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Jesberg P, Monzon A, Gitomer SA, Herrmann BW. Pediatric primary salivary gland tumors. Am J Otolaryngol 2023; 44:103948. [PMID: 37352681 DOI: 10.1016/j.amjoto.2023.103948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/03/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVES To characterize the presentation and treatment of children presenting with primary salivary gland neoplasms. METHODS A retrospective review of primary salivary tumor patients presenting to Children's Hospital Colorado between January 2000 and August 2020. RESULTS Fifty children were identified with primary salivary gland tumors, comprising of 39 (78 %) benign and 11 (22 %) malignant lesions. Pleomorphic adenoma was the most common benign tumor (36/39, 92 %), while acinic cell carcinoma was the most common malignancy (7/11, 64 %). The parotid gland was the most common site, followed by the submandibular gland (66 % vs. 34 %). No tumors were found in the sublingual glands. Benign neoplasms accounted for 70 % of parotid lesions and 94 % of submandibular tumors. No significant differences in age (13.6 years, SD 4 vs. 13.0 years, SD 4.3) were noted between patients with benign and malignant disease, but tumors in females were more frequently malignant (M:F 1:1.3 vs. 1:2.7 for benign and malignant tumors, respectively). Neck dissection and/or facial nerve sacrifice were required in 27 % (3/11) and 9.1 % (1/11) of malignancies, respectively. Local recurrence was observed in 7.7 % (3/39) of benign cases and 9.1 % (1/11) of malignant cases. No salivary malignancies required chemotherapy, though one patient with neurofibromatosis received imatinib prior to resection. Two patients with locoregional malignancy received adjunctive radiation. The average duration of follow up for benign and malignant disease were 12.6 ± 25 and 45.1 ± 32 months, respectively. CONCLUSIONS This study presents one of the larger single institutional experiences of pediatric primary salivary neoplasms in the past 20 years, identifying pleomorphic adenoma and acinic cell carcinoma as the most common benign and malignant etiologies, respectively. While this review found most neoplasms presented as a localized mass effectively managed with conservative surgical resection, aggressive tumors required multidisciplinary care.
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Affiliation(s)
- Parker Jesberg
- University of Colorado School of Medicine, Aurora, CO, United States of America.
| | - Anthony Monzon
- University of Colorado School of Medicine, Aurora, CO, United States of America.
| | - Sarah A Gitomer
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States of America; Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, United States of America.
| | - Brian W Herrmann
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States of America; Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, United States of America.
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2
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Chen J, Xu H, Li X. Von Mises stress peak (VMSP) and laryngomalacia severity score (LSS) are extremely useful in the selection of treatment for laryngomalacia. Eur Arch Otorhinolaryngol 2023; 280:3287-3293. [PMID: 36757513 DOI: 10.1007/s00405-023-07866-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/29/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To analyze the judgment efficiency of a computer stress model and severity score in severity evaluation and treatment plan selection of laryngomalacia patients. METHODS Twenty-two children (12 cases in the operation group and 10 cases in the follow-up group) with moderate to severe laryngomalacia were assessed by laryngomalacia severity score (LSS) which included visual analogue scale (VAS) and clinical score. A computer stress model of the laryngeal cavity was constructed for all children, with the von Mises stress peak (VMSP) of the model used as another quantitative evaluation method. The ROC curves of two quantitative evaluation methods, the LSS and the VMSP, were analyzed respectively, according to the clinical guideline which is regarded as the gold standard for judging whether surgery is needed. The diagnostic efficiency indexes such as sensitivity, specificity, and accuracy were calculated. The area under ROC curves (AUC) of the two methods were compared by a DeLong model. Spearman correlation analysis and Kappa test were used to test the correlation and consistency of the two quantitative evaluation methods. The independent sample t test was used to compare the difference of LSS and VMSP between operation group and follow-up group. RESULTS The sensitivity, specificity, and accuracy of LSS in judging whether laryngomalacia was operated or not were 83.33%, 80.00% and 81.82%, respectively, and the area under ROC curve (AUC) was 0.825 (p < 0.05). The sensitivity, specificity, and accuracy of the computer stress model for laryngomalacia were 58.33%, 90.00% and 72.73%, respectively, and the AUC was 0.796 (p < 0.05). The spearman correlation coefficient between LSS and VMSP was 0.833, p < 0.001, which is statistically significant. LSS (t = 3.251, p = 0.004) and VMSP (t = 2.435, p = 0.024) of the two groups were statistically different. CONCLUSION VMSP and LSS have high diagnostic efficacy in the quantitative evaluation of the severity of laryngomalacia and the selection of treatment plan. The consistency of the two quantitative evaluation methods is good, which has practical value for the evaluation of the severity of laryngomalacia and has guiding significance for surgery.
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Affiliation(s)
- Jiali Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital of Shanghai, Shanghai Jiao Tong University, 355th Luding Road, Shanghai, 200062, People's Republic of China
| | - Hongming Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital of Shanghai, Shanghai Jiao Tong University, 355th Luding Road, Shanghai, 200062, People's Republic of China
| | - Xiaoyan Li
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital of Shanghai, Shanghai Jiao Tong University, 355th Luding Road, Shanghai, 200062, People's Republic of China.
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3
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Bajpai S, Naranje KM, Gautam A, Singh A. A Case of Unilateral Facial Swelling. Neoreviews 2022; 23:771-773. [PMID: 36316257 DOI: 10.1542/neo.23-10-e771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Shivani Bajpai
- Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kirti M Naranje
- Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arun Gautam
- Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anita Singh
- Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Wang H, Liang J, Belcher R, Compton M, Weiss VL, Ely K, Johnson J, Coogan A. Nondiagnostic category of Milan System for Reporting Pediatric Salivary Gland Cytopathology: outcomes and root cause analysis. Cancer Cytopathol 2022; 130:609-619. [PMID: 35298098 PMCID: PMC10030067 DOI: 10.1002/cncy.22571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fine-needle aspiration (FNA) results classified as the nondiagnostic category of the Milan system for reporting salivary gland cytopathology (MSRSGC) may be infrequently encountered in children. Clinical management may be challenging due to lack of data regarding outcomes and underlying causes. METHODS We retrospectively analyzed 106 consecutive pediatric salivary gland FNAs (2000-2020; 45% performed under image guidance). The outcomes of patients with nondiagnostic results were analyzed. Clinical parameters, FNA procedural parameters, and histopathologic parameters were compared between diagnostic and nondiagnostic cases. A root cause analysis was performed using the fishbone diagram and the 5 Whys method. RESULTS A total of 103 initial FNAs were identified. The nondiagnostic rates for initial and repeat biopsy were 16% (16/103) and 67% (2/3), respectively. Initial nondiagnostic FNAs were most frequently managed by clinical/radiologic follow-up only (56%, 9/16), followed by direct surgery (19%, 3/16) and repeat FNA (19%, 3/16). By histologic and clinical/radiologic follow-up, the risk of malignancy for nondiagnostic cases was zero. Palpation guidance (P < .05), inadequate sampling determined by rapid on-site evaluation (P < .01), and lesions with cystic, vascular, or diffuse nature (P < .05) were significantly associated with nondiagnostic results. By root cause analysis, proceduralist sampling error and lack of ultrasound guidance were the most common primary and secondary causes, respectively. CONCLUSIONS Pediatric salivary gland lesions of the nondiagnostic MSRSGC category have minimal risk of malignancy and may be successfully managed by clinical/radiologic follow-up. The root causes for nondiagnostic results were often multifactorial and primarily related to proceduralist sampling, characteristics of the lesions, and lack of ultrasound guidance.
