1
|
Taguchi A, Kojima T, Okanoue Y, Kagoshima H, Hasebe K, Yamamoto H, Hori R. Validation of indications for enucleation for benign parotid gland tumors. Head Neck 2023; 45:931-938. [PMID: 36799774 DOI: 10.1002/hed.27321] [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: 10/18/2022] [Revised: 01/11/2023] [Accepted: 01/29/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Enucleation has been reported as a minimally invasive surgery for Warthin's tumor (WT). However, the definite indications for enucleation have not been clarified. METHODS Enucleation was indicated by the following findings: findings of WT, cystic fluid, or benign leukocytes by fine-needle aspiration cytology; a well-margined and homogeneous pattern on imaging; and a tumor location in the tail or preauricular area of the parotid gland. We reviewed 552 cases treated with parotid gland surgery in our hospital. RESULTS A total of 108 tumors were treated with enucleation and included no malignant solid tumors or pleomorphic adenoma. Enucleation demonstrated low invasiveness and complication rates. Revision surgery for WT reappearance after enucleation was rare and showed minimal scarring, with a lower risk of facial weakness. CONCLUSIONS The indication criteria for enucleation were validated. Such enucleation is useful, as it is associated with minimal invasiveness, low complication rates, and safety in revision surgery.
Collapse
Affiliation(s)
- Atsushi Taguchi
- Department of Otolaryngology, Tenri Hospital, Nara, Japan
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuyoshi Kojima
- Department of Otolaryngology, Tenri Hospital, Nara, Japan
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Okanoue
- Department of Otolaryngology, Tenri Hospital, Nara, Japan
| | - Hiroki Kagoshima
- Department of Otolaryngology, Tenri Hospital, Nara, Japan
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koki Hasebe
- Department of Otolaryngology, Tenri Hospital, Nara, Japan
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hirotaka Yamamoto
- Department of Otolaryngology, Tenri Hospital, Nara, Japan
- Department of Otolaryngology, Head and Neck Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Ryusuke Hori
- Department of Otolaryngology, Tenri Hospital, Nara, Japan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
2
|
Sah SK, Sah NK, Khan ZA. Triple Assessment of a Palpable Parotid Lump in "One-Stop" Clinics. J Maxillofac Oral Surg 2022; 21:972-978. [PMID: 36274879 PMCID: PMC9474984 DOI: 10.1007/s12663-021-01590-5] [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: 05/22/2020] [Accepted: 05/06/2021] [Indexed: 10/21/2022] Open
Abstract
Introduction The National Institute of Clinical Excellence in the UK (NICE) recommended the use of "one-stop" clinics for the assessment and management of head and neck lumps like those established for breast lumps. "One-stop" clinics should follow a triple assessment protocol involving physical examination, radiological imaging and fine-needle aspiration cytology (FNAC). Methods A retrospective analysis of 144 patients with suspected parotid tumours from 2005 to 2011 was done. Patients were assessed for individual modalities and compared against the final histological diagnosis. Statistical analysis was used for sensitivity and specificity, as well as positive and negative predictive values. All calculations were performed using SPSS version 16 (Statistical Packages for the Social Sciences, Chicago, IL). A p value of < 0.05 was considered to indicate statistical significance. Results A total of 105 patients underwent all the three modalities. Out of them, 93 had imaging that was considered radiologically benign and 12 were reported to have a malignant lesion. Cytologically, 75 were found to have a benign tumour, 13 were malignant, and 17 were considered to be indeterminate. The most common benign neoplasm was pleomorphic adenoma followed by Warthin's tumour. The sensitivity and specificity of triple assessment were 96% (p value 0.878-0.984) and 73% (p value 0.42-0.904), respectively. The positive predictive value was 96% (p value 0.878-0.984) and negative predictive value came out to be 93% (p value 0.42-0.904). Conclusions The overall accuracy of triple assessment was found to be 92%. This study concludes that triple assessment is a useful assessment tool to evaluate a patient with parotid lump. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-021-01590-5.
Collapse
Affiliation(s)
- S. K. Sah
- Craniofacial Center, Janakpurdham, Nepal
- Pinderfields Hospital, Wakefield, UK
| | - N. K. Sah
- Craniofacial Center, Janakpurdham, Nepal
| | - Z. A. Khan
- Craniofacial Center, Janakpurdham, Nepal
| |
Collapse
|
3
|
Wang Q, Zheng Y, Liu J. Squamous Cell Carcinoma Arising in a Parotid Warthin's Tumor: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2022:1455613221123861. [PMID: 36007016 DOI: 10.1177/01455613221123861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Warthin's tumor is the second most common benign neoplasm of the parotid gland. Epithelial malignant transformation of Warthin's tumor, especially to squamous cell carcinoma, is a rare event. The authors present a case report of a 57-year-old male patient with a mass in the left parotid gland. This paper documents the appearance of squamous cell carcinoma within Warthin's tumor of the left parotid gland and reviews the other similar features of 12 cases.
