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PubMed2002

Changing frequency of parotid gland neoplasms--analysis of 560 tumours treated in a district general hospital.

An analysis of all parotidectomies performed for neoplastic lesions in the maxillofacial unit at a district general hospital during a 26-year period between 1974-1999 was undertaken. The details analysed were age, sex, histology and temporal variations in the frequency of specific tumour types during the study period. A total of 538 parotidectomies performed on 529 patients in whom 560 tumours were present, formed the basis of this study. Marked variations were present in the age and sex distribution and relative frequency of specific tumour types in this study, when compared to previous reports. There were also differences in the age and sex distribution of pleomorphic adenoma and adenolymphoma (P <0.0001) in this study. The relative frequency of benign tumours and adenolymphoma increased, whereas that of pleomorphic adenoma decreased during the study period. In addition, there was a statistically significant decrease in the relative frequency of pleomorphic adenoma (P <0.0001) and an increase in adenolymphoma (P <0.0001) when comparisons were made with previous studies. This study from a defined population may be more representative of the true proportion of specific tumours in this population. The potential implications of the results on the investigation and treatment of parotid neoplasms is highlighted.

Adolescent↗
PubMed2000

[A rare case of multiple neoplasms of parotid gland: adenolymphoma and squamous cell carcinoma].

The authors have presented a very rare case of multiple primary neoplasms of parotid gland: adenolymphoma and squamous cell carcinoma. Primary multiple neoplasms and multifocal neoplasms are a very complex problem and therefore have been a topic of many articles. The authors describe mechanism of origin, frequency of occurrence, possibilities of diagnostics. The main reason of these neoplasms origin are simultaneously exposure of the tissue to damaging factors and special tissue sensitivity.

Adenolymphoma↗
PubMed1998

[Estimation of the scintigraphy, sialography and fine needle aspiration biopsy use in the diagnosis of the benign parotid gland neoplasms].

The aim of this study was to estimate diagnostic value of the scintigraphy, sialography and fine needle aspiration biopsy in the diagnosis of parotid gland nonmalignant neoplasms. Evaluation was performed on a 116-patient group with parotid gland nonmalignant neoplasms treated in 1st Department of Laryngology, Silesian Medical University in Katowice, Poland, from 1989 to 1995.

Adenoma, Pleomorphic↗
PubMed2006

[The histo-clinical analysis of 95 malignant neoplasms of parotid gland].

INTRODUCTION: Malignant tumors constituted 25% of all gland tumors, the most frequently in parotid gland. MATERIAL AND METHODS: The study is analysis of 436 patients with parotid gland tumors who underwent surgery in ENT Department. The results of histopatological diagnosis are presented. We analysed surgical treatment, intraoperative tumor stage and accuracy of fine - needle aspiration cytology in diagnosis. RESULTS: Malignant tumors constituted 22% of all gland tumors. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumor. Tumor stage T3-T4 was in 88,5% cases. Accuracy of fine-needle aspiration cytology in diagnosis of parotid tumors is 81,2%.

Adult↗
PubMed1979

Sebaceous lymphadenoma: ultrastructural observations and lipid analysis.

Sebaceous lymphadenoma is a rare, benign neoplasm of the parotid gland. In the 18 years since the initial report seven additional cases have been published. None includes ultrastructural studies or lipid analysis. Electron microscopy shows that the epithelial cells undergo a progressive maturation from basal to the typical lipid-laden mature sebaceous cells as in the cutaneous sebaceous glands. No morphologic differences are found between cutaneous sebaceous glands and the sebaceous glands in this parotid neoplasm. Thin-layer chromatography demonstrates the same type of lipids in the subaceous lymphadenoma as well as in cutaneous sebaceous glands. These findings suggest that the parotid salivary gland may be ectodermally rather than endodermally derived.

Humans↗
PubMed2006

Synchronous unilateral parotid gland neoplasms of three different histological types.

A 67-year-old male with three synchronous tumors in the unilateral parotid gland is reported. Postoperative histological examinations confirmed the presence of three synchronous primary tumors, specifically pleomorphic adenoma, Warthin's tumor and salivary duct carcinoma, in the right parotid gland. To our knowledge, this is the first case report describing three different histological types in the unilateral parotid gland.

Adenolymphoma↗
PubMed1998

Facial nerve reconstruction: outcome and failures.

OBJECTIVE: Our study was conducted to assess the outcome of reconstruction of the facial nerve after various resections for parotid neoplasms. METHOD: A 10-year retrospective analysis of 350 primary parotid neoplasms (of which 70 were malignant) and 10 recurrent benign neoplasms involving facial nerve resection in 19 and 2 patients, respectively. Four patients had total resection of the facial nerve and reconstruction with a five-branch assemblage using standard microtechniques. Four patients had reconstruction of the orbital branch only. Twelve patients, of whom three also had a midface branch reconstructed, had reconstruction of the ramus mandibularis. One patient had a direct anastomosis of a partial resection of the main trunk of the nerve. Objective assessment of muscle activity was carried out in the distribution of the reconstructed nerve with a minimum of 18 months follow-up. RESULTS: All four patients with total facial nerve reconstruction had excellent tone in repose. None had purposeful focused movement, and all had mass movement; however, all had good eye closure. None of the patients with mandibular branch grafting alone had useful return of function, but those who had concomitant midface grafting had good return of function of the reconstructed branches. All patients who had orbital grafting had appropriate eye closure. CONCLUSIONS: Facial nerve grafting is effective to rehabilitate gaps in the pes anserinus, even if patients undergo postoperative radiotherapy. Total nerve grafting provides good tone in repose and eye closure, which justifies the procedure. Single-branch grafting is mandatory for the orbital branch, but one can question the use of a single-branch graft for the mandibular branch.