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Affiliation(s)
- Huiying Wang
- Department of Pathology, Microbiology and Immunology
| | | | - Ryan Belcher
- Department of Otolaryngology, Vanderbilt University Medical Center
| | | | | | - Kim Ely
- Department of Pathology, Microbiology and Immunology
| | - Joyce Johnson
- Department of Pathology, Microbiology and Immunology
| | - Alice Coogan
- Department of Pathology, Microbiology and Immunology
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Suleiman R, Darwish T, Shamma H, Safadi MF. Malignant mixed tumour of the parotid gland in a preterm neonate with cytomegalovirus infection. BMJ Case Rep 2022; 15:e248616. [PMID: 35568413 PMCID: PMC9109013 DOI: 10.1136/bcr-2021-248616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2022] [Indexed: 11/04/2022] Open
Abstract
A young pregnant woman presented to the emergency department with acute lower abdominal pain. The ultrasound examination showed not only a viable fetus with a gestational age of 24 weeks but also a heteroechoic mass of about 7×7 cm involving parts of the face. The patient was found to be in active labour with rapid progression, and she gave birth to a dead female neonate. The autopsy showed a large malignant mixed tumour of the left parotid gland and revealed infection with cytomegalovirus. To our knowledge, this is the first reported case of a malignant mixed tumour of salivary glands in fetuses.
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Affiliation(s)
- Riham Suleiman
- Department of Obstetrics and Gynaecology, Maternity University Hospital, Damascus, Syrian Arab Republic
| | - Tuka Darwish
- Department of Obstetrics and Gynaecology, Maternity University Hospital, Damascus, Syrian Arab Republic
| | - Hadeel Shamma
- Department of Pathology, Klinikum Chemnitz gGmbH, Chemnitz, Sachsen, Germany
| | - Mhd Firas Safadi
- General, Visceral and Proctological Surgery, Diakonmed Diakoniekrankenhaus Chemnitzer Land gGmbH, Hartmannsdorf, Saxony, Germany
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6
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Submandibular gland capillary hemangioma in an infant. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2021.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Chalard F, Hermann AL, Elmaleh-Bergès M, Ducou le Pointe H. Imaging of parotid anomalies in infants and children. Insights Imaging 2022; 13:27. [PMID: 35201515 PMCID: PMC8873326 DOI: 10.1186/s13244-022-01166-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/27/2022] [Indexed: 12/19/2022] Open
Abstract
A wide spectrum of disorders involves the parotid glands, in infancy and childhood. Acute or chronic inflammatory/infectious diseases are predominant. The first branchial cleft anomalies are congenital lesions that typically manifest during childhood. Tumor lesions are more likely to be benign, with infantile hemangioma the most common in infancy and pleomorphic adenoma the most frequent in childhood. Malignant tumors are uncommon, with mucoepidermoid carcinoma the least rare. Infiltrative parotid diseases are rare and have some pediatric clinical specificities. These common and uncommon disorders of parotid glands during childhood and their imaging characteristics are reviewed.
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Affiliation(s)
- François Chalard
- Department of Pediatric Radiology, Hôpital Armand Trousseau, 26, Avenue du Dr. Arnold Netter, 75012, Paris, France.
| | - Anne-Laure Hermann
- Department of Pediatric Radiology, Hôpital Armand Trousseau, 26, Avenue du Dr. Arnold Netter, 75012, Paris, France
| | | | - Hubert Ducou le Pointe
- Department of Pediatric Radiology, Hôpital Armand Trousseau, 26, Avenue du Dr. Arnold Netter, 75012, Paris, France
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8
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Wang H, Liang J, Borinstein SC, Belcher R, Mannion K, Virgin F, Compton ML, Weiss VL, Ely K, Johnson J, Coogan A. Fine-Needle Aspiration Biopsy of Pediatric Salivary Gland Tumors: Analysis of Patient Tolerability, Sedation Requirement, and Procedural Complication. Acta Cytol 2022; 66:179-186. [PMID: 35226899 PMCID: PMC9976783 DOI: 10.1159/000522208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/09/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Fine-needle aspiration (FNA) biopsy is the standard diagnostic tool recommended by consensus management guidelines for preoperative evaluation of salivary gland tumors in adults. However, its utility in the pediatric population remains debated due to a paucity of data and inherited challenges of pediatric management (patient cooperation, the need for sedation, and procedural complications). METHODS Consecutive series of 92 FNA biopsies of pediatric salivary gland lesions with available procedural data were included for retrospective analysis. Patient demographics, procedural characteristics, and complications were assessed. RESULTS Sixty-three patients (68%) tolerated FNA without sedation. Sedation need was significantly associated with younger age, concurrent non-FNA procedure requiring sedation, ultrasound guidance, interventional radiologist as the proceduralist, and radiology suite as the facility setting. The sedation rates for children, and early, middle, and late adolescents were 69%, 32%, 12%, and 10%, respectively, with an optimal cutoff point of ≤12 years for age derived from receiver operating characteristic curve analysis. No significant procedural complications were observed. Sedation did not provide significantly better diagnostic yield. CONCLUSION FNA biopsy of salivary gland tumors is safe, well tolerated by the pediatric population, and can be effectively performed in an outpatient setting without sedation in most cases. FNA biopsy is a useful tool in the preoperative management of pediatric patients with salivary gland tumors.
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Affiliation(s)
- Huiying Wang
- Department of Pathology, Microbiology and Immunology
| | | | | | - Ryan Belcher
- Department of Otolaryngology, Vanderbilt University Medical Center
| | - Kyle Mannion
- Department of Otolaryngology, Vanderbilt University Medical Center
| | - Frank Virgin
- Department of Otolaryngology, Vanderbilt University Medical Center
| | | | | | - Kim Ely
- Department of Pathology, Microbiology and Immunology
| | - Joyce Johnson
- Department of Pathology, Microbiology and Immunology
| | - Alice Coogan
- Department of Pathology, Microbiology and Immunology
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Galluzzi F, Garavello W. Surgical treatment of pleomorphic adenoma of parotid gland in children: a systematic review. Auris Nasus Larynx 2022; 49:547-553. [DOI: 10.1016/j.anl.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 01/08/2022] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
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10
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Manogaran RS, Mandelia A, Bhuskute G, Mathialagan A. Head-and-Neck Solid Tumors in Children: A Retrospective Review from a Tertiary Care Institute in North India. J Indian Assoc Pediatr Surg 2021; 26:299-306. [PMID: 34728914 PMCID: PMC8515538 DOI: 10.4103/jiaps.jiaps_145_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/19/2020] [Accepted: 08/04/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives The aim of this study was to review the clinical profile, management, and outcome of solid tumors in the head-and-neck region in children at our institute. Methods We retrospectively reviewed children with head-and-neck solid tumors who were treated jointly under the departments of Pediatric Surgery and Otorhinolaryngology at our institute between 2016 and 2019. Results In the study period, 10 children (6 males, 4 females) with a median age of 9.5 years (range 5 days-16 years) were treated by our unit. The patients had four tumors arising from the parotid, 2 from nose/naso-pharynx, 1 each from the tongue, submandibular gland, para-pharyngeal space, and infratemporal fossa. A majority (90%) of the patients underwent complete surgical excision of the tumor, preserving the loco-regional neurovascular structures to minimize postoperative morbidity. Malignant lesions were seen in 4 patients (2 rhabdomyosarcoma, 1 primitive neuro-ectodermal tumor, 1 mucoepidermoid carcinoma) and 6 patients had benign pathology (3 pleomorphic adenoma, 2 mature teratoma, 1 schwanomma). Additional therapy with chemotherapy and local radiotherapy was required in 3 out of 4 patients with malignant pathology. The median follow-up duration is 15 months. At last follow-up, all patients are alive and 9 out of 10 patients (90%) are disease-free. Conclusion Our experience highlights rare and difficult tumors in the head-and-neck region in children. These tumors are not commonly managed by the pediatric surgeon in routine practice. The paper outlines the multi-modality management of these tumors, which is essential for an optimal outcome.
