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Results for “parotidectomy”

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PubMedDate not supplied

Lymphoepithelial cyst with crystalloid formation. Cytologic features of two cases.

BACKGROUND: The presence of amylase crystalloids (AC) in cystic lesions of the parotid gland is a rare occurrence and has been diagnosed to date as sialadenitis. We report the first two cases of parotid lymphoepithelial cyst (LC) containing this type of crystalloid. CASES: Case 1, a 56-year-old male, presented with a 3-cm parotid cyst. Fine needle aspiration (FNA) was performed on the mass. Smears showed numerous crystalloids identical to those described as crystallized amylase. Case 2, a 36-year-old female, had a 2-cm parotid mass. FNA smears exhibited the same features as did case 1. The two patients were treated with superficial parotidectomy, and an LC containing AC was diagnosed in both cases. CONCLUSION: When the above findings are present on FNA of parotid gland, the diagnosis of LC must be considered.

Adult↗

PubMedDate not supplied

Cystic lesion of the parotid gland with squamous metaplasia mistaken for squamous cell carcinoma. A case report.

BACKGROUND: The diverse range of diseases that affect the salivary glands may lead to problems and pitfalls in cyto-diagnosis. While false negative diagnosis of cystic salivary gland tumors is well known, false positive cytodiagnosis in nonneoplastic salivary cysts is less well documented. CASE: An 85-year-old female presented with a painless left parotid gland swelling of three months' duration. Fine needle aspiration cytology yielded fluid, smears of which showed keratinizing squamous cells with nuclear atypia leading to a cytologic diagnosis of cystic squamous cell carcinoma. A total radical parotidectomy followed. Histopathologic study showed cystic dilatation of many of the salivary ducts, which were lined with metaplastic squamous epithelium that showed atypia. There was no evidence of squamous cell carcinoma. CONCLUSION: Squamous metaplasia is known to occur in benign salivary gland lesions, such as pleomorphic adenoma and Warthin's tumors, as well as in salivary duct cysts and necrotizing sialometaplasia. However, atypical squamous metaplasia of salivary duct cysts mimicking squamous cell carcinoma on cytology is unusual.

Aged↗

PubMedDate not supplied

Uncommon tumors of the salivary gland in fine needle aspiration biopsies. A surgeon's perspective.

OBJECTIVE: To determine the utilization of fine needle aspiration (FNA) biopsy in guiding the surgeon in the management of patients with parotid masses and to study the cytohistologic correlations of rare parotid tumors. STUDY DESIGN: FNA biopsies and parotidectomies performed by a head-and-neck surgeon over an approximate three-year period were analyzed. Cytologic features of rare salivary gland tumors were also studied and correlated with their histology. RESULTS: In an acinic cell carcinoma in a 15-year-old female whose smears were stained with Diff-Quik, novel negative images of crystals were found intracytoplasmically and extracellularly, corresponding to the crystallized, membrane-bound, exocrine, secretory substance ultrastructurally. A truly malignant mixed tumor from a 73-year-old female showed capsular invasion in the primary site that later metastasized to the lung with both epithelial and mesenchymal components. The tumor cells did not exhibit nuclear atypia except for fine cytoplasmic vacuoles in the Diff-Quik-stained smears. Basal cell adenoma, membranous (dermal analogue) type, from an 87-year-old female had an interesting geographic pattern on smears. CONCLUSION: Within three years, a total of 70 FNAs were performed. Of those cases, 46 had surgery. Preoperative FNAs of the salivary gland lesions were utilized by the surgeon in guiding treatment options for large, fixed masses as well as masses < 1 cm, in elderly and acquired immunodeficiency syndrome patients.

Adolescent↗

PubMed2001

Treatment of postparotidectomy salivary fistula with botulinum toxin.

We report on the successful treatment with botulinum toxin type A local injections of a salivary fistula that occurred after superficial parotidectomy. In a 58-year-old woman, transcutaneous discharge of saliva in the preauricular region had persisted in spite of 2 surgical revisions. Moreover, facial weakness and synkinesis had developed as a result of an iatrogenic lesion that had occurred at the time of primary surgery and required immediate reanastomosis of the main nerve trunk. Botulinum toxin A was injected into the deep lobe of the remaining parotid gland under ultrasonographic guidance. Additionally, botulinum toxin A was injected into the left orbicularis oculi muscle in order to improve the synkinesis. No adverse effects were observed. The sialorrhea was stopped for 11 months, and the synkinesis of the facial muscles was reduced significantly for 4 months. We conclude that botulinum toxin A injection is a successful alternative for the treatment of chronic salivary fistula.