Collapse
Affiliation(s)
- Qian Wang
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jifeng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
4
|
Roh JL. Function-preserving surgery via single transverse cervical incision for Warthin's tumor in the parotid gland. Head Neck 2022; 44:1335-1341. [PMID: 35243713 DOI: 10.1002/hed.27027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND This study evaluated functional and disease control outcomes after gland-preserving surgery via a single transverse cervical incision for Warthin's tumor of the parotid gland. METHODS One-hundred eleven patients with Warthin's tumor underwent the preservation of most normal parotid tissues and the facial nerve combined with the en-bloc resection of tumors. Postoperative complications, subjective satisfaction, salivary function, and metachronous tumor were assessed in each patient. RESULTS No patients had an extension to modified Blair or periauricular incision with the median operation time of 32 min. Temporary and permanent paralysis of the facial nerve was 5 (4.0%) and none of 125 tumor resection sides, respectively. Postoperative complications were minimal. The secretory functions between the affected and unaffected glands did not differ. One patient had metachronous tumor for a median follow-up of 72 months. CONCLUSION Functional gland-preserving surgery via single transverse cervical incision can safely treat Warthin's tumor in the parotid gland.
Collapse
Affiliation(s)
- Jong-Lyel Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| |
Collapse
|
5
|
Lee E, Badger C, Mamidi IS, Benito DA, Li L, Goodman JF, Thakkar PG, Joshi A. Ultrasound-guided ethanol sclerotherapy for multifocal unilateral Warthin's tumor after partial parotidectomy. ULTRASOUND (LEEDS, ENGLAND) 2022; 30:158-161. [PMID: 35509301 PMCID: PMC9058389 DOI: 10.1177/1742271x211030302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/12/2021] [Indexed: 05/03/2023]
Abstract
Introduction Warthin's tumor, also known as papillary cystadenoma lymphomatosum, is one of the most common benign salivary gland neoplasms. The current first-line treatment for Warthin's tumor is parotidectomy. However, surgical resection has the risk of complications including facial nerve weakness and Frey's syndrome. Recently, ultrasound-guided ethanol sclerotherapy (UGES) has been found to be efficacious in the treatment of a variety of head and neck lesions. Case report We present a patient with multifocal Warthin's tumor who was managed with partial parotidectomy and two cycles of ultrasound-guided ethanol sclerotherapy. Discussion Ethanol sclerotherapy has been used as a minimally invasive alternative to surgical excision or observation alone for a variety of head and neck masses. To our knowledge, this is the first case presented in the literature where sclerotherapy was used in conjunction with a partial parotidectomy. Minimizing the extent of surgical resection can reduce the risk of facial nerve weakness and Frey's syndrome and negate the need for fat grafting for defect reconstruction. Conclusion UGES may serve as a safe and reliable procedure that can be performed in conjunction with partial parotidectomy for patients who wish to achieve definitive diagnosis while also minimizing the risk of complications associated with extensive parotidectomy.
Collapse
Affiliation(s)
- Esther Lee
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC and Western University of Health Sciences, Pomona, CA, USA
- Esther Lee, Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Western University of Health Sciences, Pomona, CA, USA.
| | - Christopher Badger
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Ishwarya S Mamidi
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Daniel A Benito
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Lilun Li
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Joseph F Goodman
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Punam G Thakkar
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Arjun Joshi
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| |
Collapse
|
6
|
Hurry KJ, Karunaratne D, Westley S, Booth A, Ramesar KCRB, Zhang TT, Williams M, Howlett DC. Ultrasound-guided core biopsy in the diagnosis of parotid neoplasia: an overview and update with a review of the literature. Br J Radiol 2022; 95:20210972. [PMID: 34860569 PMCID: PMC8822560 DOI: 10.1259/bjr.20210972] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Accurate diagnosis of parotid neoplasia is a key to determine the most appropriate patient management choice, including the need for surgery. This review provides an update of the literature on current practice and outcomes of parotid tissue sampling techniques, with an emphasis on ultrasound-guided core biopsy (USCB) and comparison with fine needle aspiration cytology (FNAC). METHODS A literature review of EMBASE, Medline, PubMed and Google Scholar was conducted. RESULTS USCB has higher sensitivity, specificity and lower non-diagnostic rates than optimized FNAC. It also has a significantly higher sensitivity for the detection of malignancy. Significant complications post-USCB are uncommon, with only one reported case of tumour seeding and no cases of permanent facial nerve dysfunction. The technique is less operator-dependent than FNAC, with less reported variation in results between institutions. CONCLUSIONS USCB can be considered as the optimum tool of choice for the diagnosis of parotid neoplasia. This would particularly be the case in centres utilizing FNAC with high non-diagnostic rates or reduced diagnostic accuracy when compared to USCB published data, or in centres establishing a new service. ADVANCES IN KNOWLEDGE An update of the role and outcomes of USCB in the diagnosis of parotid gland pathologies.Research shows that USCB preforms better than FNAC, in terms of sensitivity and specificity, particularly in the case of malignant neoplasia.Complications following USCB were found to be higher than that of FNAC; however, no long-term major complications following either method have been reported in the literature.