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Affiliation(s)
- Ravi Sankar Manogaran
- Department of Neurosurgery, Division of Neuro-otology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ankur Mandelia
- Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Govind Bhuskute
- Department of Neurosurgery, Division of Neuro-otology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arulalan Mathialagan
- Department of Neurosurgery, Division of Neuro-otology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Incidental Cone Beam CT Finding of Juvenile Pleomorphic Adenoma. Case Rep Dent 2020; 2020:8862657. [PMID: 33312742 PMCID: PMC7719488 DOI: 10.1155/2020/8862657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/08/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022] Open
Abstract
Pleomorphic adenoma is a benign mixed tumor composed of epithelial and myoepithelial cells, less commonly occurring in minor salivary glands or in children. A case of juvenile pleomorphic adenoma missed clinically and incidentally found in cone beam CT images is described. Clinical, radiographic, and histologic images are presented.
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12
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Qayoom S, Singh AK, Chakrabarti D, Singh HP, Singh US. Oncocytic mucoepidermoid carcinoma (OMEC) of the parotid gland in a 12-year-old patient: A diagnostic challenge on cytology. Diagn Cytopathol 2020; 49:E60-E64. [PMID: 33237638 DOI: 10.1002/dc.24581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/09/2022]
Abstract
Mucoepidermoid carcinoma is the most common malignant salivary gland neoplasm comprising approximately 10% of all tumours of the major salivary gland. Owing to a plethora of morphological variations, it poses a diagnostic challenge on fine-needle aspiration cytology. Oncocytic variant of mucoepidermoid carcinoma is a rare subtype seen in the age group of 20-80 years. It is crucial to make the correct diagnosis on cytology as it has therapeutic implications. Oncocytes can be present in a wide range of salivary gland lesions ranging from non-neoplastic conditions to benign and malignant lesions. We report a case of oncocytic mucoepidermoid carcinoma of the parotid gland in a 12-year-old boy which is the youngest age reported for the same. On cytology, this case was initially diagnosed as Warthin's tumour and was supported by radiology. However, histomorphological findings clinched the diagnosis of an oncocytic variant of mucoepidermoid carcinoma with the aid of immunohistochemistry.
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Affiliation(s)
- Sumaira Qayoom
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Ajay K Singh
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Deep Chakrabarti
- Department of Radiation Oncology, King George's Medical University, Lucknow, India
| | - Hitendra P Singh
- Department of Otorhinolaryngology and Head Neck Surgery, King George's Medical University, Lucknow, India
| | - Uma S Singh
- Department of Pathology, King George's Medical University, Lucknow, India
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D'Arco F, Ugga L. Computed tomography and magnetic resonance imaging in pediatric salivary gland diseases: a guide to the differential diagnosis. Pediatr Radiol 2020; 50:1293-1307. [PMID: 32556808 DOI: 10.1007/s00247-020-04684-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/09/2020] [Accepted: 04/16/2020] [Indexed: 12/12/2022]
Abstract
Salivary gland pathologies in children are frequent, particularly viral infections, but rarely need cross-sectional imaging. However, when a mass involves the salivary spaces (primarily or as a secondary invasion from other neck spaces) it may pose problems in the differential diagnosis and in immediate management. Infrequently, systemic autoimmune diseases can also involve the salivary parenchyma in children and correctly interpreting the constellation of findings in the whole body is critical for the diagnosis. Distinguishing between cystic and solid masses is the first step for radiologists in order to narrow down the diagnosis. Location and spatial extension are the most important elements differentiating cystic masses, while signal characteristics, internal structure and local invasion help in the differential diagnosis of solid masses.
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Affiliation(s)
- Felice D'Arco
- Department of Radiology, Neuroradiology Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences,, University of Naples "Federico II", Naples, Italy
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14
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Shah BA, Singh AP, Sherwani AY, Ahmad SM. Pleomorphic adenoma of the upper lip: A rare case report. Natl J Maxillofac Surg 2020; 11:289-291. [PMID: 33897197 PMCID: PMC8051652 DOI: 10.4103/njms.njms_20_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 02/18/2019] [Accepted: 05/28/2019] [Indexed: 11/04/2022] Open
Abstract
Pleomorphic adenoma (PA), also called mixed tumor, is the most common benign tumor of the salivary glands that mostly occurs in the parotid or submandibular glands but may also occur in the minor salivary glands that are distributed throughout the oral cavity. The common sites of PA of the minor salivary glands are the palates followed by lips and cheeks. Surgical removal with adequate margins is the principal treatment. We present a case of PA (arising from the minor salivary gland of the upper lip) - a rare site in a 65-year-old female who presented with a swelling upper lip of 2-year duration. Fine-needle aspiration cytology of the swelling revealed PA which was confirmed by histopathological examination after complete excision of the swelling.
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Affiliation(s)
- Baabar Ali Shah
- Department of Maxillo-Facial Surgery, District Hospital Baramulla, Baramulla, Jammu and Kashmir, India
| | - Amrit Pal Singh
- Department of Maxillo-Facial Surgery, District Hospital Baramulla, Baramulla, Jammu and Kashmir, India
| | - Afak Yusuf Sherwani
- Department of General Surgery, District Hospital Baramulla, Baramulla, Jammu and Kashmir, India
| | - Syed Masood Ahmad
- Department of Hospital Administration, District Hospital Baramulla, Baramulla, Jammu and Kashmir, India
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15
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Nix JS, Rooper LM. Navigating small biopsies of salivary gland tumors: a pattern-based approach. J Am Soc Cytopathol 2020; 9:369-382. [PMID: 32660844 DOI: 10.1016/j.jasc.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 12/15/2022]
Abstract
Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a specific diagnosis is not feasible in all cases, a cautious and thoughtful approach to the differential diagnosis and a keen awareness of clinical consequences can facilitate the most complete and useful classification possible. In this review, we present a general strategy for the evaluation of small salivary biopsies, including consideration of clinical and radiographic information, systematic assessment of histologic patterns, and judicious use of immunohistochemistry and molecular studies. We then focus on the distinctive differential diagnoses raised by 6 specific histologic patterns: tubular and cribriform architecture, squamous differentiation, mucin and other secretions, high-grade cytology, epithelial and lymphoid elements, and oncocytic features. Throughout this systematic and pattern-based approach, we focus on practical and cost-effective strategies to overcome the most common diagnostic challenges in limited material.
