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The Pan African Medical Journal 2022Tumors of the parotid gland can be challenging if left untreated. We report three cases of patients with initial clinical and therapeutic manifestations of neglected...
Tumors of the parotid gland can be challenging if left untreated. We report three cases of patients with initial clinical and therapeutic manifestations of neglected parotid tumours in Madagascar: two women and one man aged 42, 47 and 51 years, with tumours that had been developing for 4, 7 and 11 years respectively. One patient was suspected to have malignant tumour due to skin necrosis. The diagnosis was then confirmed by cytopuncture. After obtaining the informed consent, total parotidectomy was performed in all patients. Facial nerve sacrifice with cervical lymph node dissection was established in the patient with a malignant tumour. No intraoperative adverse events were reported. Parotid tumors can become cancerous without proper treatment. Socio-economic factors are involved in delayed consultation. However, early consultation in patients with parotid tumors would prevent management risks.
Topics: Male; Humans; Female; Parotid Neoplasms; Adenoma, Pleomorphic; Parotid Gland; Lymph Node Excision; Risk Management; Retrospective Studies
PubMed: 36915420
DOI: 10.11604/pamj.2022.43.184.29628 -
Archives of Pathology & Laboratory... Feb 2008The salivary glands, despite their relatively simple morphology, give rise to more than 30 histologically distinct benign and malignant tumors. Salivary gland neoplasms... (Review)
Review
The salivary glands, despite their relatively simple morphology, give rise to more than 30 histologically distinct benign and malignant tumors. Salivary gland neoplasms comprise less than 2% of all tumors in humans and 3% of all head and neck tumors. They arise in the parotid gland in 80% of cases, and approximately 80% are benign and 20% are malignant. Among them are lymphoepithelial lesions, rare lesions of the salivary glands and especially of the parotid gland that are characterized by lymphocytic infiltration associated with an epithelial proliferation. They are divided into benign, which is considered as a tumorlike condition, and malignant, which is a rare carcinoma of the salivary glands. This article provides a review of the current knowledge on lymphoepithelial carcinoma with a look at its association with benign lesions and on the importance of making the correct diagnosis for the appropriate treatment.
Topics: Carcinoma, Squamous Cell; Epithelial Cells; Humans; Hyperplasia; Lymphatic Metastasis; Lymphocytes; Metaplasia; Parotid Neoplasms; Radiotherapy Dosage
PubMed: 18251590
DOI: 10.5858/2008-132-278-LCOTPG -
Annals of the Royal College of Surgeons... Jan 2021Parotid masses causing facial palsy are highly indicative of malignancy. A significant number of cases describing benign parotid disease causing facial palsy have been...
INTRODUCTION
Parotid masses causing facial palsy are highly indicative of malignancy. A significant number of cases describing benign parotid disease causing facial palsy have been reported.
MATERIALS AND METHODS
We performed a systematic review of the literature to establish the aetiology, clinical features, investigations and management undertaken during these presentations to assess how these factors differed from malignant presentations and to establish an evidence-based algorithm for their management.
RESULTS
A total of 85 cases were identified from 78 articles. Cystadenolymphomas were the most common histopathological type ( = 0.034). Mean facial palsy recovery duration in neoplastic aetiology was longer than for infective aetiology ( = 0.033). A significant association existed between uncommon infective organisms and development of facial palsy ( = <0.0001).
CONCLUSION
Uncommon benign aetiologies are associated with facial palsy. Investigations and management should be guided by patients' clinical presentations, avoiding excessive treatment. Complete facial palsy recovery rates are high, although not immediate.
Topics: Algorithms; Cystadenoma; Diagnosis, Differential; Evidence-Based Medicine; Facial Paralysis; Humans; Lymphoma; Parotid Gland; Parotid Neoplasms
PubMed: 32969265
DOI: 10.1308/rcsann.2020.0194 -
Journal of Otolaryngology - Head & Neck... Nov 2018Secretory Carcinoma (SC) is a recently described malignancy affecting salivary glands of the head and neck, with a paucity of evidence regarding the natural history,... (Review)
Review
BACKGROUND
Secretory Carcinoma (SC) is a recently described malignancy affecting salivary glands of the head and neck, with a paucity of evidence regarding the natural history, morbidity, and mortality. This study aimed to investigate the current treatment options utilized for SC, as well as its presentation and outcomes.
METHODS
This study is a retrospective case series and includes patients diagnosed with SC at four Maritime Canadian institutions. Literature review of patient outcomes following treatment of SC is also included.
RESULTS
Thirteen patients were identified. Parotid was the most common subsite (69%), followed by minor salivary gland (23%) and submandibular gland (8%). All patients were S100 positive and had at least one additional positive confirmatory stain, including mammaglobin, CK7, or vimentin. Two patients had N2b disease. All patients were treated with primary surgery, and four were offered adjuvant radiotherapy. There was one instance of locoregional recurrence, and one of metastasis. Three patients displayed perineural invasion on pathology, and one patient displayed lymphovascular invasion.