Adult↗
PubMed1993

Vascular neoplasms of the parotid gland. Parotid vascular tumors.

Vascular neoplasms of the parotid gland are common in early childhood, particularly in females. We reviewed the clinical, histologic, and treatment details of 10 cases of hemangiomas and one case of lymphangioma that involved the parotid gland. Histologically, the cellularity and increased division figures in these lesions should not be interpreted as a sign of a malignant condition. A watchful expectancy for spontaneous regression and preservation of the facial nerve at surgery are advocated.

Adolescent↗
PubMed1998

[Indications for elective neck dissection in malignant epithelial parotid tumors].

The purpose of the present study was to define the indications and extension for the treatment of lymph nodes in clinically NO patients with primary malignant epithelial parotid tumors. A retrospective analysis was performed on 46 cases with such tumor out of 307 parotid neoplasms (246 benign, 61 malignant) consecutively treated from 1985 to 1994. Lymph node metastases were present only in the histotypes with a high degree of malignancy (overall incidence, 24%). Two patients (5%) showed occult metastases. No correlation was found between the size of the neoplasm and the incidence of lymph node metastases. However, the latter were significantly more common in locally highly aggressive neoplasms (class "a"), 8%; class "b" 43%; P = 0.006). Due to the small number of cases, it was not possible to correlate the incidence of occult metastases with neoplasm size or local extension. As regards topographic distribution of lymph node metastases, level II was always involved, level V was never involved, and level i.v was involved only when metastases were found in the upper levels. Occult metastases were found only at level II. Over a follow-up period of 2 to 10 years, no cases were seen with cervical recurrences. Although drawn from a limited series, the results are similar to the data generally reported in the literature, showing that lymph node metastases are rare in neoplasms with a low grade of malignancy whereas there is a significant increase in the incidence of metastatic lymph nodes and occult metastases when the grade of malignancy is high. In conclusion, in clinically NO patients, a suprahomohyoid neck dissection (levels I-II-III) is indicated only when the neoplasm shows a high grade of malignancy or when it is a class "b" malignancy. In the other cases, neck dissection is determined by the clinical evidence of metastasis and can be extended to the lower levels. Neck dissection can be avoided in NO patients whenever ultrasound and fine needle biopsy are both routinely used in the preoperative evaluation of the cervical lymph nodes.

Epithelial Cells↗
PubMed1999

Quantitative study on expression of p16 multiple tumor suppressor gene in salivary gland neoplasm.

The expression of p16 gene in normal salivary acini, benign tumors and carcinomas were microscopically and quantitatively observed by using immunohistochemical method LSAB and CMIASWIN methods. The expression of p16 gene were found in all 3 groups. The positive unit (PU) was higher in tumor group and cancer group than that in normal group (P < 0.01). Furthermore, the PU of p16 was stronger in cytoplasm than in nucleus. Malignant tumors and acini surrounding the tumor revealed strong positives and weak positives respectively. The PU of p16 gene was higher in deep lobe of recurrent parotid neoplasm with incomplete capsule than that in shallow lobe of primary parotid neoplasm with complete capsule. The findings suggests that p16 gene plays an equally important role in the salivary gland tumors and tumors in other part of the body.

Adenoma, Pleomorphic↗
PubMed2000

Prudent management of the mid-cheek mass: revisiting the accessory parotid gland tumor.

OBJECTIVES/HYPOTHESIS: The head and neck surgeon's fascination with parotid surgery arises from the gland's spectrum of histopathological presentations, as well as the diversity of its morphological features. A mass arising in the mid-cheek region may often be overlooked as a rare accessory lobe parotid neoplasm. This report serves to revisit the topic of accessory parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of salivary fistula, facial nerve paralysis, and recurrence are avoided. STUDY DESIGN: This is a retrospective review of our experience with four accessory parotid gland neoplasms and five other masses mimicking this lesion. METHODS: A literature review and retrospective chart review. RESULTS: Over a 6-year period, we have encountered four true accessory lobe tumors, all pleomorphic adenomas. These presented very similarly to four other more commonly encountered masses not of salivary origin and one normal but hyperplastic accessory parotid gland. All were removed through a wide parotidectomy-style approach modified by extending incisions anterosuperiorly and inferoanteriorly. The only complication was a minor salivary fistula in one patient. There were no permanent facial paralyses. CONCLUSIONS: Accessory parotid gland neoplasms are rare and may present as innocuous extraparotid mid-cheek masses. A high index of suspicion, prudent diagnostic skills (including fine-needle aspiration [FNA] biopsy followed by computed tomography [CT] imaging), and meticulous surgical approach (extended parotidectomy-style incision and limited peripheral nerve dissection when possible) are the keys to successful management of these lesions.

Adult↗