, 0.86, and 0.94 in the test set, respectively. The integrated model had better diagnostic performance than single-phase radiomics model, but it had similar diagnostic performance to that of the radiomics model based on the arterial phase ( > 0.05). The sensitivity, specificity, and accuracy in the diagnosis of PA were 0.86, 0.46, and 0.70 for the non-subspecialized radiologist and 0.88, 0.77, and 0.84 for the subspecialized radiologist, respectively. Six venous phase parameters were finally selected in differentiating WT from BCA. The predictive effect of the model was favorable, with AUC value of 0.95, sensitivity of 0.96, specificity of 0.83, and accuracy of 0.92. The sensitivity, specificity, and accuracy in the diagnosis between WT and BCA were 0.26, 0.87, and 0.45 for the non-subspecialized radiologist and 0.85, 0.58, and 0.77 for the subspecialized radiologist, respectively.
CONCLUSION
The CT-based radiomics analysis showed favorable predictive performance for differentiating PA, WT, and BCA, thus may be helpful in the clinical decision-making.
Topics: Humans; Adenolymphoma; Adenoma; Adenoma, Pleomorphic; Cell Differentiation; Parotid Neoplasms; Retrospective Studies; Tomography, X-Ray Computed; Parotid Gland
PubMed: 36367128
DOI: 10.1259/dmfr.20220009