Adenolymphoma↗

PubMed2002

Primary parotid gland Hodgkin's lymphoma.

Hodgkin's lymphoma with its primary manifestation in the parotid gland is an exceedingly rare entity and is not usually suspected in the initial evaluation of a parotid mass. Because it is not suspected, the results of fine-needle aspiration cytology are often misleading, and parotidectomy is needed for a definitive diagnosis. The most common subtype encountered is lymphocyte-predominant. The prognosis is favorable; the 5-year survival rate exceeds 90%. Treatment consists of chemotherapy, radiotherapy, or both. A case of primary parotid gland Hodgkin's lymphoma is presented along with a review of the literature and a discussion of the evaluation and management of this rare entity.

Adult↗

PubMedDate not supplied

Benign pleomorphic adenomas in children.

Benign pleomorphic adenomas of the salivary glands in children are rare. Reported are 30 patients under the age of 21 years presenting with this neoplasm. Twelve patients were first seen with recurrent or persistent tumor following previous attempts at removal. Retreatment resulted in control of the neoplasm in eight patients with follow-up from 5 to 24 years. Two additional patients have developed malignant degeneration of their neoplasms. All 18 previously untreated patients have remained free of recurrence. As with adults, the treatment of choice for benign pleomorphic adenomas of the parotid gland developing in children is parotidectomy with preservation of the facial nerve. Tumors arising in the submandibular gland are best treated by complete excision of the gland as well as the tumor.

Adenoma↗

PubMed1997

Salivary gland double tumor: synchronous ipsilateral pleomorphic adenoma and acinic cell carcinoma of the parotid gland.

A 44-year-old woman underwent a partial parotidectomy for a slowly enlarging parotid mass diagnosed by fine needle aspiration biopsy as a pleomorphic adenoma. Though macroscopically recognized to be composed of two nodules, differing to some extent from one another, the mass appeared to constitute a single tumor. The microscopic examination disclosed two disparate neoplasms, which were separated from each other by a thin fibrous band. The larger of the two nodules was a pleomorphic adenoma and the smaller one an acinic cell carcinoma. The metachronous--and, even more, the synchronous--occurrence of two histologically different tumors in one major salivary gland is an exceptional and probably coincidental event.

Adenoma, Pleomorphic↗

PubMed1997

Trigeminal neo-neurotization of the paralyzed face.

Sporadic reports throughout the literature have documented the spontaneous return of facial function following deliberate intraoperative sacrifice of the facial nerve. Trigeminal reinnervation of the facial muscles has been suggested as one possible mechanism for this occurrence. Evidence for the phenomenon of trigeminal neo-neurotization has been documented experimentally. The case of a 62-year-old woman who underwent total left parotidectomy with transection of a large facial nerve segment is presented in order to provide further clinical evidence supporting trigeminal neo-neurotization of the facial nerve. Despite the lack of any efforts to reinnervate the patient or graft the facial nerve defect, the patient spontaneously developed return of facial function. Postoperative clinical and electrical testing in this case supports trigeminal-facial reinnervation as the cause for return of facial function. The case report is summarized with a brief discussion, and the relevant literature is thoroughly reviewed.

Electromyography↗

PubMed1990

Combined pterional-anterolateral approaches to cranial base tumors.

Advanced tumors of the paranasal sinuses, parotid gland, orbit, parapharynx, and cranial cavity may invade the infratemporal fossa by direct extension or through natural anatomic pathways. The inability to control disease involving this region is reflected by the unacceptably high recurrence rates for both intracranial and extracranial neoplasms. Between 1983 and 1986, a pterional (or subtemporal) approach was combined with such conventional anterolateral procedures as a mandibulopharyngectomy, maxillectomy, orbitectomy, and parotidectomy in 13 patients with advanced skull base lesions. The tumor origin was extracranial in ten cases and intracranial in three patients. Seven of the neoplasms were malignant and six were histologically benign. Complete tumor removal was achieved in all patients. Repair of the ablative defect was achieved with a temporalis myogenous flap in ten patients, and primary closure or distant myocutaneous flaps in the remaining three patients. Postoperative complications included three lateral nasocutaneous fistulae secondary to temporalis myogenous flap necrosis and isolated cases of stroke, cerebral edema, pneumocephalus, and cerebrospinal fluid rhinorrhea. Twelve patients are alive without evidence of disease at a mean interval of 25 months. The remaining patient died from lung metastases 11 months after surgery.

