Comprehensive analysis of parotid mass: A retrospective study of 369 cases (original) (raw)
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Clinical Presentations And Surgical Outcomes Of Parotid Gland Tumors
2015
and included 34 patients who underwent parotidectomy. Data were collected regarding clinical presentations, benign versus malignant nature of the disease on FNAC reports, radiological findings, type of surgery instituted, complications encountered and histology reports of the surgical specimens and subjected to statistical analysis. Results: All patients had presented with a lump usually painless. Thirty (88%) patients had benign pathology while four (12%) had malignancies. Most common surgical procedure instituted was superficial parotidectomy, performed in 90% (n = 31). The most common complication was Sialocele (n=5; 15%) followed by facial nerve palsy (n= 2; 6%).The value of FNAC as a diagnostic tool was with 96.66% specificity and 75% sensitivity. Conclusion: Pleomorphic adenoma is most common benign pathology. Superficial parotidectomy is the most commonly offered surgical procedure. Parotid surgeries are safely performed with low morbidity and no mortality. [Jayman R NJIRM 20...
Parotid Gland Tumours: A Clinicopathological Study
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Salivary gland tumours are interesting and challenging due to their relative infrequency of incidence, Histopathological (HPE) and behavioural diversity and the regional anatomic relationship with important structures. Salivary gland tumours comprise about 3-4% of all head and neck neoplasms. 70% of these tumours arise in parotid gland, 22% in sub-Mandibular gland and 8% in the rest. Of these tumours 80% of parotid, 50% of sub-Mandibular, 50% of sublingual and 25% of minor salivary glands are benign. Parotid gland is the most common site of salivary gland tumours. Most common parotid tumour is pleomorphic adenoma followed by Warthin's tumour. Most common malignant tumour of parotid gland is muco-epidermoid carcinoma. FNAC of salivary gland swelling is commonly accepted, sensitive and specific technique in the diagnosis of both neoplastic and non-neoplastic lesions of salivary gland. The traditional open biopsy is no longer justified because of risk of tumour spillage and damage to the facial nerve. Treatment of parotid tumours is either by surgery (Superficial/Total parotidectomy) alone or surgery followed by radiotherapy in certain cases. Tumours should be excised, not enucleated. AIMS OF THE STUDY To study the demographic profile of patients with parotid gland tumours to study the clinico-pathological features of parotid gland tumours. To evaluate the role of FNAC in the pathological diagnosis of parotid gland tumours and to correlate the FNAC reports with histopathology. To study the various surgical procedures adopted for parotid gland tumours and the incidence of immediate complications after surgery. MATERIALS AND METHODS Between November 2007 and November 2009 at the Department of surgery of the Government Medical College, Calicut, Kerala 57 patients with parotid neoplasm were clinically evaluated and among them 32 were females and 25 were males. Nearly 50% of the patients belonged to 2 nd and 3 rd decades followed by 5 th and 6 th decades. Preliminary FNAC showed 32 (56.16%) out of 57 as pleomorphic adenoma, followed by Warthin's tumour in 17.54% and Muco-epidermoid carcinoma in 10.53%. The Benign epithelial tumour was observed in 8.77%, monomorphic adenoma in 3.51% and adenoid cystic carcinoma in 3.51% of the patients. RESULTS All the patients were subjected to excision biopsy and Histo-pathological study. The Sensitivity of FNAC for benign tumours and malignant tumours was 100% and 80% respectively; Whereas the specificity for benign tumour and malignant tumours was 80% and 100% respectively. The Recurrence rate and post-operative facial weakness were low. CONCLUSIONS Sensitivity of FNAC for benign tumour was 100% and for malignant tumour was 80%. Specificity of FNAC for benign tumour was 80% and for malignant tumour was 100%. There were no complications attributed to FNAC.