Collapse
Affiliation(s)
- Katharine Julia Hurry
- Department of Oral and Maxillofacial Surgery, East Sussex Healthcare NHS Trust, East Sussex, East Sussex
| | | | - Suzanne Westley
- Department of Oral and Maxillofacial Surgery, Queen Victoria Hospital, East Grinstead, England
| | - Alessandra Booth
- Queen Mary University, London Dental Institute, London, United Kingdom
| | - Keith C R B Ramesar
- Histopathology Department, East Sussex Healthcare NHS Trust, East Sussex, East Sussex
| | | | - Michael Williams
- Department of Oral and Maxillofacial Surgery, East Sussex Healthcare NHS Trust, East Sussex, East Sussex
| | - David C Howlett
- Department of Oral and Maxillofacial Surgery, East Sussex Healthcare NHS Trust, East Sussex, East Sussex
| |
Collapse
|
7
|
Fíková A, Kuchař M, Kalfeřt D, Dostálová L, Balko J, Zábrodský M, Plzák J. Experience with follow-up strategy in selected patients with Warthin tumour diagnosed by ultrasound-guided fine-needle aspiration biopsy (FNAB). Eur Arch Otorhinolaryngol 2021; 279:2049-2055. [PMID: 34212241 DOI: 10.1007/s00405-021-06959-3] [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: 03/31/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Warthin tumour (WT) management options comprise surgery or follow-up. The purpose of this study was to asses our experience with the follow-up strategy in selected patients with an ultrasound-guided fine-needle aspiration biopsy (FNAB) showing WT. METHODS We performed a retrospective analysis of patients diagnosed with WT using FNAB between 1.1.2006 and 31.12.2019. Patients were divided into three groups according to the therapeutic approach-immediate surgery, follow-up or surgery and follow-up. RESULTS 323 patients were diagnosed with WT and met the study's inclusion criteria (154 women, 47.7% and 169 men, 52.3%). 192 patients were operated right after the diagnosis, 109 patients were observed with their first detected tumour and 22 patients had parotid WT surgery and were in the wait-and-scan protocol with a contralateral tumour, recurrence or both. The growth rate (GR) of observed WT was highly variable (mean GR 1.0 mm/year (5%), median GR 0.8 mm (9%), range - 19.7 to +20.0 mm/year). From 131 patients in the follow-up group, 19 patients underwent surgery and definitive histology revealed 17 WTs and 2 adenocarcinomas. However, these 2 patients had changes in sonographic findings at their next control. The mean observation time was 44.7 months (range 12-138 months) in patients followed exclusively at our institution and 50.9 months (range 12-110 months) in patients observed in cooperation with an otorhinolaryngologist at the patients' place of residence. CONCLUSION Ultrasound-guided FNAB is an accurate and simple method in WT diagnosis and based on its result a follow-up strategy can be chosen for selected patients with WT.
Collapse
Affiliation(s)
- Alžběta Fíková
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic.
