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PubMed1989

[Neoplasms of the parotid space. Therapeutic guides].

The Authors report about 161 neoplasms of the parotid space observed in the ten-year period since 1977 to 1987. With the exception of carcinomas and mucoepidermoid tumors, always to be treated by total parotidectomy, for the remaining pathology of the gland either neoplastic or not neoplastic as well as the extra salivary tissues diseases, the Authors suggest a conservative surgical treatment, in respect of the facial nerves and of the salivary tissue not directly involved.

Adolescent↗

PubMedDate not supplied

[Auriculotemporal syndrome in patient with prostatic secondaries to the cervical vertebrae and neck lymph nodes].

Auriculotemporal syndrome is characterized by flushing sweating and hypersensitivity in the temporal, parotid and preauricular area during mastication. The syndrome is a rare complication after 1) injuries in this area, 2) parotidectomy, 3) surgery of fractures of the temporomandibular articulation 4) neoplasms of the parotid gland. It usually appears a few days to 1-2 years after the appearance of the above mentioned causes. A case of auriculotemporal syndrome in a 70 year old man with metastatic Ca from the prostate to the cervical vertebrae and neck lymphnodes is reported. On this occasion, the literature is reviewed and emphasis is given in pathogenesis and treatment of the syndrome.

Aged↗

PubMed1989

Cancer of the periauricular region.

Cutaneous carcinoma of the auricular and periauricular region can be diagnosed early and often can be cured; however, many of these tumors become difficult to treat because of local spread and regional metastasis. Those tumors that are not treated early often require more aggressive treatment with ear canal resection, partial temporal bone resection, or even parotidectomy and radiation therapy. Mohs histographic surgery combined with conventional excision affords the best marginal control for local eradication of these tumors.

Ear Neoplasms↗

PubMed1977

[Parotid lithiasis. Surgical tactics].

Calculi situated behind the buccinator muscle must be approached via a parotidectomy incision. In many cases, simple removal of the intra-canalar or intra-parenchymatous calculus is sufficient.

Adolescent↗

PubMed1989

[Cystic lymphoid hyperplasia of the parotid in relation to acquired immunodeficiency syndrome (HIV+). Apropos of 2 cases].

Cystic lymphoid hyperplasia of the parotid, a rare disease, was recently described in patients with acquired immunodeficiency syndrome. We reported here 2 new cases of this illness. The 2 HIV+ patients showed an enlargement of parotid gland. A superficial parotidectomy was performed. The histological and immunohistochemical studies were completed in one case by a histoenzymological and ultrastructural study. We could see numerous cystic cavities lined with a cylindrical or metaplastic malpighian epithelium and surrounded by a lymphoid tissue, similar to a true lymph node with germinal centers. In these lymphoid structures, we could find some epithelial remnants and numerous epimyoepithelial islands. Besides, anomalies similar to those described in persistent generalized lymphadenopathies were obvious: hyperplastic germinal centers with multiplication of B lymphocytes and thin mantle zone, perifollicular hypervascularization, numerous macrophages, plasmocytes and T lymphocytes with increase of T8 cytotoxic subset in interfollicular and paracortical areas. An early opportunist infection is suggested in the histogenesis of this disease.

Acquired Immunodeficiency Syndrome↗

PubMed1989

[Differential diagnosis of parotid tumors: toxoplasmosis lymphadenitis of the parotid gland].

The most common clinical symptom of toxoplasmosis in adults is a cervicofacial lymphadenopathy. The cat is very important in the epidemiology of toxoplasmosis, but contact with cat excreta is most uncommon. The cause of oral transmission in adults is more likely to be eating undercooked contaminated meat containing tissue cysts, particularly raw pork. Toxoplasmosis as a cause of lymphadenopathy is an unusual, and normally postoperative, finding after parotidectomy for a "tumour". In the last 8 years we have seen ten patients with an acute toxoplasmosis infection. We report two patients showing clinical signs of a parotid gland tumour in whom we demonstrated an intraglandular toxoplasmosis lymphadenopathy before operation. We treated these patients successfully using pyrimethamine and sulphonamide, so that surgery was unnecessary.

Adult↗

PubMed1989

[Malignant neoplasm of the parotid gland. A caseload contribution].

Data from a retrospective study conducted on 20 patients with parotid malignancies are reported. Males were more often affected than females and adult-elderly than the young. A large percentage of the cases were histologically undifferentiated. Eleven total parotidectomies were performed. A further 9 patients only required surgical biopsies for the purpose of histological confirmation. Two of the twenty patients are still alive over 10 years after diagnosis of the tumour.

Adult↗

PubMed1978

[Traumatic lesions of the parotid salivary system. 15 cases (author's transl)].