Surgical Presentation and Outcome of Parotid Gland Tumours
Journal of the College of Physicians and Surgeons Pakistan Jcpsp, 2013
OBJECTIVE: To assess the clinical presentation and outcome of surgical management of various parotid gland disorders requiring parotidectomy.STUDY DESIGN: Case series.PLACE AND DURATION OF STUDY: Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2003 to December 2010.METHODOLOGY: Patients presenting in surgical OPD with parotid gland disorders requiring parotidectomy were included. Data were obtained through the Hospital Management Information System (HMIS) and patient charts. The sociodemographic profile of the patient, presenting features among patients, benign versus malignant nature of the disease, FNAC reports, type of surgical procedure instituted, complications encountered and histology reports of the surgical specimens were all recorded on a proforma. The data were subjected to statistical analysis with SPSS version 15.RESULTS: Out of 126 patients, 62 (49%) were males and 64 (51%) females with mean age of 41 ± 12.6 years. All had presented with a lump usually painless. One hundred and fourteen (90.47%) patients had benign pathology while 9.52% (n = 12) had malignanciy. Superficial parotidectomy was carried out in 79.36% (n = 100) patients, total parotidectomy in 19% (n = 24) and extended total parotidectomy was performed in 2 cases (with mucoepidermoid carcinoma). The most common post-operative complication was greater auricular nerve paresis (n = 19; 15%) followed by facial nerve transient paresis (n = 10; 8%). There was no in-hospital mortality.CONCLUSION: Parotid gland lumps commonly affect relatively young individuals of either gender. Most of the patients have benign pathology. Superficial parotidectomy is the most commonly offered surgical procedure. Parotid surgeries are safely performed in general surgery units with low morbidity and no mortality.
Benign tumors of the parotid gland: a retrospective study of 339 patients
Acta Chirurgica Belgica, 2017
Aim: Among 339 patients operated for benign tumor of the parotid gland: the recurrences and the postoperative complications rates were compared WITH those published in literature. Materials and methods: About 339 patients operated: 274 primarily and 65 for recurrence or residual tumor. Variables: sex, age, surgical techniques, pre-or postoperative radiotherapy, histology, size and localization of the tumors, disease free intervals, recurrences and postoperative complications. Results: 177 men and 162 women. Median age: 55 years and mean follow-up: 10.4 years. About 39 patients had adjuvant radiotherapy (11.5%). After primary surgery, four patients experienced recurrences (1.5%). After salvage surgery, eight patients recurred (12.3%). The recurrence rate was the highest among pleomorphic adenomas. Facial paralysis was more frequent after salvage surgery. Discussion: Recurrence rate 10 years later was lower after primary than after salvage surgery (p ¼ 0.01). There was no relation between adjuvant radiotherapy and recurrence rate probably because the low rate of recurrences. Conclusion: Recurrence rate after primary surgery is lower after superficial or total parotidectomy than after other surgical techniques. Pleomorphic adenomas have the highest rate of recurrences. Age and sex have no significant influence over the rate of recurrences. The most frequent postoperative complications are facial paralysis and Frey's syndrome.
Surgical presentation and outcome of parotid gland tumours. J Coll Physicians Surg Pak. 2013 Sep;23(9):625-8. doi: 09.2013/JCPSP.625628. [PubMed] PMID:24034185, 2013
To assess the clinical presentation and outcome of surgical management of various parotid gland disorders requiring parotidectomy. Study Design: Case series.Place and Duration of Study: Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2003 to December 2010. Methodology: Patients presenting in surgical OPD with parotid gland disorders requiring parotidectomy were included. Data were obtained through the Hospital Management Information System (HMIS) and patient charts. The sociodemographic profile of the patient, presenting features among patients, benign versus malignant nature of the disease, FNAC reports, type of surgical procedure instituted, complications encountered and histology reports of the surgical specimens were all recorded on a proforma. The data were subjected to statistical analysis with SPSS version 15.Results: Out of 126 patients, 62 (49%) were males and 64 (51%) females with mean age of 41 ± 12.6 years. All had presented with a lump usually painless. One hundred and fourteen (90.47%) patients had benign pathology while 9.52% (n = 12) had malignanciy. Superficial parotidectomy was carried out in 79.36% (n = 100) patients, total parotidectomy in 19% (n = 24) and extended total parotidectomy was performed in 2 cases (with mucoepidermoid carcinoma). The most common post-operative complication was greater auricular nerve paresis (n = 19; 15%) followed by facial nerve transient paresis (n = 10; 8%). There was no in-hospital mortality.Conclusion: Parotid gland lumps commonly affect relatively young individuals of either gender. Most of the patients have benign pathology. Superficial parotidectomy is the most commonly offered surgical procedure. Parotid surgeries are safely performed in general surgery units with low morbidity and no mortality.