| | - Martin Kuchař
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - David Kalfeřt
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - Lucie Dostálová
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - Jan Balko
- Department of Pathology and Molecular Medicine 2nd Faculty of Medicine, Charles University, Faculty Hospital Motol, V Úvalu 84, 15006, Prague, Czech Republic
| | - Michal Zábrodský
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| | - Jan Plzák
- Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic
| |
Collapse
|
8
|
Long-Term Outcomes of Radiofrequency Ablation for Treatment of Cystic Warthin Tumors versus Solid Warthin Tumors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126640. [PMID: 34205502 PMCID: PMC8296459 DOI: 10.3390/ijerph18126640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/06/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022]
Abstract
Background: To describe the long-term outcomes of radiofrequency ablation (RFA) of parotid Warthin tumors that have different consistencies and locations. Methods: We reviewed ten patients with Warthin tumors undergoing RFA treatment from 2016 to 2019. The mean follow-up was 24.3 ± 13.1 months (range 7–42 months). Results: RFA was performed on 11 tumors in ten patients. Cystic tumors (n = 4) had better volume reduction ratios (VRR) than solid tumors (n = 7) at month one and month six, following RFA (77.9% vs. 47.3%, 95.1% vs. 80.6%, respectively, p = 0.003). Tumors in both superficial lobes and deep lobes (n = 7) were larger than tumors in superficial lobes alone (n = 4), though there was no difference in VRR after treatment. All residual tumors were found in superficial lobes. There was no increase in residual tumor size. Every patient showed marked cosmetic improvements, with visible tumors becoming non-palpable masses. Conclusions: RFA is a safe and effective treatment for Warthin tumors, with better volume reduction in cystic tumors. Results remained satisfying over the long-term for all residual tumors found in superficial lobes, making it easier for re-intervention if necessary.
Collapse
|
9
|
Psychogios G, Vlastos I, Thölken R, Zenk J. Warthin’s tumour seems to be the most common benign neoplasm of the parotid gland in Germany. Eur Arch Otorhinolaryngol 2020; 277:2081-2084. [DOI: 10.1007/s00405-020-05894-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/28/2020] [Indexed: 01/09/2023]
|
10
|
So T, Sahovaler A, Nichols A, Fung K, Yoo J, Weir MM, MacNeil SD. Utility of clinical features with fine needle aspiration biopsy for diagnosis of Warthin tumor. J Otolaryngol Head Neck Surg 2019; 48:41. [PMID: 31464652 PMCID: PMC6716907 DOI: 10.1186/s40463-019-0366-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/20/2019] [Indexed: 11/25/2022] Open
Abstract
Background Conservative management of Warthin tumor (WT) may be a viable alternative to surgery, but there are concerns of missed malignancies on fine needle aspiration biopsy (FNAB). The purpose of this study is to measure the sensitivity and positive predictive value of FNAB for WT, and to identify clinical features associated with WT that can aid in this diagnosis. Methods Retrospective analysis of patients from January 1, 2006 to April 30, 2017 at a tertiary care center in London, Ontario, Canada. All patients with a diagnosis of WT on FNAB or resection were included. Electronic medical records were identified for 177 patients that fit the criteria. Study outcomes included the sensitivity and positive predictive value of FNAB alone for WT, and, when including clinical features associated with WT. Results The mean age of patients in this study was 63.2 years (SD 10.4); 115 (65%) were male, and 157 (89%) were past or present smokers. The measured sensitivity and positive predictive value of FNAB for WT were 95.8 and 97.2% respectively. Two cases were classified as WT on FNAB but confirmed at resection as mucoepidermoid carcinoma and acinic cell carcinoma. When only patients with multifocal, bilateral or incidental tumors were assessed, sensitivities and positive predictive values for each were 100%. Isolating for inferior pole location also resulted in a positive predictive value of 100%. Conclusions The sensitivity and positive predictive value of FNAB for WT in this study are high, with two false negatives on FNAB. Multifocal, bilateral, incidentaloma and inferior pole location were identified as potential clinical features that may increase the diagnostic confidence for WT, strengthening the argument for conservative management in these patients. Overall, this study serves as an initial exploration into whether clinical features may be included with FNAB results to improve the sensitivity and positive predictive value of diagnosing WT. Further research is necessary before these findings can be translated into clinical practice.
Collapse
Affiliation(s)
- Thomas So
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Axel Sahovaler
- Department of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - Anthony Nichols
- Department of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - Kevin Fung
- Department of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - John Yoo
- Department of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada
| | - Michele M Weir
- Department of Pathology and Laboratory Medicine, Western University and London Health Sciences Centre, London, ON, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada. .,Victoria Hospital, Suite B3-429, 800 Commissioners Rd E, 31, London, ON, N6A 5W9, Canada.