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MESH Headings
- Artifacts
- Biomarkers, Tumor/metabolism
- Biopsy/methods
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/metabolism
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/diagnosis
- Carcinoma, Mucoepidermoid/metabolism
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Diagnosis, Differential
- Humans
- Immunohistochemistry/methods
- Mucins/biosynthesis
- Salivary Gland Neoplasms/diagnosis
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
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Affiliation(s)
- J Stephen Nix
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa M Rooper
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Ronchi A, Di Martino M, Caputo A, Zeppa P, Colella G, Franco R, Cozzolino I. Fine-Needle Aspiration Cytology Is an Effective Diagnostic Tool in Paediatric Patients with Mucoepidermoid Carcinoma as Secondary Neoplasm. Acta Cytol 2020; 64:520-531. [PMID: 32526741 DOI: 10.1159/000508395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in paediatric population, accounting for 16% of all cases. Patients affected by a previous solid or leukaemic neoplasm during their childhood may develop a second different tumour during the follow-up. In this setting, salivary gland MEC is relatively frequent, accounting for 6% of the second neoplasms in paediatric patients. Consequently, the occurrence of salivary gland nodules in paediatric patients with a previous neoplasm should be considered an event with a high risk of malignancy that poses peculiar diagnostic challenges. SUMMARY This study was designed to define clinical and instrumental findings and morphological features of MEC on fine-needle aspiration cytology (FNAC) samples in paediatric patients with and without a previous neoplasm. Five patients under 19 years are included in this series. FNAC was performed in all patients on a parotid nodule. We have identified 2 groups of patients: (a) 2 cases with previous history of malignancy (acute lymphoblastic leukaemia and Hodgkin lymphoma) and (b) 3 cases without previous malignant neoplasms. In all cases, a final diagnosis of MEC was rendered. Key Messages: MEC may occur as a second malignancy in paediatric patients. FNAC is certainly a valid and accurate diagnostic tool for this type of neoplasm, even in the paediatric age, allowing the correct management of the patients.
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Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Martina Di Martino
- Unit of Hematology-Oncology, Pediatric Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - Giuseppe Colella
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Dental Specialty, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy,
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Snyder V, Bayrak S, Woodroof J, Kakarala K. A Parathyroid Hemangioma of the Retropharynx. JAMA Otolaryngol Head Neck Surg 2019; 144:1181-1183. [PMID: 30242327 DOI: 10.1001/jamaoto.2018.2248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Vusala Snyder
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City
| | - Sinehan Bayrak
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City
| | - Janet Woodroof
- Department of Clinical Pathology, University of Kansas Medical Center, Kansas City
| | - Kiran Kakarala
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City
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Ronchi A, Montella M, Zito Marino F, Panarese I, Pagliuca F, Colella G, Franco R, Cozzolino I. Diagnostic accuracy of FNA cytology for diagnosis of salivary gland tumors in pediatric patients. Cancer Cytopathol 2019; 127:529-538. [DOI: 10.1002/cncy.22162] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/21/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Iacopo Panarese
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Francesca Pagliuca
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Giuseppe Colella
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Dental Specialty University of Campania “Luigi Vanvitelli” Naples Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
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Davudov MM, Hasanova P. Pleomorphic adenoma of the parotid gland. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Isaiah A, Sengupta AL, Mitchell RB. An Unusual Neck Mass in a Child. EAR, NOSE & THROAT JOURNAL 2019; 99:103-104. [PMID: 32162551 DOI: 10.1177/0145561318823965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Amal Isaiah
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern and Children's Health, Dallas, TX, USA
| | - Anita L Sengupta
- Department of Pathology, UT Southwestern and Children's Health, Dallas, TX, USA
| | - Ron B Mitchell
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern and Children's Health, Dallas, TX, USA
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21
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Pleomorphic adenoma of the head and neck in children: presentation and management. Laryngoscope 2018; 129:2603-2609. [DOI: 10.1002/lary.27590] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 12/18/2022]
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Pediatric Pleomorphic Adenoma of the Parotid: Case Report, Review of Literature and Novel Therapeutic Targets. CHILDREN-BASEL 2018; 5:children5090127. [PMID: 30231590 PMCID: PMC6162389 DOI: 10.3390/children5090127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 09/12/2018] [Accepted: 09/17/2018] [Indexed: 11/17/2022]
Abstract
Salivary gland tumors are extremely rare and encompass a diverse group of histologies. Less than 5% of the affected population is pediatric. We present a case of 6-year-old child with pleomorphic adenoma of the parotid. The patient underwent a superficial parotidectomy. Recurrence was not observed in the six months of follow-up. Surgery is the mainstay of the management of benign salivary gland tumors. Although novel molecular agents are being explored, personalized therapy would be a challenge due to the rarity and vast genetic/histologic variations of salivary gland tumors.
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Dremmen MH, Tekes A, Mueller S, Seyfert D, Tunkel DE, Huisman TA. Lumps and Bumps of the Neck in Children-Neuroimaging of Congenital and Acquired Lesions. J Neuroimaging 2016; 26:562-580. [DOI: 10.1111/jon.12376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/18/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Marjolein H.G. Dremmen
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
- Division of Pediatric Radiology, Department of Radiology; Erasmus MC - University Medical Center Rotterdam; Rotterdam The Netherlands
| | - Aylin Tekes
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
| | - Samantha Mueller
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
| | - Donna Seyfert
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
| | - David E. Tunkel
- Division of Pediatric Otolaryngology; Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins Hospital; Baltimore MD
| | - Thierry A.G.M. Huisman
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
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24
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Erbek SS, Köycü A, Topal Ö, Erbek HS, Özlüoğlu LN. Submandibular Gland Surgery: Our Clinical Experience. Turk Arch Otorhinolaryngol 2016; 54:16-20. [PMID: 29392010 DOI: 10.5152/tao.2016.1467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 04/26/2016] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to assess the demographic findings and surgical results of patients who underwent submandibular gland excision at a tertiary care center. Methods The clinical characteristics and histopathological results of 45 patients who had undergone submandibular gland excision between 1997 and 2014 were evaluated in detail. Results Twenty-eight (62.2%) and 17 (37.8%) patients presented with a complaint of a painful mass and painless mass, respectively. Histopathologic investigation of the surgical specimens revealed sialolithiasis in 14 patients (31.1%), chronic sialadenitis in 16 (35.6%), benign tumor in 12 (26.7%), malignant tumor in two (4.4%), and mucocele extravasation in one. As complications, permanent paralysis of the marginal mandibular branch of the facial nerve was seen in one patient (2.2%), temporary paralysis of the marginal mandibular branch of the facial nerve was seen in seven (15.6%), orocutaneous fistula was seen in one (2.2%), and temporary paralysis of the hypoglossal nerve was seen in one (2.2%). Conclusion This study revealed that in patients presenting with complaints of a submandibular gland mass, sialolithiasis, sialadenitis, and benign masses were the mostly diagnosed disorders. Transcervical submandibular gland excision is a satisfactory procedure with low complication and recurrence rates when it is performed on selected patients and obeyed to surgical techniques.
