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Acta Otorhinolaryngologica Italica :... Jun 2005Malignant tumours of the parotid gland represent a group of relatively rare lesions. The medical records of 363 patients with parotid swelling treated between 1974 and...
Malignant tumours of the parotid gland represent a group of relatively rare lesions. The medical records of 363 patients with parotid swelling treated between 1974 and 2003 at the "G. Ferreri" Department of Otorhinolaryngology, "La Sapienza" University in Rome were retrospectively analysed. Clinical presentation, pre-operative investigations, surgical procedure, histopathology report, post-operative complications, and the oncological results of 19 patients who underwent extended radical parotidectomy for malignant neoplasm of the parotid gland are discussed. Extended radical parotidectomy, reserved for neoplasms in an advanced stage, involves the removal of the entire parotid gland, with sacrifice of the facial nerve and the resection en bloc of the adjacent structures affected by neoplastic infiltration, such as the temporal bone, the mandibular bone, the skin, blood vessels and nerves. In addition to this surgical treatment, a cycle of adjuvant radiotherapy is also necessary. The overall rate of survival at 10 years depends mainly on the histological characteristics of the tumour, and, in this series, is reported to be approximately 58%. These data indicate that total extended radical parotidectomy combined with post-operative radiotherapy, represents the best therapeutic approach with regard both to quality of life and life expectancy, in patients with an advanced stage of malignant neoplasm of the parotid gland.
Topics: Adult; Combined Modality Therapy; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Otorhinolaryngologic Surgical Procedures; Parotid Neoplasms; Tomography, X-Ray Computed
PubMed: 16450772
DOI: No ID Found -
Archives of Pathology & Laboratory... Jul 2014Diagnoses most commonly associated with a unilateral parotid mass include sialadenitis, pleomorphic adenoma, Warthin tumor, and mucoepidermoid carcinoma. However, rare... (Review)
Review
Diagnoses most commonly associated with a unilateral parotid mass include sialadenitis, pleomorphic adenoma, Warthin tumor, and mucoepidermoid carcinoma. However, rare entities, such as intraparotid schwannoma, must be considered in the differential diagnosis. We present a brief literature review that is illustrative of the current difficulty of preoperative diagnosis of intraparotid schwannoma, which is an exceptionally rare entity, with approximately 80 cases described to date. It may mimic common neoplasms and inflammatory salivary gland conditions on fine-needle aspiration and imaging, but is more likely to be associated with the facial nerve. Depending upon the tumor's spatial relationship to the facial nerve and the extent of neurologic dysfunction, the decision may be made to observe the tumor rather than attempt resection. This potential implication for patient management is a critical consideration that highlights the need for timely, appropriate biopsy and diagnosis.
Topics: Diagnosis, Differential; Facial Nerve; Female; Humans; Immunohistochemistry; Male; Neurilemmoma; Parotid Neoplasms; Prognosis
PubMed: 24978928
DOI: 10.5858/arpa.2013-0014-RS -
European Annals of Otorhinolaryngology,... Oct 2019Primary liposarcoma is very rare in the parotid gland. To date, only 8 cases of primary parotid liposarcoma have been reported. The aim of this study is to report on a...
INTRODUCTION
Primary liposarcoma is very rare in the parotid gland. To date, only 8 cases of primary parotid liposarcoma have been reported. The aim of this study is to report on a case of primary parotid liposarcoma highlighting the complexity of its treatment and analyze treatment outcomes of other reported cases.
CASE SUMMARY
We report a case of parotid liposarcoma arising in the left parotid gland of a 66 year-old man, causing local morbidity, recurrence, repeated surgical treatment and death 5 months after initial treatment.
DISCUSSION
Parotid liposarcoma is marked by a high probability of local recurrence of up to 70% and is prone to distant metastatic spread, as was the case in our patient. Based on limited experience from published literature, optimal treatment entails radical surgery with negative margins. Postoperative radiotherapy is an option for patients with large high-grade tumors, positive margins and involvement of complex anatomic subsites. High-grade tumors have a worse outcome despite the addition of surgery and postoperative radiotherapy.