| |
Collapse
|
11
|
Evaluation of Outcomes following Radiofrequency Ablation for Treatment of Parotid Tail Warthin Tumors. J Vasc Interv Radiol 2019; 30:1574-1580. [PMID: 31471194 DOI: 10.1016/j.jvir.2019.04.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 04/12/2019] [Accepted: 04/24/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate efficacy and safety of radiofrequency (RF) ablation for parotid Warthin tumor. MATERIALS AND METHODS From September 2016 to August 2017, 7 consecutive patients with biopsy-proven parotid Warthin tumors who did not undergo surgery presented with symptoms or cosmetic concerns and underwent US-guided percutaneous RF ablation treatment. RF ablation procedures were performed using the moving shot technique. US, contrast-enhanced CT, or MR imaging was performed 6-12 months after each procedure. Complications and cosmetic scale improvement after RF ablation were also evaluated. RESULTS There was a significant reduction in mean tumor volume from 14.6 cm3 ± 13.1 (range, 1.9-35.5 cm3) to 0.8 cm3 ± 0.5 (range, 0.2-1.54 cm3) and a mean cosmetic scale improvement (from 4 to 1) on imaging studies 6-12 months after RF ablation compared with before RF ablation (P < .05). Volume reduction ratios at 1-2 months, 5-6 months, and 10-12 months after RF ablation were 51.2% ± 18.1%, 87.8% ± 10.6%, and 94.3% ± 2.0%. There was no facial nerve injury. One patient with parotitis and hematoma recovered in 1 week. CONCLUSIONS RF ablation using the moving shot technique could be an effective and safe alternative treatment for parotid tail Warthin tumors in patients unsuitable for or unwilling to undergo surgical resection.
Collapse
|
12
|
Jin M, Fu J, Lu J, Xu W, Chi H, Wang X, Cong Z. Ultrasound-guided percutaneous microwave ablation of parotid gland adenolymphoma: A case report. Medicine (Baltimore) 2019; 98:e16757. [PMID: 31464905 PMCID: PMC6736372 DOI: 10.1097/md.0000000000016757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Parotid gland adenolymphoma is one of the most common benign tumors in parotid gland, and mainly treated by surgery. Despite the widespread of ultrasound-guided percutaneous microwave ablation, there is no report concerning its application in parotid gland adenolymphoma. Herein, we reported a 2-year follow-up result of a male patient underwent ultrasound-guided percutaneous microwave ablation for parotid gland adenolymphoma. PATIENT CONCERNS A 73-year-old man was admitted due to a hypoechoic nodule measuring 2.67 × 1.42 × 1.35 cm in posterior-inferior area of parotid gland with a high flow velocity in color Doppler flow imaging. DIAGNOSE The lesion was pathologically diagnosed as parotid gland adenolymphoma. INTERVENTIONS Ultrasound-guided percutaneous microwave ablation was performed to the tumor due to the fact that the patient refused to receive an open surgery in consideration of older age. OUTCOMES The ablation procedure lasted about 2 minutes and 15 seconds, without significant adverse effect. The reduction ratios of tumor at postoperative 1 and 3-month were 53% and 82%, respectively. The tumor was fully absent at postoperative 8-month evaluation. Finally, there was no evident recurrence at postoperative 24-month evaluation. LESSONS Ultrasound-guided percutaneous microwave ablation is a safe and effective treatment for parotid gland adenolymphoma, which may serve as a novel alternative approach for patients unsuitable for open surgery.
Collapse
|
13
|
Jechova A, Kuchar M, Novak S, Koucky V, Dostalova L, Zabrodsky M, Kalfert D, Plzak J. The role of fine-needle aspiration biopsy (FNAB) in Warthin tumour diagnosis and management. Eur Arch Otorhinolaryngol 2019; 276:2941-2946. [DOI: 10.1007/s00405-019-05566-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 07/13/2019] [Indexed: 12/26/2022]
|
14
|
Does increasing the incidence of extracapsular dissection for benign tumors of the parotid correlate with an increased need for revision surgery? Oral Oncol 2019; 94:111-114. [DOI: 10.1016/j.oraloncology.2019.05.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/22/2019] [Accepted: 05/25/2019] [Indexed: 12/27/2022]
|
15
|
Seok J, Jeong WJ, Ahn SH, Jung YH. The growth rate and the positive prediction of needle biopsy of clinically diagnosed Warthin's tumor. Eur Arch Otorhinolaryngol 2019; 276:2091-2096. [PMID: 31165929 DOI: 10.1007/s00405-019-05493-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 05/09/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE This study reports the clinical course, including the growth rate, of Warthin's tumor (WT) and evaluates the positive prediction of needle biopsy for WT. METHODS The medical records of 182 patients clinically diagnosed with WT were retrospectively reviewed. Tumor growth rates were measured in patients who underwent serial radiologic exams with minimum 6-month time intervals, and the positive prediction value (PPV) of needle biopsy was evaluated in comparison with surgical pathology in patients who underwent surgical excision of the tumors. RESULTS Serial radiologic exams were available for growth rate measurement in 31 tumors (size 0.7-9.1 cm) from 25 patients. Among these, 24 tumors increased in size, and 7 were stable. The median follow-up duration was 23.5 months [interquartile range (IQR) 14.8-51.9], and the tumor growth rate ranged from - 0.36 to 2.26 cm per year (median 0.26, IQR 0.07-0.44). Needle biopsy results were available for comparison with postoperative pathology specimens in 147 patients. The PPV was 97.7% for fine-needle aspiration biopsy and 100% for core-needle biopsy. There were no reports of inflammation, facial nerve paralysis, or admission event during the follow-up. CONCLUSIONS WT glows slowly and can be predicted by needle biopsy. Therefore, parotid masses diagnosed as Warthin's tumor can be treated or left untreated based on the patient's needs and clinical decision-making.
