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PubMed2006

[Evaluation of the fine needle aspiration biopsy in the presurgical diagnosis of tumors of the parotid gland].

The treatment ofparotid masses is generally surgery. The presurgical assesment is made by clinical examination, radiology and fine needle aspiration (FNA). FNA has been applied for the last decades and has been the subject of many reviews. It is a safe, rapid and economic procedure that can be made as an ambulatory procedure. In this study we have reviewed the parotidectomies performed in our institution during the years 1998 - 2003 where a preoperative FNA was available. The sensitivity of FNA in our hands is 40% and specifity 96.3%. We have also calculated the utility of clinical examination and radiology in the assessment of parotid masses.

Adolescent↗
PubMed2006

Sarcoidosis presenting as a solitary parotid mass.

We describe an unusual case of sarcoidosis in which the patient presented with a discrete solitary parotid mass and no other manifestation of the disease. The diagnosis was based on the unexpected pathologic findings during examination of a superficial parotidectomy specimen. To the best of our knowledge, no such presentation has been previously reported in the English-language literature.

Diagnosis, Differential↗
PubMed2006

Toxoplasmosis lymphadenitis presenting as a parotid mass: a report of 2 cases.

Toxoplasmosis manifesting as a parotid mass is rare; our review of the literature found only 6 previously reported cases. We report 2 new cases. Both patients presented with a small, mobile left parotid mass, and both were successfully treated with a diagnostic superficial parotidectomy. In both cases, the patient had been regularly exposed to cats and had recently eaten undercooked meat. When evaluating a parotid mass, otolaryngologists should be aware of the infectious causes of parotid swelling and lymphadenopathy and consider the possibility of toxoplasmosis when the history and pathologic findings are not suggestive of more common diseases.

Adult↗
PubMed2006

Polymorphous low-grade adenocarcinoma of the parotid gland.

Polymorphous low-grade adenocarcinoma (PLGA) of the parotid gland is rare. We describe a new case in which the patient underwent parotidectomy only to experience an extensive recurrence 2 years later. The recurrence was treated with radical surgical excision and radiation therapy, and the patient remained disease-free at 5 years of follow-up. We also review the literature on primary parotid PLGA.

Adenocarcinoma↗
PubMed2007

Polymorphous low-grade adenocarcinoma of the parotid gland. Case report and review of the literature.

Polymorphous low-grade adenocarcinoma (PLGA) is difficult to diagnose both clinically and histologically due to its indolent presentation, and because of its morphological diversity that includes several microscopic patterns. The aggressive biologic behavior seen in minor salivary glands as compared to major glands is apparently associated histologically to a predominance of the papillary pattern in the former. Biologic behavior of PLGA in the major salivary glands is uncertain, as some cases have developed recurrences and metastases independently of the presence of a papillary pattern. A case of PLGA originated de novo in parotid gland is presented a 60 year-old male, treatment was surgically excised through superficial parotidectomy and to postoperative radiotherapy (46 Gy). Forty-eight months later the patient is alive with no signs of recurrence, as well as a review of the literature, with particular emphasis in its differential diagnosis and biological behavior.

Adenocarcinoma↗
PubMed1991

Surgical landmarks for the facial nerve.

A number of different approaches can be used to expose the facial nerve. The route taken will depend on the pathology and the portion of the nerve that requires exposure. When performing a parotidectomy approach to the extratemporal portion of the facial nerve, the tragal pointer is a key landmark, but other landmarks also should be used to identify the facial nerve safely. The lateral semicircular canal, the chorda tympani nerve, the digastric ridge, and the cochleariform process are some of the useful landmarks in the mastoid and middle ear. When performing a middle fossa approach, the superior semicircular canal, the greater petrosal nerve, and a window through the tegmen tympani into the attic are useful guideposts. The surgeon should use as many of the available landmarks as feasible to perform safe facial nerve surgery.

Ear, Inner↗
PubMed1991

[Thalamocapsular metastasis of muco-epidermoid adenocarcinoma of the parotid gland].

A 58 years woman with muco-epidermitis carcinoma of the left parotid gland treated by parotidectomy and external radiation developed seven years later a left hemianopsia and moria related to thalamo-capsulo-lenticular lesions. Three stereotactic biopsies were performed. Neuropathological examination confirmed a secondary lesion of carcinoma with the same histological features than primary lesion of the parotid. Due to the metastasis location treatment consisted in external radiotherapy guided by stereotactic coordinates.

Adenocarcinoma↗
PubMed1991

Facial palsy following fine needle aspiration biopsy of parotid hemangioma: a case report and review of the literature.