Topics: Aged; Fatal Outcome; Humans; Liposarcoma; Male; Neck Dissection; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Rare Diseases; Skin Neoplasms
PubMed: 30876853
DOI: 10.1016/j.anorl.2018.01.013 -
Head & Face Medicine Mar 2021The purpose of this study is to determine the histopathological spectrum and risk of primary malignancy of asymptomatic parotid lesions incidentally discovered on...
BACKGROUND
The purpose of this study is to determine the histopathological spectrum and risk of primary malignancy of asymptomatic parotid lesions incidentally discovered on cross-sectional imaging.
METHODS
Over a 10-year period, 154 patients underwent 163 ultrasound-guided parotid lesion biopsies at our institution. This retrospective chart review included 89 lesions in 87 patients with asymptomatic parotid lesions discovered on cross-sectional imaging studies performed for unrelated clinical indications. The histopathologic findings of all sampled lesions were reviewed. We evaluated the patient demographics and pathological diagnoses of sampled parotid lesions to determine the histopathological spectrum and risk of malignancy.
RESULTS
The average age was 67.5 years and 92 % were males. 25 % of patients had bilateral lesions. The average size of the parotid lesions was 1.5 cm and 91 % were located in the superficial lobe. 92.1 % of lesions were benign with Warthin tumor being the most common diagnosis followed by pleomorphic adenoma. 2.3 % of lesions were primary parotid malignant neoplasms, while 5.6 % were metastatic lesions in patients with known malignancy.
CONCLUSIONS
The incidence of primary parotid malignant neoplasm in asymptomatic incidentally discovered parotid lesions is low. Imaging or clinical follow-up may be considered in patients with incidental parotid lesions who prefer to avoid biopsy.
Topics: Adenolymphoma; Aged; Biopsy; Female; Humans; Male; Parotid Gland; Parotid Neoplasms; Retrospective Studies
PubMed: 33757536
DOI: 10.1186/s13005-021-00262-6 -
Head and Neck Pathology Jun 2021Sebaceous lymphadenoma is a rare salivary gland neoplasm most commonly occurring in the sixth to eighth decades of life. Cross sectional imaging typically demonstrates a...
Sebaceous lymphadenoma is a rare salivary gland neoplasm most commonly occurring in the sixth to eighth decades of life. Cross sectional imaging typically demonstrates a multicystic expansile mass, most commonly occurring in the parotid gland, where the radiographic differential diagnosis would include Warthin tumor in this location and age group. Ultimately, the diagnosis is confirmed with the histopathologic findings of tubuloglandular epithelial profiles with sebaceous differentiation and cystic change set within a dense, benign lymphocytic infiltrate. These features are exemplified in this sine qua non radiology-pathology correlation article.
Topics: Aged, 80 and over; Humans; Male; Neoplasms, Glandular and Epithelial; Parotid Neoplasms
PubMed: 33398686
DOI: 10.1007/s12105-020-01266-5 -
The Laryngoscope Feb 2023To design a deep learning model based on multimodal magnetic resonance image (MRI) sequences for automatic parotid neoplasm classification, and to improve the diagnostic...
OBJECTIVE
To design a deep learning model based on multimodal magnetic resonance image (MRI) sequences for automatic parotid neoplasm classification, and to improve the diagnostic decision-making in clinical settings.
METHODS
First, multimodal MRI sequences were collected from 266 patients with parotid neoplasms, and an artificial intelligence (AI)-based deep learning model was designed from scratch, combining the image classification network of Resnet and the Transformer network of Natural language processing. Second, the effectiveness of the deep learning model was improved through the multi-modality fusion of MRI sequences, and the fusion strategy of various MRI sequences was optimized. In addition, we compared the effectiveness of the model in the parotid neoplasm classification with experienced radiologists.
RESULTS
The deep learning model delivered reliable outcomes in differentiating benign and malignant parotid neoplasms. The model, which was trained by the fusion of T2-weighted, postcontrast T1-weighted, and diffusion-weighted imaging (b = 1000 s/mm ), produced the best result, with an accuracy score of 0.85, an area under the receiver operator characteristic (ROC) curve of 0.96, a sensitivity score of 0.90, and a specificity score of 0.84. In addition, the multi-modal paradigm exhibited reliable outcomes in diagnosing the pleomorphic adenoma and the Warthin tumor, but not in the identification of the basal cell adenoma.
