PAROTID GLAND TUMORS: AN EVALUATION AT TERTIARY CARE HOSPITAL. ORIGINAL PROF-0-3324 (original) (raw)
Related papers
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.
Mucoepıdermoıd carcınoma of the parotıd gland mımıckıng a benıgn cystıc lesıon
Eastern Journal of Medicine, 2011
Abstract. Mucoepidermoid carcinoma is the most common malignant salivary gland neoplasm. It affects both major and minor salivary glands and when major salivary glands are affected, the parotid gland is the most common. The incidence has been reported to range from 4-12% of all the parotid tumors. Mucoepidermoid carcinoma of parotid gland is usually of low grade type with a marked cystic component causing considerable diagnostic difficulties. Hence cystic lesions of parotid gland should not be merely dismissed as benign entities and mucoepidermoid carcinoma should be always included in differential diagnosis. In this presentation, we report a case with initial diagnosis of benign cystic lesion based on FNAC and MRI findings which was later diagnosed histologically as low grade mucoepidermoid carcinoma of the parotid gland. Key words: Mucoepidermoid carcinoma, mucocele, cystic lesions, parotid gland
Primary Salivary Gland Tumors- A two years study at Nobel Medical College
Nepalese medical journal, 2019
Salivary gland tumors are a heterogenous group of neoplasms that are relatively rare but represent a wide variety of both benign and malignant histopathologic subtypes. The global incidence is 1 in 100,000 individuals and comprises less than 3% of all head and neck neoplasms. 1 The frequency of benign tumors of salivary glands is higher in females whereas malignant tumors occur more frequently in males. 2,3 The most common benign tumor is pleomorphic adenoma followed by warthin's tumor, whereas most common malignant tumor is mucoepidermoid carcinoma followed by adenoid cystic carcinoma. 2-5 Benign tumors of salivary glands are most commonly seen in 30-70 years with a mean age of 45 years and peak incidence of malignant tumor in seen in 6th and 7 th decades. 6,7 Conclusions: Benign salivary tumors are more common than malignant tumors with the most common occurrence in parotid glands. Pleomorphic adenoma is the most common benign tumor whereas; mucoepidermoid carcinoma is the most common malignant tumor in patients visiting Nobel medical college.
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.
Mucoepidermoid Carcinoma of the Parotid Gland
Archives of Otolaryngology–Head & Neck Surgery, 2004
To determine clinical and histopathologic features of mucoepidermoid carcinoma of the parotid gland, specifically, the relation of tumor stage and grade and treatment type with clinical outcome. Retrospective clinical and histopathologic review. Tertiary care medical center. From 1940 to 1994, 128 patients were treated at our institution for parotid mucoepidermoid carcinoma. Eighty-nine of these patients had their first treatment at our institution; these cases were chosen for retrospective clinical and histopathologic review. A head and neck pathologist independently reviewed the pathology specimens. Age, symptoms, stage, treatment type, tumor grade, pathological features, disease progression, and survival. Results of clinical staging were: T1 in 56 patients, T2 in 13, T3 in 1, T4 in 15, N0 in 85, N1 in 2, and N2 in 2. No patient had N3 or M1 disease. All patients underwent parotidectomy with or without neck dissection. Seven patients received postoperative radiotherapy. Tumor grade was low in 43 patients (48%), intermediate in 40 (45%), and high in 6 (7%). Only 5 patients had disease progression (local recurrence in 4, regional recurrence in 4, and distant recurrence in 2). At latest follow-up (mean follow-up, 14.7 years), 64 patients were alive without disease, 1 was alive with disease, 2 had died of mucoepidermoid carcinoma, and 22 had died of other causes. The Kaplan-Meier estimated cancer-specific survival rates at 5, 15, and 25 years were 98.8%, 97.4%, and 97.4%, respectively. In our study, tumor grade and stage appeared to be less important than previously described. With adequate parotidectomy and appropriate neck dissection, patients with mucoepidermoid carcinoma of the parotid gland appear to do well, with few recurrences.
Fifteen Years Experiences in Tumors of Parotid Glands and the Analysis of 204 Cases
Biomedical and Pharmacology Journal, 2015
The salivary glands are located around the mouth. They produce saliva, which moistens food to help with chewing and swallowing. There are three pairs of major salivary glands. The largest are the parotid glands which are located in each cheek over the jaw in front of the ears. The glands are effectively palpated bilaterally 1,13. The facial nerve and its branches pass through the parotid gland. Salivary gland tumors are uncommon, corresponding to approximately 3% of neoplasm of the head and neck region 2, 12, 13. The parotid gland is the most common site of major salivary gland tumors, and the palate is the most common site of minor salivary gland tumors 2, 3 .
Parotid Tumors: How Rare are They?
International Journal of Head and Neck Surgery, 2014
Objectives: Salivary gland neoplasms are uncommon, but they are of much interest and debate because of their remarkable variability in structure, clinical presentation, and behavior. We have studied 56 cases of parotid tumors and shared our views on the diagnosis and management of these rare tumors. Materials and methods: Fifty-six patients with parotid swelling presented to us over a period of 5 years. Preoperatively, all these patients were evaluated with fine needle aspiration cyto logy (FNAC). Depending on the report, they were subjected to further treatment. Results: out of 56 cases, 44 (79%) were benign and 12 (21%) were malignant. Pleomorphic adenoma being the commo nest benign tumor [32 cases (72%)] and among the malignant tumors, mucoepidermoid carcinoma was the commonest. Parotidectomy is the gold standard treatment for both the benign and malignant parotid tumors. Conclusion: Parotid tumors are a rare entity. Among which benign tumors are more common than malignant. An accurate diagnosis preoperatively and timely surgical management would reduce the recurrence rate and risk of complications.