We present here a case of cavernous hemangioma of the parotid which presented as an acute emergency with sudden pain, trismus and swelling. The patient subsequently developed a complete lower motor neuron facial palsy a few hours after a fine needle aspiration biopsy was performed. Total parotidectomy with preservation of the facial nerve relieved the patient of all his symptoms with complete recovery of facial function in six weeks.

Adult↗
PubMed1991

An uncommon case of parotid sialolithiasis.

A vivid example of parotid sialolithiasis diagnosed with an anterior-posterior radiograph and subsequently followed with a superficial parotidectomy is presented. The case presentation is preceded and followed by a discussion of the pathogenesis and treatment of such an abnormality.

Fibrosis↗
PubMed1991

Sump catheter drainage of parotid abscess: an alternative to surgery.

It is a clinical challenge to distinguish patients with parotid abscesses from those with acute sialadenitis. A case of parotid abscess is presented in which a CT scan with intravenous contrast enhancement localized the abscess cavity and guided its aspiration and drainage with an indwelling catheter. By using this percutaneous technique, the need for early surgical intervention by incision and drainage was eliminated. The dense overlying parotid fascia and position of the deep parotid lobe make differentiating between these two clinical entities difficult. Parotid abscesses are readily apparent on computerized tomographic (CT) scanning evaluation with intravenous contrast enhancement, presenting as discrete fluid-filled areas unlike the amorphous appearance of acute sialadenitis. CT scanning with intravenous contrast enhancement has been the preferred radiographic study of choice for evaluating parotid masses or parapharyngeal masses. The treatment of a patient with acute sialadenitis differs from that of a patient with a parotid abscess. Patients with acute sialadenitis will usually respond to vigorous intravenous (IV) hydration, use of sialagogues and appropriate antibiotic coverage. Following a period of conservative treatment with antibiotics and warm soaks, patients with parotid abscesses will usually undergo an incision and drainage procedure, and later, parotidectomy. A case of parotid abscess is presented in which a CT scan with intravenous contrast enhancement localized the abscess cavity and guided its aspiration and drainage with an indwelling catheter. Percutaneous drainage of parapharyngeal abscesses guided by CT has been previously described by Cole. By using this percutaneous technique, the need for early surgical intervention by incision and drainage was eliminated.

Abscess↗
PubMed1991

Acinic cell carcinoma of the parotid gland: review and management.

The purpose of this retrospective review is to study the management of a rare malignant tumor of the parotid gland, the acinic cell carcinoma. Incidence, pathology, clinical findings, and diagnosis are reviewed. Twenty-five patients were seen at the British Columbia Cancer Agency (BCAA) for initial treatment, recurrent disease or follow-up during the period 1958-1990. Twenty-two acinic cell carcinomas (ACC) occurred in the parotid gland. Surgical treatment regimens for parotid ACC ranged from local excision to radical excision. Local excision is not advised but superficial parotidectomy alone appears to have been adequate treatment for small superficial tumors. Eleven of 22 patients received radiotherapy. Indications for adjuvant postoperative radiotherapy are given. Nine patients with primary tumors treated with combined therapy are alive and disease-free with a mean follow-up of 10.7 years. Postoperative radiotherapy appears to be effective in eradicating microscopic residual disease although long-term follow-up is necessary to make these results clinically significant.

Adolescent↗
PubMed1991

Comparison of methods of imaging the salivary glands.

Surgery on the salivary glands can be a considerable surgical challenge because of their complex and delicate structure. To avoid damage to the facial nerve, and because pleomorphic adenomas are the most common space-occupying lesions of the parotid glands, a formal parotidectomy is often undertaken. To plan the surgical approach better and to avoid unnecessary surgery in some patients, the search for the ultimate imaging technique for the salivary glands continues. A few recent reports comparing various imaging techniques for the salivary glands are discussed in this review.

Diagnostic Imaging↗
PubMed1990

[Differential indications for the surgical management of fractures of the mandibular condyle].