Collapse
Affiliation(s)
- Jungirl Seok
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Young Ho Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| |
Collapse
|
16
|
Watchful waiting in carefully selected metachronous cystadenolymphomas of the parotid gland: a reliable option? Br J Oral Maxillofac Surg 2019; 57:425-429. [DOI: 10.1016/j.bjoms.2018.12.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 12/14/2018] [Indexed: 01/09/2023]
|
17
|
Mantsopoulos K, Goncalves M, Koch M, Traxdorf M, Schapher M, Iro H. Going beyond extracapsular dissection in cystadenolymphomas of the parotid gland. Oral Oncol 2019; 88:168-171. [DOI: 10.1016/j.oraloncology.2018.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 12/20/2022]
|
18
|
Oxidative Stress Markers Patients with Parotid Gland Tumors: A Pilot Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4340871. [PMID: 29651432 PMCID: PMC5832034 DOI: 10.1155/2018/4340871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 11/20/2017] [Indexed: 01/02/2023]
Abstract
Salivary gland tumors account for 3-6% of tumors of the head and neck. About 80% of salivary gland tumors occur in parotid glands. Oxidative stress (OS) is implicated in the origin, development, and whole-body effects of various tumors. There are no data on the occurrence of OS in the parotid gland tumors. The aim of this study was to ascertain if whole-body OS accompanies parotid gland tumors, based first of all on oxidative modifications of blood serum proteins and other markers of OS in the serum of the patients. The group studied included 17 patients with pleomorphic adenoma, 9 patients with Warthin's tumor, 8 patients with acinic cell carcinoma, and 24 age-matched controls. We found increased concentration of interleukin 4 in patients with acinic cell carcinoma, decreased plasma thiols, increased AOPP concentration, and decreased FRAP of blood serum in all groups of the patients while protein oxidative modifications assessed fluorimetrically, protein carbonyls, protein nitration, malondialdehyde concentration, and serum ABTS⁎-scavenging capacity were unchanged. These data indicate the occurrence of OS in patients with parotid gland tumors and point to various sensitivities of OS markers.
Collapse
|
19
|
Quer M, Vander Poorten V, Takes RP, Silver CE, Boedeker CC, de Bree R, Rinaldo A, Sanabria A, Shaha AR, Pujol A, Zbären P, Ferlito A. Surgical options in benign parotid tumors: a proposal for classification. Eur Arch Otorhinolaryngol 2017. [DOI: 10.1007/s00405-017-4650-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Sagiv D, Witt RL, Glikson E, Mansour J, Shalmon B, Yakirevitch A, Wolf M, Alon EE, Slonimsky G, Talmi YP. Warthin tumor within the superficial lobe of the parotid gland: a suggested criterion for diagnosis. Eur Arch Otorhinolaryngol 2016; 274:1993-1996. [PMID: 28013343 DOI: 10.1007/s00405-016-4436-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 12/16/2016] [Indexed: 10/20/2022]
Abstract
The location of Warthin tumor (WT) in the parotid gland impacts the surgical approach and may be indicative of the elusive origin of this intriguing entity. Location in the deep versus superficial lobe of the gland is not directly addressed when defining WT characteristics. Our observation, of rare occurrence of deep lobe WT, if at all, led to the current investigation. The study design is cohort study. This is a retrospective chart review of all patients undergoing parotidectomy for WT in two tertiary academic referral centers: the Sheba Medical Center (SMC), Israel, and the Christiana Care (CC), Newark, Delaware, USA. 122 consecutive adult patients underwent parotidectomy for WT (72 from SMC and 50 from CC). Seventy percent were males, with a mean age of 60.6 years. Bilateral WT or multi-centric WT were found in 9.8 and 17.2% of the cases, respectively. In one case, the tumor was described as originating in the deep lobe. In all other cases, the tumor originated and was limited to the superficial lobe. 99.2% of WT originated in the superficial lobe, corresponding with the few reports directly addressing its location in the gland. The reason for the tumor to be limited almost uniformly to the superficial lobe is unknown, and could be related to the etiopathogenesis of this elusive entity. We suggest adding tumor location within the superficial lobe to the common characteristics of WT (male, smoking, and lower pole) that serve as "common criterion" while evaluating a parotid lesion.