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Affiliation(s)
- Selim Sermed Erbek
- Department of Otorhinolaryngology, Başkent University Ankara Hospital, Ankara, Turkey
| | - Alper Köycü
- Clinic of Otorhinolaryngology, Siirt State Hospital, Siirt, Turkey
| | - Özgül Topal
- Department of Otorhinolaryngology, Başkent University Konya Hospital, Konya, Turkey
| | - Hatice Seyra Erbek
- Department of Otorhinolaryngology, Başkent University Ankara Hospital, Ankara, Turkey
| | - Levent Naci Özlüoğlu
- Department of Otorhinolaryngology, Başkent University Ankara Hospital, Ankara, Turkey
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Dutta M, Chatterjee I. A lesson learnt: retrospection in a case of pilomatricoma mimicking as parotid neoplasm. EINSTEIN-SAO PAULO 2015; 14:104-5. [PMID: 26537510 PMCID: PMC4872925 DOI: 10.1590/s1679-45082015ai3096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 08/20/2014] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mainak Dutta
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, India
| | - Indranil Chatterjee
- Department of Pediatric Surgery, Medical College and Hospital, Kolkata, India
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Tabatabai SH, Tafti MA, Rafiei B. Primary malignant epithelial salivary gland tumors in an Iranian population: A retrospective study of 81 cases. J Oral Maxillofac Pathol 2015; 19:47-52. [PMID: 26097307 PMCID: PMC4451668 DOI: 10.4103/0973-029x.157201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 03/24/2015] [Indexed: 11/26/2022] Open
Abstract
Background: Salivary gland tumors of epithelial origin are rare lesions. Few epidemiologic studies on prevalence of such condition in Iranian population have been published. This study with the aim of determining the relative frequency of epithelial salivary tumors was performed in Yazd city from 2001 to 2012. Materials and Methods: Cases diagnosed as primary malignant epithelial salivary gland tumor were collected from the Pathology Department of main hospitals and Health Department of Medical Science Yazd University from 2001–2012. Histopathologic type, tumor location, age, gender and whether patients were native or non-native were analyzed. Results: Eighty-one cases of primary malignant epithelial salivary gland tumors were recorded. Male to female ratio was 1:1.3. The most common malignancy was adenoid cystic carcinoma (35.8%) and the most common effected site was the parotid gland. Mean age for malignancy was 52.57 ± 18.25 years. Conclusion: According to the findings of this study, predilection of adenoid cystic carcinoma was more in non-natives as compared to natives (from Yazd). This could suggest the influence of racial and environmental factors on prevalence of such malignancies.
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Affiliation(s)
- Seied Hossein Tabatabai
- Department of Oral and Maxillofacial Pathology, Member of Social Determinants of Oral Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Babak Rafiei
- Private Practitioner, Dentist, Graduated From Yazd University, Yazd, Iran
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Kelly TG, Faulkes SV, Pierre SK, Moe DC, Chun RH, Kelly MS, Taylor NR, Howlett DC. Imaging submandibular pathology in the paediatric patient. Clin Radiol 2015; 70:774-86. [PMID: 25933720 DOI: 10.1016/j.crad.2015.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 03/11/2015] [Accepted: 03/18/2015] [Indexed: 11/15/2022]
Abstract
A wide range of pathologies may arise from the submandibular space (SMS) or submandibular gland (SMG) in children. We review herein the normal anatomy of the SMS and describe the role of imaging in the evaluation of SMS lesions. A schematic approach for the categorisation of SMS pathology based on imaging characteristics is provided.
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Affiliation(s)
- T G Kelly
- Children's Hospital Wisconsin/Medical College of Wisconsin, USA.
| | | | - S K Pierre
- Royal Sussex County Hospital, Brighton, UK
| | - D C Moe
- Children's Hospital Wisconsin/Medical College of Wisconsin, USA
| | - R H Chun
- Children's Hospital Wisconsin/Medical College of Wisconsin, USA
| | - M S Kelly
- Children's Hospital Wisconsin/Medical College of Wisconsin, USA
| | - N R Taylor
- Eastbourne District General Hospital, UK
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Benemmane H, Hali F, Khadir K, Benchikhi H. Hémangiome parotidien : amélioration spectaculaire sous propranolol. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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29
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Tzermpos F, Chatzichalepli C, Cocos A, Kleftogiannis M, Zarakas M, Chrysomali E. Atypical Presentation of an Upper Lip Pleomorphic Adenoma: Case Report. Acta Stomatol Croat 2014; 48:48-53. [PMID: 27688351 PMCID: PMC4872811 DOI: 10.15644/asc48/1/6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 02/03/2014] [Indexed: 10/31/2022] Open
Abstract
The pleomorphic adenoma (PA) or mixed tumor is the most common neoplasm of the salivary glands, usually presenting with a non-specific clinical manifestation and a diverse histopathological pattern. The region of the lips is the second most common site for minor gland neoplasms. The aim of this paper is to report the case of a 39 year old caucasian woman presenting with a swelling on the right side of the upper lip combined with a history of trauma in the region of the upper right central incisor, eight years ago. The swelling was attributed to the periapical lesion of the upper right central incisor that was observed on the orthopantomography. Intraoperatively the surgeon came upon a nodule of firm consistency in the mucolabial fold. The histopathologic diagnosis of this lesion was benign mixed tumor of salivary gland. This report discusses the deviation in frequency of mixed salivary gland tumor between upper and lower lip, the clinical differential diagnosis, the histopathological pattern and the appropriate treatment.
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Affiliation(s)
- Fotios Tzermpos
- National and Kapodistrian University of Athens, School Of Dentistry
| | | | - Alina Cocos
- National and Kapodistrian University of Athens, School Of Dentistry
| | | | - Marissa Zarakas
- National and Kapodistrian University of Athens, School Of Dentistry
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Cockerill CC, Daram S, El-Naggar AK, Hanna EY, Weber RS, Kupferman ME. Primary sarcomas of the salivary glands: case series and literature review. Head Neck 2013; 35:1551-7. [PMID: 23728801 DOI: 10.1002/hed.23203] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2012] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Mesenchymal malignancies of salivary origin are rare and are histologically diverse. We reviewed our experience with these tumors, as well as the published literature, with an emphasis on treatment modalities and prognosis. METHODS We identified 17 patients treated for malignant mesenchymal cell tumors at The University of Texas MD Anderson Cancer Center between 1990 and 2007. We compared our results to the literature from January 1990 to July 2010. RESULTS Tumors were located primarily in the parotid gland and were primarily T1 tumors (<5 cm). All patients were treated with surgical resection, and 13 patients were given adjuvant therapy. Seven patients (41%) had recurrence, and 4 developed distant metastases. The overall 5-year and 10-year survival rates were 42% and 20%, respectively. CONCLUSIONS Our case series and literature review show that sarcomas of the salivary glands have a high rate of recurrence and are associated with a poor prognosis.
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Affiliation(s)
- Cara C Cockerill
- The University of Texas Medical School at Houston, Houston, Texas
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Salzman R, Starek I, Faisal H, Tichy T. Pediatric parotideomasseteric pilomatrixoma in children. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2013; 158:600-4. [PMID: 24077233 DOI: 10.5507/bp.2013.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 08/22/2013] [Indexed: 11/23/2022] Open
Abstract
AIMS To review definitive histological diagnoses of patients with great salivary gland tumors with focus on the relatively high incidence of pediatric pilomatrixomas. The authors focus on clinical investigation, imaging methods and fine needle aspiration cytology of pilomatrixomas. METHODS We treated 12 children with great salivary gland masses aged from 6 months to 18 years from 1995 to 2010. The records of these patients were reviewed to determine sex, age, clinical presentation, and histological findings. RESULTS Among children having true neoplasms, there was a prevalence of carcinomas (6 out of 9), with low-grade mucoepidermoid and acinic cell carcinomas (two each) as the dominating histopathological diagnosis. There was one adenoid cystic carcinoma and one curious undifferentiated carcinoma in a 6 month old baby. Among all 6 benign lesions, accounting for a half of the total, pilomatrixoma was the most common (2 out of 6) diagnosis, representing 17% (2 out of 12) of all salivary gland lumps and 66% (2 out of 3) of all true benign neoplasms. CONCLUSIONS Pilomatrixoma should be included in the differential diagnosis of pediatric parotideomasseteric lumps. Clinical investigation reveals adherence to the skin but not to the underlying tissue. Clinical assessment and ultrasound guided fine needle aspiration cytology in typical findings strongly support the diagnosis. Cytopathologists must be aware of the preliminary diagnosis of a pilomatrixoma to use proper fixation of the smears. In doubts, frozen biopsy must be sent before parotidectomy is performed.