CONCLUSION
Secretory Carcinoma remains understudied regarding its natural history, presentation, and treatment options. This study is the largest single case series in Canada, and highlights the young age and possible aggressiveness of SC. As well, we provide the most comprehensive literature review to date, with a focus on treatment and outcomes for this disease entity.
Topics: Adult; Aged; Biopsy, Fine-Needle; Breast Neoplasms; Carcinoma; Cohort Studies; Combined Modality Therapy; Female; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Nova Scotia; Parotid Neoplasms; Retrospective Studies; Salivary Gland Neoplasms; Survival Analysis
PubMed: 30446016
DOI: 10.1186/s40463-018-0315-6 -
Brazilian Journal of Otorhinolaryngology 2022To investigate the prognostic factors to developing parotid and neck metastasis in locally advanced and relapsed Cutaneous Squamous Cell Carcinoma (CSCC) of the head and...
OBJECTIVE
To investigate the prognostic factors to developing parotid and neck metastasis in locally advanced and relapsed Cutaneous Squamous Cell Carcinoma (CSCC) of the head and neck region.
METHODS
Single-center retrospective cohort study enrolling consecutive patients with advanced CSCC from 2009 to 2019. Seventy-four cases were identified. Study variables demographic data, clinical skin tumor stage, neck stage, parotid stage (P stage), surgical treatment features, and parotid, regional, and distant metastases. Survival measures: Overall Survival (OS) and Disease-Specific Survival (DSS).
RESULTS
The study group included 72.9% men (median age, 67 years); 67.5% showed T2/T3 tumors, 90.5% comorbidities, 20.2% immunosuppressed, with median follow-up: 35.8 months. The most frequent skin primary were auricular and eyelid regions, 75% underwent primary resection with flap reconstruction. Parotid metastasis was present in 50%, 32.4% showing parotid extracapsular spread, multivariate analysis found OR = 37.6 of positive parotid metastasis evolving into positive neck metastasis, p = 0.001. Occult neck metastasis, neck metastasis, and neck extracapsular spread were observed in 13.5%, 51.3%, and 37.8%, respectively. Kaplan-Meier survival: Clinical T4 versus T1, p = 0.028, P1 stage: 30% and 5% survival at 5 and 10 years, P3 stage: 0%, p = 0.016; OS and DSS showed negative survival for the parotid metastasis group, p = 0.0283.
CONCLUSION
Our outcomes support a surgically aggressive approach for locally advanced and relapsed CSCC, with partial parotidectomy for P0, total parotidectomy for P1-3, selective I-III neck dissection for all patients and adjuvant radiochemotherapy to appropriately treat these patients with advanced CSCC of the head and neck region.
LEVEL OF EVIDENCE
II b - Retrospective Cohort Study - Oxford Centre for Evidence-Based Medicine (OCEBM).
Topics: Male; Humans; Aged; Female; Neck Dissection; Carcinoma, Squamous Cell; Squamous Cell Carcinoma of Head and Neck; Retrospective Studies; Parotid Neoplasms; Skin Neoplasms; Neoplasm Staging; Neoplasm Recurrence, Local; Head and Neck Neoplasms
PubMed: 35042657
DOI: 10.1016/j.bjorl.2021.11.007 -
Ethiopian Journal of Health Sciences Jan 2023Intraductal carcinoma is a rare low grade neoplasm of salivary glands with an excellent prognosis. It most frequently occurs in the parotid gland. Ectopic localizations... (Review)
Review
BACKGROUND
Intraductal carcinoma is a rare low grade neoplasm of salivary glands with an excellent prognosis. It most frequently occurs in the parotid gland. Ectopic localizations are quite rare.
METHODS
This case report describes a man in his 60's who was referred to ear, nose and throat outpatient department with 1-month history of painless swelling of the right parotid region.
RESULTS
Ultrasound-guided fine-needle aspiration unveiled a cytologic specimen judged as "suspicious for malignancy" and patient underwent a partial superficial parotidectomy. Immunohistochemistry confirmed diagnosis of intraductal carcinoma of right parotid gland.
CONCLUSIONS
There are few reported cases concerning this clinical entity following thorough review of the literature and recent developments with reference to the contribution of cytology and histopathology will probably modify its classification and management.
Topics: Male; Humans; Carcinoma, Intraductal, Noninfiltrating; Parotid Gland; Parotid Neoplasms; Biopsy, Fine-Needle; Immunohistochemistry
PubMed: 36890933
DOI: 10.4314/ejhs.v33i1.21 -
Otolaryngology--head and Neck Surgery :... Apr 2023Various prognostic factors are associated with the survival of patients with parotid mucoepidermoid carcinoma (MEC). The aim of this systematic review is to summarize...
OBJECTIVE
Various prognostic factors are associated with the survival of patients with parotid mucoepidermoid carcinoma (MEC). The aim of this systematic review is to summarize the clinical and pathologic prognostic factors on survival outcomes in patients with parotid MEC.