Collapse
Affiliation(s)
- Doron Sagiv
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. .,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Robert L Witt
- Otolaryngology-Head and Neck Surgery, Christiana Care, Newark, Delaware/Thomas Jefferson University, Philadelphia, PA, USA
| | - Eran Glikson
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Jobran Mansour
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Bruria Shalmon
- Department of Pathology, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Arkadi Yakirevitch
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michael Wolf
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eran E Alon
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Guy Slonimsky
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Yoav P Talmi
- Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
21
|
Luers JC, Guntinas-Lichius O, Klussmann JP, Küsgen C, Beutner D, Grosheva M. The incidence of Warthin tumours and pleomorphic adenomas in the parotid gland over a 25-year period. Clin Otolaryngol 2016; 41:793-797. [PMID: 27343470 DOI: 10.1111/coa.12694] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Pleomorphic adenoma (PA) is reported to be the most common benign parotid tumour followed by Warthin tumour (WT), but the proportion of these two entities might have changed. DESIGN Retrospective file analysis. SETTING Tertiary referral head and neck centre. PARTICIPANTS Patients who underwent a parotidectomy within a period of 25 years (1990-2014). MAIN OUTCOME MEASURES Rate of occurrence of PA and WT as well as the development of the PA/WT ratio over the years. RESULTS Overall, 1818 patients with WT (707, 38.9%) and PA (1111, 61.1%) were identified. There was a dominance of PA over WT in all years. An increase in percentage of WT, from 24% in 1990 to 48% in 2014, in comparison with PA was evident. CONCLUSIONS In our single-institution hospital-based material of parotidectomies, the percentage of WT in comparison with PA has significantly increased over the last 25 years.
Collapse
Affiliation(s)
- J C Luers
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - O Guntinas-Lichius
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, Jena University Hospital, Jena, Germany
| | - J P Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, Giessen, Germany
| | - C Küsgen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - D Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - M Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| |
Collapse
|
22
|
Warthin's tumor of parotid gland: Surgery or follow-up? Diagnostic value of a decisional algorithm with functional MRI. Diagn Interv Imaging 2016; 97:37-43. [DOI: 10.1016/j.diii.2014.11.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
23
|
Schwalje AT, Uzelac A, Ryan WR. Growth rate characteristics of Warthin's tumours of the parotid gland. Int J Oral Maxillofac Surg 2015; 44:1474-9. [PMID: 26314235 DOI: 10.1016/j.ijom.2015.07.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 07/28/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to evaluate growth characteristics of parotid gland Warthin's tumours. The medical records of 134 patients who had a cytological or histopathological diagnosis of Warthin's tumour between 1997 and 2013, at a single tertiary care centre, were reviewed retrospectively. Thirteen of these patients underwent observation with 30 serial computed tomography or magnetic resonance imaging scans of the head and neck, with 24 Warthin's lesions identified. The mean length of time between scans was 882 days, and mean initial and final sizes per lesion were 3.9 cm(3) and 5.6 cm(3), respectively. Average growth of these lesions was 8% per year (95% confidence interval -27% to 43%; range -148% to 460%; median -8%), and was highly variable (standard deviation 96%). Age over 75 years was associated with slower growth (P=0.03), but gender, smoking status, multifocality, bilaterality versus unilaterality, and initial size did not correlate with the growth rate. Warthin's tumours appear to have an approximate average doubling time of 9 years, but can have a wide range of growth rates, with many cases showing a reduction in size. Either conservative management or surgical resection could be supported by these data, depending on the current size of the tumour, appearance, symptoms, and the age, health, and wishes of the patient.