Adolescent↗

PubMed1990

Reduction of salivary flow with transdermal scopolamine: a four-year experience.

Scopoderm transdermal therapeutic system (TTS) is applied to prevent nausea and vomiting associated with motion sickness. Dry mouth is the most common side effect, appearing in up to two thirds of the patients treated. We have used this side effect to the benefit of patients with sialorrhea or with difficulties swallowing normally secreted amounts of saliva. More than 100 patients with tumors of the aerodigestive tract before and after surgery, and patients after parotidectomies, after tracheotomies, with peritonsillar abscesses, tonsillitis and pharyngitis, and neurologic disorders were thus treated. Reduced secretion of saliva was seen in 50% to 100% of the treatment groups. Other side effects were minimal and we recommend the use of scopoderm TTS for reduction of salivary flow.

Administration, Cutaneous↗

PubMed1993

Subtotal petrosectomy in the management of advanced parotid neoplasms.

Circumferential growth of parotid neoplasms may involve the external auditory meatus posteriorly, the floor of the middle cranial fossa superiorly, and the neurovascular structures of the jugular foramen medially. Inadequate tumor resection in these anatomically complex regions will result in local disease recurrence at the lateral skull base. A subtotal petrosectomy approach has been combined with a standard total parotidectomy in the management of 27 patients with aggressive parotid tumors. Twenty-two patients had malignant lesions and 10 individuals had recurrent disease. The resultant conductive hearing loss is outweighed by the following advantages of this technique: (1) the ability to obtain tumor-free bony margins, (2) proximal intratemporal facial nerve identification, (3) vascular control of the jugular bulb and petrous carotid artery, and (4) the dissection and protection of cranial nerves IX through XII. Our series of 27 patients will be detailed with an emphasis on surgical technique and overall patient results.

Adult↗

PubMedDate not supplied

[Bilateral tumors of the parotid glands. (author's transl)].

Bilateral parotid tumors occur very rarely; they account for 0.5% of 544 cases of parotid tumors recorded at the National Cancer Institute of Milan from 1945 to 1974. Three cases of bilateral tumors are described; two tumors were synchronous and one metachronous. The patients were women of 51, 46 and 52 years. The histologic type was the same on both sides in all cases, namely adenolymphoma, mucoepidermoid carcinoma and mixed tumor respectively. Surgical exicston was the treatment of choice; according to the histology of the tumors partial (adenolymphoma) or total parotidectomy (mixed and malignant tumors) was performed. As to the case of mucoepidermoid cancer of both parotid glands no recurrence was observed after five years.

Adenolymphoma↗

PubMedDate not supplied

Parotid gland tumors in infants and children.

Eleven cases of parotid tumors in children under 16 years of age are considered. The series accounts for 1.6% of 657 cases of parotid tumor of all ages observed during the period 1930-1975 and consists of 6 mixed tumors, 2 mucoepidermoid tumors, 2 angiomas, and 1 benign lymphoepithelial lesion. All the patients underwent surgical treatment, 6 radical and 5 limited. The results of treatment point out that mixed tumors require radical parotidectomy. The attitude towards pediatric parotid tumors is dicussed.

Adolescent↗

PubMed2002

Parotid gland function and dentin apposition in rat molars.

Previous studies have clearly established the down-regulating effect of a sucrose-rich diet on primary dentinogenesis in rat molars. Earlier observation of the negative effect of a high-sucrose diet on a parotid function involved in the control of intradentinal solute movement led us to hypothesize that parotid gland function(s) may have a role in regulating dentinogenesis. Dentin apposition in 1st and 2nd molars of young rats was measured by planimetry in sagittal sections. The following experimental variables were tested: standard and high-sucrose diets, removal of the parotid or the submandibular/sublingual glands, and diets in powder or pellet form. Removal of the submandibular/sublingual glands and changes in diet consistency did not significantly affect dentin apposition. Dentin apposition was significantly depressed by the high-sucrose diet or following parotidectomy. A further decrease followed the combination of the two treatments. Parotid glands appeared to exert a positive effect on dentin apposition in rat molars.

Analysis of Variance↗

PubMed2004

Adenoid cystic carcinoma of the parotid metastasizing to liver: case report.