CONCLUSION
An accurate and efficient AI based classification model was produced to classify parotid neoplasms, resulting from the fusion of multimodal MRI sequences. The effectiveness certainly outperformed the model with single MRI images or single MRI sequences as input, and potentially, experienced radiologists.
LEVEL OF EVIDENCE
3 Laryngoscope, 133:327-335, 2023.
Topics: Humans; Parotid Neoplasms; Artificial Intelligence; Deep Learning; Sensitivity and Specificity; Magnetic Resonance Imaging; Retrospective Studies
PubMed: 35575610
DOI: 10.1002/lary.30154 -
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 -
Otolaryngology--head and Neck Surgery :... Jun 2018Objectives To investigate the clinical predictors and survival implications of perineural invasion (PNI) in parotid gland malignancies. Study Design Case series with...
Objectives To investigate the clinical predictors and survival implications of perineural invasion (PNI) in parotid gland malignancies. Study Design Case series with chart review. Setting Tertiary care medical center. Subjects and Methods Patients with parotid gland malignancies treated surgically from 2000 to 2015 were retrospectively identified in the Head and Neck Cancer Registry at a single institution. Data points were extracted from the medical record and original pathology reports. Results In total, 186 patients with parotid gland malignancies were identified with a mean follow-up of 5.2 years. Salivary duct carcinoma (45), mucoepidermoid carcinoma (44), and acinic cell carcinoma (26) were the most common histologic types. A total of 46.2% of tumors were found to have PNI. At the time of presentation, facial nerve paresis (odds ratio [OR], 64.7; P < .001) and facial pain (OR, 3.7; P = .002) but not facial paresthesia or anesthesia (OR, 2.8, P = .085) were predictive of PNI. Malignancies with PNI were significantly more likely to be of advanced T and N classification, be high-risk pathologic types, and have positive margins and angiolymphatic invasion. PNI positivity was associated with worse overall (hazard ratio, 2.62; P = .001) and disease-free survival (4.18; P < .001) on univariate Cox regression analysis. However, when controlling for other negative prognosticators, age, and adjuvant therapy, PNI did not have a statistically significant effect on disease-free or overall survival. Conclusions PNI is strongly correlated with more aggressive parotid gland malignancies but is not an independent predictor of worse survival. Facial paresis and pain were predictive of PNI positivity, and facial paresis correlated with worse overall and disease-free survival.
Topics: Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Disease-Free Survival; Facial Nerve; Facial Paralysis; Female; Humans; Male; Margins of Excision; Middle Aged; Neck Dissection; Neoplasm Invasiveness; Pain Measurement; Parotid Neoplasms; Prognosis; Retrospective Studies; Survival Rate; Tertiary Care Centers; Treatment Outcome
PubMed: 29337642
DOI: 10.1177/0194599817751888 -
Brazilian Journal of Otorhinolaryngology 2015Benign tumors of the parotid gland comprise the majority of salivary gland tumors. (Review)
Review
INTRODUCTION
Benign tumors of the parotid gland comprise the majority of salivary gland tumors.
OBJECTIVE
To review the clinical characteristics of parotid gland tumors submitted to surgical treatment by the same surgeon.
METHODS
Retrospective study with 154 patients who had parotid gland tumors. Clinical and histological data, type of surgery, and complications were assessed and described.
RESULTS
The main manifestation was a mass with a median evolution of 12 months for benign tumors and five months for malignant tumors. Ultrasonography was the most frequent complementary exam. Pleomorphic adenoma was the most common of the benign tumors, and mucoepidermoid carcinoma was the most frequent malignant tumor. Superficial parotidectomy with preservation of the facial nerve was the most common surgical procedure and reversible paresis of branches of the facial nerve was the most common complication.
CONCLUSIONS
Pleomorphic adenoma is the most common parotid gland tumor and superficial parotidectomy with preservation of the facial nerve is the most common and appropriate treatment for most low-morbidity tumors.
Topics: Adenoma, Pleomorphic; Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Parotid Neoplasms; Postoperative Complications; Retrospective Studies; Young Adult
PubMed: 25934418
DOI: 10.1016/j.bjorl.2015.03.007 -
Journal of the American Veterinary... Feb 2019
Topics: Animals; Cat Diseases; Cats; Cystadenocarcinoma; Male; Parotid Gland; Parotid Neoplasms
PubMed: 30714872
DOI: 10.2460/javma.254.4.475