On the basis of 15 cases, the authors define their attitude to traumatic lesions of the parotid salivary system. In the first place, such lesions must be accurately diagnosed by careful examination and catheterisation of the papilla. This simple manoeuvre makes it possible to avoid emergency sialography. Secondly, treatment varies according to the type of lesion: with a lesion of the facial nerve, suture or nerve graft in the case of loss of substance; with a minimal parenchymatous lesion, observation is necessary after the avoidance of surgery or drainage; with a severe parenchymatous lesion, parotidectomy is necessary, with exploration of the facial nerve.

Adolescent↗

PubMed1989

[Parotid gland tumors. What not to do].

Patients with a tumour located anterior or inferior to the ear probably have a parotid gland tumour. These patients should be referred without further investigation to an ear, nose and throat specialist. Diagnostic measures that may be performed are fine needle aspiration cytology and ultrasonography. Biopsy or enucleation of the tumour should not be carried out. Correct treatment is parotidectomy with preservation of the facial nerve. Inadequate primary treatment may lead to a very unpleasant situation for the patient and for the physician. This is illustrated by three case histories.

Adenoma↗

PubMed1985

[Cylindroma on a pleomorphic adenoma. Apropos of 2 case reports].

Among a group of 863 patients with epithelial tumors of the salivary glands, including 470 with pleomorphic adenomas, the latter were associated with carcinomas in 20 cases and of these two were adenoid cystic carcinoma. In both cases these were isolated parotid tumors, lacking functional symptomatology and failing to recur 2 and 4 years respectively after parotidectomy. Diagnosis was mainly by histology and was based on the finding of a co-existing pleomorphic adenoma and an authentic adenoid cystic carcinoma, not to be confused with the benign pseudo-cylindromatous appearance sometimes detected in simple pleomorphic adenomas. This association of adenoid cystic carcinoma and pleomorphic adenoma increases the risk of recurrence and of metastases--long-term follow up is necessary. Prognosis is dependent mainly on the quality of the initial surgical excision.

Adenoma, Pleomorphic↗

PubMed1987

Parotid cancer in Auckland 1970-1986--too little, too late.

We have reviewed the records of 98 parotid cancer patients seen in Auckland over the seventeen year period January 1970 to December 1986. The average duration of symptoms prior to receiving surgical attention was fifteen months and 58% of patients had stage III disease on presentation. The histological profile of our group of patients was different from that reported in other series with increased numbers of patients having bad outlook tumours. There were seven histological types of parotid cancer and these could be divided into two distinct prognostic groups with mucoepidermoid, malignant mixed, adenoid cystic and acinic cell comprising the more indolent tumours and squamous cell, undifferentiated and adenocarcinoma following a more agressive course. The overall five year cure rate was 35%: 65% of patients were either dead or had developed recurrent disease within this period. Radiotherapy appeared to be beneficial for stage I and II lesions, but in advanced cases it had no obvious impact on survival. The initial surgery for parotid cancer should comprise at least a superficial parotidectomy plus a suprahyoid neck dissection if possible. In addition, patients with positive nodes or more aggressive histology should undergo radical neck dissection. All patients with parotid cancer should have adjuvant radiotherapy.

Adolescent↗

PubMed1986

Bulimia and parotid enlargement--case report and treatment.

Bulimia is a behavioral eating disorder affecting young adult women. Parotid enlargement may occur as a result, although the cause of this swelling is as yet unknown. These changes can be irreversible, unresponsive to resumption of normal dietary habits. The physical unattractiveness of this complication can adversely affect the patient's wellbeing, demanding more active treatment. Treatment of this parotid enlargement has not previously been dealt with definitively. A case study is presented wherein such an individual was treated with bilateral superficial parotidectomy with good results, both emotionally and physically. As the incidence of this disorder continues to increase dramatically, the surgeon may gain a place in the treatment of bulimia.

Adult↗

PubMed1986

[Primary malignant melanoma of the parotid gland: anatomico-clinical study. Apropos of a case and review of the medical literature].

A 62 yo man presented with an enlargement of the parotid gland that had accentuated over the past ten months. Results of a needle aspiration cytology were interpreted as consistent with an adenocarcinoma. A surgical investigation was decided. Frozen and paraffin sections of superficial parotidectomy specimen disclosed a malignant melanoma. This specimen also contained an intraparotid lymph node which was free of tumor. Cervical lymph node dissection yielded 4 metastatic adenopathies among 15 lymph nodes. A retrospective search for an anterior melanocytic lesion was negative. The final diagnosis was primary malignant melanoma of the parotid gland. Cervical radiotherapy was applied. 7 months later, the patient died of diffuse metastatic involvement in the skin, brain, lungs and liver. No local recurrence occurred. Review of the medical literature revealed the rarity of malignant melanomas of the parotid gland (0.68%). No significant differences concerning clinical data and pathological aspects were noted in so called primary malignant melanoma and secondary malignant melanoma of the parotid gland. Nevertheless, primary malignant melanoma of the parotid gland is a controversial entity. Pathogenesis is discussed on the light of modern concepts of diffuse neuro-endocrine system. Prognosis remains poor, due to a late diagnosis and to an inherent aggressiveness of this type of tumor.