Otolaryngologia Polska, 2017
Introduction: Salivary gland tumors are rare and comprise 3-10% of all tumors of the head and neck. Materials and methods: Between 2006 and 2016, 149 patients with parotid gland tumors were treated in our department. Our report is based on medical records, histopathological examinations, and surgery reports. Results: We found 126 benign and 23 malignant tumors, and both tumor types were seen more frequently in men. The mean age of all patients was 58.3 years; it was 65.5 years for patients with malignant tumors and 56.9 years for those with benign tumors. Among the analyzed patients, the peak incidence was seen in the age range of 60-69 years. Moreover, this age range was approximately the same for all tumors and benign tumors, whereas for malignant tumors it was 70-79 years. Benign tumors were significantly more frequent, and comprised 84.56% of all tumors. The most common benign tumors were pleomorphic adenoma and adenolymphoma, accounting for 93.66% of cases. The most common malignant tumors were as follows: polymorphous low-grade adenocarcinoma (26.07%), NOS adenocarcinoma (13.04%), and acinic cell carcinoma (13.04%). The most common treatment modality was standalone surgery. Conclusions: Our retrospective analysis is in line with previous national and international studies.
Parotid gland surgery: 4-Year review of 118 cases in an Asian population
Head & Neck, 2003
Background. To determine the presentation and management of parotid lesions requiring excision in a largely Chinese Asian population. Methods. Retrospective study of 118 consecutive parotidectomies. Results. Thirty-seven percent were Warthin's tumor (WT), 33% pleomorphic adenoma (PA), 21% other benign disease (OBD), and 9% malignant tumor (MT). Mean age was significantly different between benign (51 years) and malignant (40 years) lesions. MT decreased above 50 years, but increased five times with pain and two times with a noninferior pole lesion. Sensitivity of fine-needle aspiration (FNA) for differentiating benign from MT = 78%, for WT =5 8%, for PA =82%, for OBD = 28%, and for MT = 38%. CT scans did not alter WT management. Facial nerve (FN) paresis was not associated with histology, tumor size, site, or parotidectomy type. Conclusions. This is the first report documenting that most benign parotid tumors are WT and not PA. MT risk is greater in those less than 50 with pain and a noninferior pole lesion. Cystic lesions such as WT require great care in the evaluation of FNA findings.
Parotid Tumor: A review of seven years' experience
Introduction: Parotid tumors represent about 80% of all salivary gland tumors. Our study was conducted to assess the clinical features, diagnostic accuracy of fine needle aspiration cytology (FNAC), surgical outcome and histological pattern of all patients underwent parotid surgery for parotid tumor at Patan Hospital. Methods: All data of patients who underwent parotid surgery from 2060 to 2067 Be at Patan Hospital were collected retrospectively from medical files and analyzed. Results: Among 18, all were presented with lump in the parotid region. Mean age of the patients was 45 years. Malignancy was common among older age group (mean age 51 vs 44 for benign). The overall accuracy in detecting malignant tumors was 88.89% with positive predictive and negative predictive values 100% and 83.24% respectively. Out of 18 histological reports, 15(83.33%) were benign lesions, pleomorphic adenoma was being most common 9(60%) among benign lesions, and 3(16.67%) were malignant lesions. Conclusion: Painless lump is most common presentation of the parotid tumor. Benign pathology is common and majority of them are pleomorphic adenoma. Malignancy is prevalent in older age group.
Sri Lanka Journal of Surgery, 2017
Introduction Parotid tumours are heterogeneous neoplasms with complex morphology and dubious clinical characters. The aim of our study was to assess the demographics, frequency, morphology, management & long term follow up results of the patients undergoing parotidectomy. Methodology This prospective study was conducted on all parotidectomies performed at the Dept. of Surgery and Surgical Oncology of three premiere teaching institutes of Kolkata between January 2011 to December 2015. Result and discussion The mean age of presentation in our study was comparable with other series [9,10]. Pleomorphic adenoma was most common with 51 (41.5%) patients and Warthin's tumour was 2nd most common with 19 (15.4%) patients. Permanent facial nerve palsy was seen in 0.04% of our patients. Pain (41.3%) and swelling (100%) were the most frequent presenting feature of malignancy. 15 (34%) patients with malignant tumour required additional reconstruction by pectoralis major myocutaneous flap. Conclusion Our study came out with many similarities in clinical course of parotid tumours in other parts of the world as well as a few individual findings. Surgery with optimum preoperative planning and counselling remains the mainstay of treatment.