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Affiliation(s)
- Richard Salzman
- Department of Otorhinolaryngology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Strub GM, Georgolios A, Graham RS, Powers CN, Coelho DH. Massive transcranial parotid pleomorphic adenoma: recurrence after 30 years. J Neurol Surg Rep 2013; 73:1-5. [PMID: 23946917 PMCID: PMC3658653 DOI: 10.1055/s-0032-1329189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pleomorphic adenoma, also known as benign mixed tumor, is the most common tumor affecting the parotid gland and can reach massive size; however, intracranial invasion is rare. Recurrence of pleomorphic adenoma after excision is a well-known phenomenon and can present decades after resection of the primary tumor. Here we present the case of a 53-year-old man who presented to our clinic with ear fullness, otalgia, and hearing loss 30 years after undergoing total parotidectomy and external beam radiotherapy for pleomorphic adenoma. Magnetic resonance imaging revealed a massive transcranial tumor invading the mastoid cavity, the dura of the posterior fossa, the fallopian and semicircular canals, the jugular foramen, the lateral infratemporal fossa skull base, the sigmoid and transverse sinuses, and the superior parapharyngeal region. Gross examination and histopathological studies confirmed that the mass was a recurrent pleomorphic adenoma. Here we discuss the features of recurrent pleomorphic adenoma and review the current literature.
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Affiliation(s)
- Graham M Strub
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia
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Involution of a large parotid hemangioma with oral propranolol: an illustrative report and review of the literature. Case Rep Pediatr 2012; 2012:353812. [PMID: 23227404 PMCID: PMC3512253 DOI: 10.1155/2012/353812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 10/30/2012] [Indexed: 02/01/2023] Open
Abstract
Propranolol has emerged as a new treatment option for infantile hemangiomas. We describe a 20-month-old boy with a large right parotid hemangioma diagnosed at the age of 37 days. Starting at the age of 2.5 months, he received oral propranolol for 6.5 months. Although the mass regressed, it recurred when propranolol was discontinued. He was successfully retreated at the age of 11 months with propranolol for another 5.5 months without further recurrences. Treatment was tolerated well. Our paper and a review of the literature demonstrate that propranolol appears to be safe and effective for symptomatic infantile parotid gland hemangiomas.
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Galer C, Santillan AA, Chelius D, Huh W, El-Naggar A, Hanna E, Weber RS, Kupferman ME. Minor salivary gland malignancies in the pediatric population. Head Neck 2012; 34:1648-51. [PMID: 22267165 DOI: 10.1002/hed.21980] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2011] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Minor salivary gland malignancies in children are rare and data on treatment and outcomes are limited. METHODS A retrospective chart review of all pediatric patients with the pathologic diagnosis of minor salivary gland malignancy at a tertiary care cancer hospital was used to conduct this review. RESULTS From 1952 to 2006, 35 children with minor salivary gland cancers were treated at The University of Texas MD Anderson Cancer Center. Mean age was 15.2 +/- 2.9 years with a slight female predominance. Recurrence occurred in 4 patients and was significantly associated with positive margins, advanced stage, and high histologic grade. Overall survival (OS) and disease-specific survival (DSS) were 89.3% and 88.4%, respectively, at 5 years. Advanced stage, positive margins, and high grade were associated with adverse survival. CONCLUSION Minor salivary gland malignancies in children are rare. Surgical resection with clear margins yields excellent outcomes in patients with low-intermediate grade and early stage tumors. Patients with high-grade malignancies do poorly despite multimodality therapy.
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Affiliation(s)
- Chad Galer
- Department of Otolaryngology - Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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35
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Ritwik P, Cordell KG, Brannon RB. Minor salivary gland mucoepidermoid carcinoma in children and adolescents: a case series and review of the literature. J Med Case Rep 2012; 6:182. [PMID: 22759529 PMCID: PMC3427042 DOI: 10.1186/1752-1947-6-182] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 04/18/2012] [Indexed: 11/25/2022] Open
Abstract
Introduction Because well-documented cases of mucoepidermoid carcinomas that are of minor salivary gland origin and occur in children and adolescents have rarely been reported, little information regarding their clinical features and biologic behavior is available. This case report represents a retrospective clinical analysis of five minor salivary gland mucoepidermoid carcinomas accessioned from a 35-year period at the Louisiana State University School of Dentistry and combines the data with 15 well-documented cases from the English language literature. Case presentation The five mucoepidermoid carcinomas in patients from birth to 19 years of age accounted for 1.3% of the accessioned minor salivary gland neoplasms. There were an additional 15 well-documented cases in the literature. Combining the data for the 20 mucoepidermoid carcinomas resulted in a mean age of 13.5 years and a 2.3:1 female-to-male ratio. Collectively, the hard palate, soft palate, and hard palate/soft palate junction accounted for 85% of the cases. Thirty-five percent of the cases presented as a fluctuant submucosal swelling with surface color alterations. The average duration was five months, and bone involvement occurred in seven cases. A histologic grade of low to intermediate predominated (95%). Surgical removal was the treatment in all cases. Thirteen cases had adequate follow-up of three years or more, and recurrence was documented in only one case. There were no cases of death or metastasis in this series. Conclusions In children and adolescents, mucoepidermoid carcinomas have a female predilection and occur most commonly on the hard or soft palate or both. A fluctuant submucosal lump with a bluish color is a helpful diagnostic clue. The histologic grades of most mucoepidermoid carcinomas in the first and second decades of life are low and, to a lesser degree, intermediate. Complete surgical excision is the treatment of choice and results in a recurrence rate of less than 10%.
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Affiliation(s)
- Priyanshi Ritwik
- Department of Pediatric Dentistry, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, Box 139, New Orleans, LA 70119, USA.
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Liu B, Liu JY, Zhang WF, Jia J. Pediatric parotid tumors: clinical review of 24 cases in a Chinese population. Int J Pediatr Otorhinolaryngol 2012; 76:1007-11. [PMID: 22503446 DOI: 10.1016/j.ijporl.2012.03.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Revised: 03/16/2012] [Accepted: 03/20/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate the incidence, types, and treatment outcomes of pediatric parotid tumors in Chinese population. METHODS Pediatric salivary gland tumors treated at Stomatolgy Hospital, of Wuhan University, from 1990 to 2010, were analyzed retrospectively. RESULTS One hundred and two patients 18 years old or younger were diagnosed as parotid mass, of which 24 (23.5%) were parotid tumors. Of these patients, 11 (45.8%) were benign and 13 (54.2%) malignant. Hemangioma was the most frequent no-epithelial tumor. The most common benign epithelial tumor was pleomorphic adenoma (63.6%), and the most common malignant epithelial tumor was mucoepidermoid carcinoma (38.5%), with both of them showing a female to male predominance. The most common treatment was parotidectomy (83.3%). CONCLUSIONS Although pediatric parotid masses are unusual, they can represent a variety of pathological diagnoses, including malignancy. The intralesional injection can treat parotid hemangiomas in pediatric population effectively. Parotidectomy remains the mainstay treatment for both pediatric parotid gland benign and malignancies of epithelial cell origin. Adjuvant radiotherapy should be used judiciously in pediatric patients due to the higher risk of post-irradiation complications.