BACKGROUND: Adenoid cystic carcinoma is a rare malignant parotid tumor. Metastasis can occur even a decade or more after initial treatment of the primary. CASE PRESENTATION: We report a 60 year old female patient who presented with adenoid cystic carcinoma of the parotid gland. She underwent a total conservative parotidectomy followed by adjuvant radiotherapy. While on follow up, patient developed multiple liver metastases which manifested three years later. Patient lived for another two years before she died of her disease. CONCLUSIONS: Although distant metastases of adenoid cystic carcinoma develop frequently, isolated metastasis to liver is unusual. Even after manifestation of distant metastasis, patients can be expected to live for a number of years. Palliative chemotherapy can be considered in symptomatic cases while the usefulness of metastasectomy is controversial.

Carcinoma, Adenoid Cystic↗

PubMed2003

Synchronous sebaceous lymphadenoma with squamous cell carcinoma - case report.

BACKGROUND: Sebaceous lymphadenoma is a rare benign salivary gland tumour of uncertain histogenesis. So is synchronous occurrence of two benign or malignant neoplasms. CASE-REPORT: 68-year-old female presented with right side parotid swelling associated with pain and gradual increase is size. Fine needle aspiration cytology of parotid swelling was suggestive of pleomorphic adenoma. Total conservative parotidectomy was performed and histopathology of the specimen revealed sebaceous lymphadenoma with squamous cell carcinoma. CONCLUSIONS: Sebaceous lymphadenoma and squamous cell carcinoma are two rare benign and malignant neoplasms arising in parotid gland. Synchronous occurrence of these two entities has not been reported.

Journal Article↗

PubMed2006

Giant lipoma arising from deep lobe of the parotid gland.

BACKGROUND: Lipomas are common benign soft tissue neoplasms but they are found very rarely in the deep lobe of parotid gland. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus knowledge of the anatomy and meticulous surgical technique are essential. CASE PRESENTATION: A 71-year-old female presented with a large asymptomatic mass, which had occupied the left facial area for over the past fifteen years, and she requested surgical excision for a cosmetically better facial appearance. The computed tomography (CT) scan showed a well-defined giant lipoma arising from the left deep parotid gland. The lipoma was successfully enucleated after full exposure and mobilization of the overlying facial nerve branches. The surgical specimen measured 9 x 6 cm in size, and histopathology revealed fibrolipoma. The patient experienced an uneventful recovery, with a satisfying facial contour and intact facial nerve function. CONCLUSION: Giant lipomas involving the deep parotid lobe are extremely rare. The high-resolution CT scan provides an accurate and cost-effective preoperative investigative method. Surgical management of deep lobe lipoma should be performed by experienced surgeons due to the need for meticulous dissection of the facial nerve branches. Superficial parotidectomy before deep lobe lipoma removal may be unnecessary in selected cases because preservation of the superficial lobe may contribute to a better aesthetic and functional result.

Journal Article↗

PubMed2006

Sentinel Lymph Node Biopsy for Cutaneous Head and Neck Melanoma: Mapping the Parotid Gland.

BACKGROUND: Sentinel lymph node biopsy (SLNB) for primary cutaneous head and neck melanoma (CHNM) has been shown to be successful and is the current standard of care for intermediate-thickness melanoma. We evaluated our experience with CHNM associated with SLNB mapping to the region of the parotid gland. METHODS: Retrospective review of a prospectively collected melanoma database identified 1014 CHNMs. Two-hundred twenty-three patients underwent SLNB, and 72 (32%) had mapping in the region of the parotid gland between May 1995 and June 2003. RESULTS: The mean number of SLNs per patient was 2.5. A sentinel lymph node (SLN) was successfully identified in 94% of patients, and in 12%, the SLN was positive for metastatic disease. Biopsy of intraparotid SLNs was performed in 51.4% and of periparotid SLNs in 26.4%, and a superficial parotidectomy was performed in 22.2%. Ten patients were found to have lymph nodes in the parotid region with metastatic disease (eight identified by SLNB), and two (20%) patients developed intraparotid lymph node recurrence in the setting of a negative SLNB. Same-basin recurrence in SLN-negative patients was 3.3% with a median follow-up of 26 months. Facial nerve dysfunction was identified in seven (10%) patients. Facial nerve function returned to preoperative status in all patients. CONCLUSIONS: SLNB for patients with primary CHNM mapping to the parotid gland can be performed with a high degree of accuracy and a low morbidity consisting of temporary facial nerve paresis.

Adolescent↗