DATA SOURCES
Articles published from database inception to July 2020 on OVID Medline, OVID Embase, Cochrane Central, and Scopus.
REVIEW METHODS
Studies were included that reported clinical or pathologic prognostic factors on survival outcomes for adult patients with parotid MEC. Data extraction, risk of bias, and quality assessment were conducted by 2 independent reviewers.
RESULTS
A total of 4290 titles were reviewed, 396 retrieved for full-text screening, and 18 included in the review. The average risk of bias was high, and quality assessment for the prognostic factors ranged from very low to moderate. Prognostic factors that were consistently associated with negative survival outcomes on multivariate analysis included histologic grade (hazard ratio [HR], 5.66), nodal status (HR, 2.86), distant metastasis (HR, 3.10-5.80), intraparotid metastasis (HR, 13.52), and age (HR, 1.02-6.86). Prognostic factors that inconsistently reported associations with survival outcomes were TNM stage, T classification, and N classification.
CONCLUSION
Histologic grade, nodal status, distant metastasis, intraparotid metastasis, and age were associated with worse survival outcomes. These prognostic factors should be considered when determining the most appropriate treatment and follow-up plan for patients with parotid MEC.
Topics: Adult; Humans; Prognosis; Neoplasm Staging; Carcinoma, Mucoepidermoid; Parotid Neoplasms; Disease-Free Survival; Retrospective Studies
PubMed: 35316125
DOI: 10.1177/01945998221086845 -
Acta Otorrinolaringologica Espanola 2016
Topics: Carcinoma, Mucoepidermoid; Child; Humans; Male; Parotid Neoplasms
PubMed: 26976338
DOI: 10.1016/j.otorri.2015.11.005 -
Medical Ultrasonography May 2021Preoperative diagnosis of parotid tumors plays a crucial role in selecting and planning the surgical treatment. Ultrasound (US) with its modern techniques can contribute... (Review)
Review
Preoperative diagnosis of parotid tumors plays a crucial role in selecting and planning the surgical treatment. Ultrasound (US) with its modern techniques can contribute to the differential diagnosis of parotid tumors. This paper aims to achieve a comprehensive review of the ultrasound techniques used in the differential diagnosis of parotid tumors, based on the latest literature data. Considering that most parotid gland tumors are located in the superficial lobe, US is frequently the first imaging technique used for the diagnosis of parotid tumors. Sonoelastography can provide additional data on the elasticity of parotid tumors, but there is an overlap between malignant and benign parotid tumors parameters. Contrast-enhanced ultrasound adds value to conventional ultrasound and allows a more complete characterization of parotid tumors. Many authors have reported promising results using contrast-enhanced ultrasound in the differential diagnosis of parotid tumors. Multiparametric ultrasound with a careful and systematic approach usually allows an accurate differential diagnosis of parotid tumors.
Topics: Diagnosis, Differential; Elasticity Imaging Techniques; Humans; Parotid Gland; Parotid Neoplasms; Ultrasonography
PubMed: 33220034
DOI: 10.11152/mu-2652 -
Cancer Medicine Oct 2023Optimum management of the N0 neck is unresolved in parotid salivary gland cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis and... (Observational Study)
Observational Study
BACKGROUND
Optimum management of the N0 neck is unresolved in parotid salivary gland cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis and its´ clinical use is increasing for head and neck tumors. The object of this study was to establish whether the technique is applicable to detect distribution of sentinel nodes for parotid tumors.
MATERIALS AND METHODS
Prosepective observational study in 30 patients with benign or low-grade T1-T2N0 malignant tumors in the parotid gland planned for surgical treatment. Distribution of SN was detected with a preoperative ultrasound-guided peritumoral injection with a technetium-99 (Tc-99 m) laballed tracer followed by a SPECT-CT and intraoperative measurement in the neck and parotidal tissue. In patients with cytologically suspected malignant tumor or highly unclerar cytology, SNB was also performed.
RESULTS
Sentinel nodes (SNs) were detected in 26/30 cases. Out of these, 7 presented with only one SN, whereas multiple sentinel nodes where detected in 19 cases. No SNs were found in neck level 1. SN was detected in level 5 independent of tumor location within the parotid gland. An intraparotidal distribution of SNs was more frequent in larger tumors.
CONCLUSIONS
The use of SN-technique in the planning of surgical treatment of parotid tumors seems feasible. It may be of clinical value for patients with parotid cancer to enable a more accurate staging and to detect occult metastasis in the SNs within the parotid as well as in the neck, enabaling the possibility to surgically remove all positive SNs at primary surgery and with reduced surgical morbidity.
Topics: Humans; Parotid Neoplasms; Feasibility Studies; Sentinel Lymph Node Biopsy; Lymphatic Metastasis; Neck; Lymph Nodes; Neoplasm Staging
PubMed: 37776164
DOI: 10.1002/cam4.6612