INTRODUCTION: Salivary gland tumors are interesting and challenging due to their relative infrequency of incidence, Histo-pathological (HPE) and behavioral diversity and the regional anatomic relationship with important structures. Salivary gland tumors comprise about 3-4% of all head and neck neoplasms. 70% of these tumors arise in parotid gland, 22% in sub-Mandibular gland and 8% in the rest. Of these tumors 80% of parotid, 50% of sub-Mandibular, 50% of sublingual and 25% of minor salivary glands are benign. Parotid gland is the most common site of salivary gland tumors. Most common parotid tumor is pleomorphic adenoma followed by Warthin's tumor. Most common malignant tumor of parotid gland is muco-epidermoid carcinoma. FNAC of salivary gland swelling is commonly accepted, sensitive and specific technique in the diagnosis of both neoplastic and non neoplastic lesions of salivary gland. The traditional open biopsy is no longer justified because of risk of tumor spillage and damage to the facial nerve. Treatment of parotid tumors is either by surgery (superficial/total parotidectomy) alone or surgery followed by radiotherapy in certain cases. Tumors should be excised, not enucleated. AIMS OF THE STUDY: To study the demographic profile of patients with parotid gland tumors to study the clinico-pathological features of parotid gland tumors. To evaluate the role of FNAC in the pathological diagnosis of parotid gland tumors and to correlate the FNAC reports with histopathology. To study the various surgical procedures adopted for parotid gland tumors and the incidence of immediate complications after surgery. MATERIALS AND METHODS: Between November 2007 and November 2009 at the Department of surgery of the Government Medical College, Calicut, Kerala 57 patients with parotid neoplasm were clinically evaluated and among them 32 were females and 25 were males. Nearly 50% of the patients belonged to 2 nd and 3 rd decades followed by 5 th and 6 th decades. Preliminary FNAC showed 32 (56.16%) out of 57 as pleomorphic adenoma, followed by Warthin's tumor in 17.54% and Muco-epidermoid carcinoma in 10.53%. The Benign epithelial tumor was observed in 8.77%, monomorphic adenoma in 3.51% and adenoid cystic carcinoma in 3.51% of the patients. RESULTS: All the patients were subjected to excision biopsy and Histo-pathological study. The Sensitivity of FNAC for benign tumors and malignant tumors was 100% and 80% respectively; Whereas the specificity for benign tumor and malignant tumors was 80% and 100% respectively. The Recurrence rate and post operative facial weakness were low. CONCLUSIONS: Sensitivity of FNAC for benign tumor was 100% and for malignant tumor was 80%. Specificity of FNAC for benign tumor was 80% and for malignant tumor was 100%. There were no complications attributed to FNAC. INTRODUCTION: Parotid gland is the most common site of salivary gland tumors. Most of these arise in the superficial lobe (1). Parotid tumors present as slow growing, painless swelling either below the ear or in the upper aspect of neck. Rarely these tumors may arise from deep lobe which present as para-pharyngeal masses (2). The utilization of parotidectomy for the treatment of neoplasms has been attributed to Betrandi (3). In the initial efforts to treat tumors of the gland, surgeons were concerned primarily about hemorrhage; patients were inevitably left with major disfiguration if they were fortunate enough to survive a parotid resection. By the mid-19th century, focus had shifted to facial nerve anatomy and techniques that would provide access for resection with facial/cranial nerve VII (CN VII) preservation. From a historical perspective, the first operation to use ether inhalation anesthesia was a parotid tumor resection performed by Dr. John C. Warren in Boston in 1846 (3). The first total parotidectomy with facial nerve preservation is said to have been accomplished by Codreanu, a Romanian, in 1892 (3). During the early years of the 20th century, many authors verified that removal of parotid gland tumors was possible with facial nerve preservation (4). Blair, Sistrunk, and others attempted to systematize the surgical approach to the facial nerve to ensure anatomic preservation when feasible, while assuring complete resection of the tumor. The first attempts at facial nerve grafting date. From the early 1950s a major series of FNAC of salivary tumors by Lineberg and Akerman in 1972 established the role of FNAC in salivary gland disease (5). The course of the facial nerve through the parenchyma of the gland is highly predictable anatomically; however, parotid tumors pose a special challenge to surgeons because of the diversity of histological subtypes and their remarkable variation in clinical behavior (6). Small benign tumors are quite indistinguishable from their malignant counterparts. Even when benignity of the neoplasm can be established with reasonable certainty, most patients are motivated to have surgical resection due to progressive disfiguration of an enlarging benign tumor (7). The present study was conducted to analyze the morphological, clinical features and the role of FNAC and HPE in the management of parotid glad tumors in this part of Kerala.