The frequency and importance of collum mandibulae fractures is indicated, especially in connection with the sequels of conservative-functional therapy, and the different classifications and types of fractures are described. The non-surgical approach is evaluated as a treatment. Its inconvenient and sometimes unsatisfactory results necessitate the surgical treatment of certain types of collum mandibulae fractures. Absolute en relative indications for osteosynthetic treatment of condylar fractures are noted, the proposed surgical technique is discussed. The importance of a universal preauricular incision continued in an incision for parotidectomy and resulting in a standard incision or a combined preauricular-submandibular incision, is pointed out. Surgical technique for intra and extra capsular collum fractures is illustrated. Our preference goes to functional stable osteosynthesis using titanium mini-plates and the often obligatory dissection of the facial nerve. The so called "condylar shave" or remodelling condylotomy in analogy with the DAUTREY-operation is a therapeutic contingency in case of bilateral collum mandibulae fractures with unilateral low condylar fracture where classical mini-plate osteosynthesis is done, and intracapsular multi-fractured condylar head on the other side where the condylar shave or rubble clearing is performed The attitude towards children is discussed. The result of this surgical technique is illustrated through the follow-up of 73 surgical treatments of collum fractures in 59 patients. We conclude that surgical osteosynthetic treatment of collum mandibulae fractures with a strict indication in case of dislocated and luxated fractures should be included in the therapeutic range of modern maxillo-facial traumatology.

Adolescent↗
PubMed1990

[Prognostic and therapeutic aspects of lympho-epithelial lesions of the parotid. Apropos of 8 cases].

The so-called benign lympho-epithelial lesion (BLEL) of the parotid is a rare condition. Its diagnosis is based on histology. For a long time there have been problems with its classification and prognosis: classification since certain cases may be classified as Sjögren's syndrome or as a precursor of the latter, prognosis there may be recurrence, contralateral involvement or progression to non-hodgkin's lymphoma. The authors discuss these factors in 8 cases and propose total parotidectomy with facial nerve preservation as the treatment of choice.

Adult↗
PubMedDate not supplied

Parotid gland metastasis from renal carcinoma.

The salivary gland most frequently involved with secondary cancer is the parotid gland. Metastases are responsible for 21-42% of malignant parotid tumors. Malignant melanoma and squamous cell cancer are the two most common tumors to metastasize to the parotid gland. Metastatic adenocarcinoma to this site has rarely been reported. Secondary renal cell carcinoma has been reported in many structures, including the brain, sinonasal tract, lungs, abdomen, genitourinary tract, bone, soft tissue, and lymphatics. Histologically proven parotid metastasis has been previously reported in only one patient. Two patients have recently been diagnosed and treated at our institution for this rare disease. The clinical presentation of each patient was quite different. One patient presented with parotid and pulmonary metastases seven years after resection of a renal tumor. Another patient had resection of a parotid mass revealing an occult metastasis from a renal cell carcinoma. Further evaluation revealed a locally extensive asymptomatic hypernephroma. The survival from the time of discovery of the parotid metastasis was 46 months for the former patient, while the latter patient is alive after 20 months. Differentiation of these tumors from vascular disorders (aneurysm or arteriovenous fistula) required selective angiography and computed tomography. Surgical excision via superficial parotidectomy with facial nerve preservation is necessary for palliation, particularly to avoid massive hemorrhage which may occur upon tumor extension into the oropharynx.

Adult↗
PubMed1989

[Cylindroma of the parotid gland. Apropos of 11 cases].

Few studies have been exclusively devoted to date to parotid cylindromas, essentially because of their rarity and their very slow progression. However, these tumours have a serious prognosis. Although local control appears to be better with complementary radiotherapy, the vital prognosis depends entirely on the presence or absence of distant metastases, essentially pulmonary. The analysis of 11 cases of parotid cylindroma leads the authors to propose a rational management. When the tumour is localised, particularly to the superficial lobe, careful total parotidectomy with preservation of the facial nerve is performed; neck dissection is only performed in the presence of obvious lymph node involvement. Postoperative irradiation is not systematically indicated. In the case of a voluminous tumour or in an obviously incomplete resection, deliberate sacrifice of the facial nerve is not essential, as radiotherapy allows good local control. Extensive mutilating operations do not appear to be justified. Chemotherapy requires the use of more effective drugs than those used at the present time. The complete remission rate in the present series was 60% at six years, but a much longer observation period is required, as the very delayed appearance of metastases is always possible.

Adult↗
PubMed1989

[Meibomian gland adenocarcinoma with regional lymph node metastasis].

Meibomian gland carcinoma of the eyelid is a common neoplasm which clinically simulates a benign condition of chalazion. Although growing slowly, metastasis to regional lymph nodes is frequent, at a rate of 17-28% in this country. Eleven (11) cases of Meibomian gland carcinoma with regional lymph node metastasis are reported, and the therapeutic modalities have been tailored to suit the individual cases, including full-thickness local excision, orbital exenteration, radical cervical dissection, and superficial parotidectomy.

Adult↗