Collapse
Affiliation(s)
- A T Schwalje
- School of Medicine, University of California - San Francisco, San Francisco, CA, USA
| | - A Uzelac
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - W R Ryan
- Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA.
| |
Collapse
|
24
|
WEMMERT SILKE, WILLNECKER VIVIENNE, SAUTER BIRGIT, SCHUH SEBASTIAN, BRUNNER CHRISTIAN, BOHLE RAINERMARIA, URBSCHAT STEFFI, SCHICK BERNHARD. Genomic alterations in Warthin tumors of the parotid gland. Oncol Rep 2014; 31:1899-904. [DOI: 10.3892/or.2014.3028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/21/2014] [Indexed: 11/06/2022] Open
|
25
|
Yaranal PJ, T U. Squamous Cell Carcinoma Arising in Warthin's Tumour: A Case Report. J Clin Diagn Res 2013; 7:163-5. [PMID: 23449505 DOI: 10.7860/jcdr/2012/4683.2697] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 07/04/2012] [Indexed: 11/24/2022]
Abstract
Warthin's tumour (adenolymphoma) is a well defined salivary gland tumour which consists of epithelial and lymphoid components. However, the malignant transformation of adenolymphoma is extremely rare. We are reporting a case of squamous cell carcinoma which arose in a Warthin's tumour of the right parotid gland, to highlight its varied cytolomorphological features which can cause diagnostic problems on cytological examination. The review of the literature has been discussed.
Collapse
Affiliation(s)
- P J Yaranal
- Associate Professor, Department of Pathology, Yenepoya Medical College , Mangalore - 575018, India
| | | |
Collapse
|
26
|
|
27
|
|
28
|
Hall JE, Statham MM, Sheridan RM, Wilson KM. Multifocal synchronous ipsilateral Warthin tumors: case report and review of the literature. EAR, NOSE & THROAT JOURNAL 2011; 89:E1-3. [PMID: 20859854 DOI: 10.1177/014556131008900901] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report a case of a 73-year-old woman who presented with an enlarging superficial parotid mass, a concomitant ipsilateral deep-lobe parotid mass, and associated upper jugular lymphadenopathy. The clinical presentation and radiographic imaging were suggestive of malignancy, and the patient was treated with total parotidectomy with upper jugular lymph node sampling. Pathologic examination revealed two distinct masses, one in the superficial lobe and one in the deep lobe of the parotid gland, both consistent with synchronous Warthin tumors. Analysis of the upper jugular lymph nodes was consistent with reactive lymphoid hyperplasia. Although the true incidence of multicentricity in ipsilateral Warthin tumors may be underappreciated and underreported, this entity should remain in the differential diagnosis for unilateral parotid masses.
Collapse
Affiliation(s)
- Joseph E Hall
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, University Hospital, Cincinnati, OH 45267, USA
| | | | | | | |
Collapse
|
29
|
Patnayak R, Jena A, Kumar Chowhan A. Role of cell block preparation in Warthin's tumour. Cytopathology 2010; 21:423; author reply 423. [PMID: 20726866 DOI: 10.1111/j.1365-2303.2010.00798.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Wojdas A, Jurkiewicz D. [The parotid gland's tumours in material of Otolaryngology Department of the Medical Military Institute between 2004-2008]. Otolaryngol Pol 2010; 63:73-5. [PMID: 20564905 DOI: 10.1016/s0030-6657(09)70193-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The parotid gland is the place where benign and malignant tumours may occur. They mostly grow in larger parotid glands. The aim of this work is to analyze operative treatment of parotid gland tumours performed in the years 2004-2008. Between 2004-2008, 128 patients underwent surgical procedure caused by parotid gland tumour, including 72 women (56%) and 56 men (44%) aged between 12-80 (the average age was 49.1); the procedures were performed in the Otolaryngology Department of the Medical Military Institute. The initial diagnosis was based on history and physical examination as well as additional examinations including standard ultrasound examination and BAC. The extent of operative treatment was based on medical examination, results of additional examinations and, finally, in special cases, on intraoperative histopathological examination. Our material includes benign tumours diagnosed in 113 patients (88.3%) and malignant ones in 15 patients (11.7%). The most frequent parotid gland tumour is polymorphic adenoma (50%), the second most frequent one is lympho-adenoma (33.6%). The results of fine-needle aspiration biopsy were confirmed in histopathological examination conducted on 101 patients (79%). It was discovered that parotid gland tumours were predominantly benign tumours. The most frequent type of parotid gland tumour was the polymorphic adenoma. The operative method was selected depending on the clinical picture supplemented by the results of additional examinations: BAC, ultrasound examination, computer tomography, MRI. In the event of suspected malignant parotid gland tumour, it is necessary to conduct intraoperative histopathological examination.
Collapse
Affiliation(s)
- Andrzej Wojdas
- Klinika Otolaryngologii CSK MON Wojskowego Instytutu Medycznego w Warszawie.
| | | |
Collapse
|