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Affiliation(s)
- Bing Liu
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
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Przewoźny T, Stodulski D, Stankiewicz C. [Major salivary gland disorders in children and adolescents]. Otolaryngol Pol 2011; 65:350-6. [PMID: 22078285 DOI: 10.1016/s0030-6657(11)70725-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 05/15/2011] [Indexed: 11/25/2022]
Abstract
The aim of this study was a review of 67 children treated for salivary gland tumors in the ENT Department Medical University of Gdańsk since 1974 to 2008. In that group we observed 52 children with tumor of the parotid gland, 13 with tumor of submandibular gland and 2 with subligual gland tumors. Tumor-like lesions were stated the largest group of tumors and were observed in 33 (49%) of children, mainly of chronic sialadenitis (17 cases). Predominant number of tumors was observed in scholarship children. The most common symptoms were slow enlargement of tumor and swelling of the salivary gland. In the group of benign tumors most common was pleomorphic adenoma (19 cases) and in the group of malignant tumors most common was clear cell carcinoma (2 cases) and rhabdomyosarcoma (2 cases). In this report the authors describe basic epidemiological and clinical data (age, sex, duration of symptoms, histological structure of tumor, diagnostic methods, methods and results of treatment) and observations connected with differences of salivary gland tumors in that group of patients.
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Cozzi DA, d'Ambrosio G, Cirigliano E, Negro V, Iacusso C, Totonelli G, Uccini S. Giant pilomatricoma mimicking a malignant parotid mass. J Pediatr Surg 2011; 46:1855-8. [PMID: 21930004 DOI: 10.1016/j.jpedsurg.2011.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 05/10/2011] [Accepted: 05/11/2011] [Indexed: 11/28/2022]
Abstract
Pilomatricomas are benign neoplasms of the hair follicle occurring relatively often in the pediatric population. However, lesions attaining massive proportions are very rarely encountered. We describe such a case presenting in the parotid region and initially misdiagnosed as malignancy. Preoperative biopsy provided accurate diagnosis and allowed definitive surgical excision using a parotid-sparing approach. In children, giant pilomatricoma should be included into the differential diagnosis of noninflammatory masses of the salivary gland region.
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Affiliation(s)
- Denis A Cozzi
- Pediatric Surgery Unit, Sapienza University, Azienda Policlinico Umberto I, Rome, RM 00161, Italy.
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Weiss I, O TM, Lipari BA, Meyer L, Berenstein A, Waner M. Current treatment of parotid hemangiomas. Laryngoscope 2011; 121:1642-50. [PMID: 21766313 DOI: 10.1002/lary.21358] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 11/08/2010] [Accepted: 01/08/2010] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Parotid hemangiomas are the most common salivary gland tumors in children. Their treatment has posed a challenge because of the lesions' expansive growth, resistance to treatment, and relationship with the facial nerve. Various treatment modalities have been attempted, and promising results have been achieved with surgical resection alone or in conjunction with endovascular sclerotherapy. Recently, bleomycin and oral propranolol have been introduced, and the results thus far are promising. Here we elucidate the treatment options and propose a treatment algorithm for parotid hemangiomas. STUDY DESIGN Retrospective chart review. METHODS We conducted a retrospective chart review of patients from 2004 to 2009 with hemangiomas involving the parotid gland. We included 56 patients and relevant parameters. RESULTS Seventy percent of patients were female. The female-to-male ratio was 2.3 to 1. Thirty-nine percent had unilateral parotid hemangiomas, 12.5% had cutaneous segmental hemangiomas. All 22 patients who underwent systemic steroid therapy responded initially, but 68% of these rebounded after cessation of therapy. Sixteen patients (29%) underwent surgery with excellent results (facial symmetry, restoration of contour, preserved facial nerve function). Seven (44%) patients received sclerotherapy 24 to 48 hours before surgery, and five (8%) received endovascular sclerotherapy alone. Ten patients were treated medically with oral propranolol. Eight of 10 had significant shrinkage of the lesion within the first month of treatment. There were no reported side effects. CONCLUSIONS Multiple treatment regimens have been used to successfully treat parotid hemangiomas. Although propranolol is a recent addition, it seems most promising. Further evaluation is warranted.
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Affiliation(s)
- Inanna Weiss
- Vascular Birthmark Institute of New York, Beth Israel and Roosevelt Hospitals, New York, New York 10023, USA
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Abstract
Salivary gland tumors in children are rare: they correspond to 8-10% of head and neck pediatric tumors. Clinicians of all disciplines should be aware of this diagnosis in front of non-inflammatory mass of the parotid or in the territory of other salivary glands. In children, 50% of salivary gland tumors are malignant which contrasts with a 10-25% risk in adults. Epithelial tumors are the most common, mucoepidermoïd carcinomas of the parotid in particular. Surgery is the treatment of choice in epithelial tumors. Adjuvant radiotherapy may be indicated in case of unfavorable prognostic factors but must be balanced with the risk of radiation-induced growth defects and secondary cancer. The role of chemotherapy is limited in these tumors, but should be discussed in case of an inoperable or metastatic lesion.
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Jaryszak EM, Shah RK, Bauman NM, Howell RJ, Rossi CT, Preciado DA. Unexpected pathologies in pediatric parotid lesions: management paradigms revisited. Int J Pediatr Otorhinolaryngol 2011; 75:558-63. [PMID: 21316113 DOI: 10.1016/j.ijporl.2011.01.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 01/13/2011] [Accepted: 01/15/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To present case vignettes of unusual pediatric parotid pathologies and discuss management paradigms in the context of these lesions. STUDY DESIGN Retrospective case series. SETTING Free-standing, academic tertiary care pediatric hospital. METHODS All patients over the past 18 months undergoing parotidectomy for a parotid mass were reviewed (N=5). RESULTS Ages ranged from 17 months to 16 years. All presented with a remarkably similar clinical course, consisting of a persistent parotid mass for more than 3 months which was usually painless. Most (4/5 patients) had been treated with antibiotics prior to Otolaryngology consultation. Fine-needle aspiration (FNA) was performed on 3 patients and was diagnostic in one. Complete excision of the mass was performed in each child through a parotidectomy approach (3 total, 2 lateral lobe). The final pathology showed metastatic neuroblastoma (17 months old), undifferentiated primitive sarcoma (22 months old), mucoepidermoid carcinoma (11 years old), nodular fasciitis (12 years old), and hyperplastic lymph node (16 years old). The patient with neuroblastoma died from complications of bone marrow transplant. CONCLUSIONS The differential diagnosis for a persistent pediatric parotid mass is expansive and differs from that found in the adult population. As this series highlights, in many cases, it is impossible to discern the pathology, or rule out malignancy, based upon the clinical course, imaging, or FNA results. Surgical excision remains the standard for management of these patients and is both diagnostic and therapeutic. Our anecdotal case series highlights the importance of having a low threshold for parotidectomy in these children.