Adult↗

PubMed1986

[Salivary gland tumors].

A standard histopathological classification of salivary gland tumor is presented by the World Health Organization and is widely used. It, however, needs a minor modification from the clinical point of view. Histologically there are different character according to different kinds of tumor. For instance malignant change occurs occasionally from benign pleomorphic adenoma, and adenoid cystic carcinoma often causes distant metastasis. Therefore, treatment should be based on histological character of tumor. However, preoperative clinical examinations to differentiate high or moderate grade malignancies from benign tumors are not yet satisfactory. By these tests malignancies are sometimes taken for benign. Parotidectomy with preservation of the facial nerve is indicated not only benign tumors but also for malignancies of low grade extension and for moderate grade malignancies. Combined use of surgery with irradiation and anti-cancer drugs is presumed to be useful for prevention of recurrence and metastasis.

Humans↗

PubMed1986

Malignant tumors of the major salivary glands.

A total of 512 patients with major salivary gland tumors were treated at our institution between the years 1960 to 1975. The 147 cases of malignant salivary gland tumors were reviewed according to presenting characteristics and stage, histology, and outcome. Treatment for each type is summarized. The battery of diagnostic aids and prognostic indicators available to the physician are also reviewed. The newer and more controversial procedures of CT scanning, nuclear magnetic resonance scanning, and fine-needle aspiration are discussed in detail. In the past, salivary gland tumors have been classified by histology alone. Current trends employ the TNM staging system in planning treatment and predicting end results. We have found a far better survival rate in patients with various tumor types presenting with stage I or II disease, but point out that patients with high-grade tumors often present with advanced disease. All major salivary gland tumors should be approached according to the principles of cancer surgery. The minimum procedure is thus superficial or total parotidectomy with preservation of the facial nerve. In low-grade malignancies, the diagnostic procedure will have accomplished this definitive treatment. Salivary gland tumors are rare in the pediatric population. Such malignancies often defy radical treatment. Although cure rates in many categories of high-grade tumors are low, the only hope for survival is an initial aggressive surgical approach. Although radiation was used for recurrent disease only during the years of this study, it is currently being used as adjuvant therapy in almost all malignancies except low-grade mucoepidermoid. Recurrences are almost always fatal.

Adult↗

PubMed1986

[Parotid metastases of clear-cell adenocarcinoma of kidney. Apropos of 2 cases].

Two patients presented parotid metastases from adenocarcinoma of kidney. These metastases are rare and may reveal or develop during the course of a cancer of kidney. In the former case diagnosis presents certain difficulties. Treatment of single metastases is by parotidectomy and nephrectomy, prognosis being similar to that of the renal adenocarcinoma.

Adenocarcinoma↗

PubMed1985

Carcinoma of the parotid gland with osteoclastlike giant cells. Immunohistochemical and ultrastructural observations.

We describe an unusual type of carcinoma of the parotid gland in a 67-year-old man. Because of rapid tumor growth, radical parotidectomy was done. Light microscopic study of the tumor revealed focal gland formation with transition to anaplastic carcinoma. Among the undifferentiated mononuclear cells and bizarre large cells were scattered many osteoclastlike multinucleated giant cells. Immunohistochemical studies on paraffin sections revealed positive staining for epithelial membrane antigen in the epithelial component; however, the multinucleated giant cells were clearly negative for this antigen. Reactions for other cell constituents (carcinoembryonic antigen, alpha 1-antitrypsin, alpha-1-antichymotrypsin, Leu-M1, Leu-M3, lysozyme, and factor VIII-related antigen) were negative in both epithelial and giant cell components of the tumor. Electron microscopy revealed poorly formed cell junctions and numerous microvilli on the surface of the mononuclear tumor cells and multinucleated giant cells, features considered not of diagnostic significance. Similar to carcinomas with osteoclastlike multinucleated giant cells in other organs, this parotid gland tumor has shown clinical and morphologic evidence of aggressive growth; pulmonary metastases developed and the patient died 28 months after radical surgery.

Aged↗

PubMed1985

A comparative analysis of the clinical, sialographic, and pathologic findings in parotid disease.

In review of the clinical and sialographic ability to predict parotid pathology, it was found that the clinical exam was consistently more accurate. Sialographic findings and histopathology were compared in 119 patients who underwent 120 sialograms and subsequent parotidectomies. Sialography alone was able to diagnose a malignant tumor in only 8 per cent (1/13) of the cases. The sialogram proved most helpful for the clinician in the management of patients when the diagnosis was calculus, obstruction, or sialectasia. On the other hand, mass lesions in or adjacent to the parotid, diffuse enlargement of the gland, or conditions such as masseter muscle hypertrophy are probably better evaluated with newer CT techniques in conjunction with sialography or without sialography.

Adolescent↗