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Affiliation(s)
- Eric M Jaryszak
- Division of Otolaryngology, Children's National Medical Center, George Washington University School of Medicine, 111 Michigan Av NW, Washington, DC 20010, USA
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Yaman H, Gerek M, Tosun F, Deveci S, Kiliç E, Arslan HH. Myoepithelioma of the parotid gland in a child: a case report. J Pediatr Surg 2010; 45:E5-7. [PMID: 20638511 DOI: 10.1016/j.jpedsurg.2010.04.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 04/14/2010] [Accepted: 04/16/2010] [Indexed: 11/30/2022]
Abstract
Myoepitheliomas of the parotid glands are very rare in the pediatric population. Only a few cases of myoepitheliomas of the salivary glands have been reported in children. They have some similar features with pleomorphic adenoma. However, they may be malignant and infiltrate locally. Hence, histopathologic examination should be considered to differentiate these tumors. The treatment of myoepitheliomas is complete removal of the tumor. We report a child with myoepithelioma of the parotid gland and review the related literature.
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Affiliation(s)
- Huseyin Yaman
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Turkey.
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Deutsch J, Trick D, Delank KW. [Giant scalp mass]. HNO 2010; 58:1204-7. [PMID: 20577705 DOI: 10.1007/s00106-010-2141-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A 55-year-old man was referred to our department with bleeding from a painless tumor located at the left parietal region of the head which had been progressively growing for a period of 2 years. Physical examination showed a fist-sized pediculated mass overlying the left parietal region and the auricle. The partly livid and ulcerated surface of the tumor was interspersed with light-yellow chalky material. The mass was totally excised. Infiltration of the skull was not observed. Histopathological examination led to the diagnosis of a giant pilomatricoma. Pilomatricoma is a rare, benign skin neoplasm that originates from hair matrix cells and is most frequently located in the head and neck region.
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Affiliation(s)
- J Deutsch
- Hals-Nasen-Ohren-Klinik, Klinikum der Stadt Ludwigshafen.
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Keelawat S, Shuangshoti S, Kittikowit W, Lerdlum S, Thorner PS. Epithelioid sarcoma of the parotid gland of a child. Pediatr Dev Pathol 2009; 12:301-6. [PMID: 19335024 DOI: 10.2350/08-11-0557.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Epithelioid sarcoma is a rare soft-tissue tumor that usually occurs in young adults, with a median age of 26 years. This malignancy has been divided into distal and proximal types. The latter is found in proximal body sites including the head and neck region. We present a rare case of parotid proximal-type epithelioid sarcoma in a 1-year-old male child; this is the 4th reported case in the literature and the youngest in a pediatric patient to date. The tumor showed prominent rhabdoid features by light microscopy. Immunohistochemical studies revealed positive staining to cytokeratin (AE1/AE3), epithelial membrane antigen, vimentin, and BAF47. Thus, while the tumor resembled a malignant rhabdoid tumor, the positive staining for BAF47 supported instead a diagnosis of epithelioid sarcoma, according to our current understanding of these 2 tumor types. Also, the clinical course was not the typical aggressive behavior of a rhabdoid tumor. The patient underwent radical parotidectomy without adjuvant therapy and remained disease-free at follow-up, 14 months after surgery.
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Affiliation(s)
- Somboon Keelawat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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Muenscher A, Diegel T, Jaehne M, Ussmüller J, Koops S, Sanchez-Hanke M. Benign and malignant salivary gland diseases in children. Auris Nasus Larynx 2009; 36:326-31. [DOI: 10.1016/j.anl.2008.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Revised: 07/24/2008] [Accepted: 07/30/2008] [Indexed: 11/26/2022]
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Abstract
Pleomorphic adenomas of the submandibular glands are exceedingly rare tumors in the pediatric practice. Patients usually present with a painless and mobile mass without any other associated symptoms. Radiologic studies are usually unable to differentiate benign from malignant tumors in most cases. Recurrences are rare with complete en bloc excision of the tumor and the submandibular gland. Except for the rare cases of malignant transformation, the prognosis is excellent.
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Soft tissue swelling of the upper lip. ACTA ACUST UNITED AC 2008; 105:271-3. [PMID: 18280958 DOI: 10.1016/j.tripleo.2007.08.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 08/28/2007] [Accepted: 08/29/2007] [Indexed: 11/22/2022]
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Emsen IM. Preoperative treatment of a parotid hemangioma with 100% ethyl alcohol. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2008; 16:239-40. [PMID: 19949507 DOI: 10.1177/229255030801600408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hemangiomas are one of the most common childhood neoplasms, occurring in approximately 12% of infants younger than one year of age. The lesions typically appear shortly after birth, increase in size over the first year and characteristically regress over the next decade. Because hemangiomas can be visible during an important stage of a child's social development, numerous authors have pursued alternative treatment strategies to avoid or reduce this lengthy involution process. Unfortunately, no effective medical treatment has been reported for children with large, deforming hemangiomas of the parotid gland and overlying cheek. In the present case, a patient with a large parotid hemangioma was treated preoperatively with an intralesional injection of 100% ethyl alcohol solution to reduce the size of the mass. The mass was removed 28 days later with no major postoperative complications.
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Affiliation(s)
- Ilteris Murat Emsen
- Numune State Hospital, Department of Plastic and Reconstructive Surgery, Erzurum, Turkey
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Lotufo MA, Júnior CAL, Mattos JPD, França CM. Pleomorphic adenoma of the upper lip in a child. J Oral Sci 2008; 50:225-8. [PMID: 18587216 DOI: 10.2334/josnusd.50.225] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Mônica A Lotufo
- Department of Oral Diagnosis, School of Dentistry, Ibirapuera University, São Paulo, Brazil.
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Rodriguez KH, Vargas S, Robson C, Perez-Atayde A, Shamberger R, McGill TJ, Healy GB, Rahbar R. Pleomorphic adenoma of the parotid gland in children. Int J Pediatr Otorhinolaryngol 2007; 71:1717-23. [PMID: 17889377 DOI: 10.1016/j.ijporl.2007.07.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Accepted: 07/15/2007] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the presentation, imaging characteristics and treatment outcome of pleomorphic adenoma of the parotid in the pediatric population. DESIGN Retrospective study with institutional review board approval. SETTING Tertiary care pediatric medical center. METHODS An extensive review of medical records with regard to presentation, imaging, histopathology, complication, recurrence and prognosis on patients 18 years or younger presenting from 1983 to 2005. RESULTS Eleven patients (six females, five males) were identified. The most common presentation was an asymptomatic mass. Preoperative imaging was done on nine patients: MRI (N=6), CT (N=3), ultrasound (N=2), and sialogram (N=1). Initial treatments included: superficial parotidectomy (N=5), total parotidectomy (N=3), excisional biopsy followed by superficial parotidectomy (N=2), and excisional biopsy (N=1). There were two recurrences (18%); one presenting 7 months following excisional biopsy who underwent superficial parotidectomy and one occurred 3 years following total parotidectomy requiring revision parotidectomy and radiation. Other complications included: transient facial nerve paresis (N=5; 45%) and permanent weakness (N=1; 9%). The patients were followed an average of 18 months. CONCLUSIONS Pleomorphic adenoma is one of the most common tumors of the parotid in children. The most common presentation is an asymptomatic mass. A preoperative evaluation with MRI or CT scan can be helpful in determining the extent of the lesion and surgical planning. Complete excision via superficial or total parotidectomy with preservation of facial nerve is the treatment of choice. Long-term follow up is recommended, though was difficult in a tertiary care center.
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Affiliation(s)
- Kimsey H Rodriguez
- Department of Otolaryngology, Tulane University Health Sciences Center, 1430 Tulane Avenue SL-59, New Orleans, LA, United States.
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