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Resumen Los linfomas de las glándulas salivales son una entidad e incidencia rara. La localización más frecuente es la glándula parótida, seguida de las glándulas submandibular y sublingual. La mayoría de los linfomas parótidos son linfomas no Hodgkin y se consideran derivados de tejido linfoide asociado a la mucosa (MALT). De manera poco frecuente, estos casos se han notificado y con frecuencia se diagnostican de manera inadecuada, ya que su presentación es relativamente benigna, comportamiento localizado, crecimiento lento y varios años de evolución.
Abstract Lymphomas of the salivary glands are a rare entity with a rare incidence. They are more commonly found on the parotid gland, followed by the submandibular and sublingual glands. The majority of parotid lymphomas are non-Hodgkin's lymphomas and are considered to be derived from mucosal-associated lymphoid tissue (MALT). Reports of these cases are scarce and often misdiagnosed since: their manifestation is relatively benign, they have a localized behavior, a slow growth and the evolution takes several years.
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The patient was a 44-year-old man with right facial paralysis as the main complaint. Upon resection of a benign parotid gland tumor (6 cm in diameter), one of the buccal branches of the right facial nerve was severed. Immediately after the surgery, facial nerve paralysis occurred in the areas innervated by the buccal and marginal mandibular branches. Therefore, on the 5th day after the surgery, acupuncture was started. The paralyzed facial site was treated weekly for 15 minutes by inserting a disposable acupuncture needle (40 mm in length and 0.16 mm in thickness) about 5 mm deep into the site. As a result, the discomfort around the right ear was alleviated and the right facial nerve paralysis was gradually improved and cured in 6 months after the onset. Acupuncture may have prevented secondary changes such as tissue scarring and atrophy after the surgery, and promoted healing. The paralysis of the areas innervated by the buccal branches may have been improved through rerooting from the other branches in the periphery region of the neurectomy site. The present case is informative in considering the indications of acupuncture.
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OBJECTIVES: To identify diagnostically meaningful differences between Warthin's tumor and malignant masses in the parotid gland by dynamic susceptibility contrast (DSC) MR imaging. METHODS: Eleven malignant parotid tumors and 9 Warthin's tumors were included. MR imaging was performed on all patients. Signal intensity time curves of tumors were obtained by DSC MR imaging and dynamic susceptibility contrast percentages (DSC%) were calculated. RESULTS: No significant difference was observed between malignant tumors and Warthin's tumors (P = 0.437), although DSC% values tended to be higher for Warthin's tumors. CONCLUSIONS: Warthin's tumor tended to have higher DSC% values than malignant parotid tumors, but this difference was not significantly different.
Subject(s)
Humans , Magnetic Resonance Imaging , Parotid Gland , PerfusionABSTRACT
OBJECTIVE@#This study aimed to investigate the value of normalized iodine concentration (NIC), spectral attenuation curve slope (SACS), area under curve (AUC), and iodine concentration difference (ICD) generated from spectral CT in the assessment of parotid gland tumors.@*METHODS@#Ninety-two patients with pathologically confirmed parotid gland tumors underwent arterial phase- and venous phase-enhanced CT in spectral CT. The patients were divided into the pleomor-phic adenoma group (group A), Warthin tumor group (group B), basal cell tumor group (group C), and malignant tumor group (group D). The SACS, AUC, NIC, ICD were measured and analyzed. Statistical analyses were performed by one-way ANOVA, and statistical significance was set at P<0.05.@*RESULTS@#SACS(AP), AUC(AP), and NIC(AP) in group A were lower than those in other groups; SACS(VP) and AUC(VP) in group C were higher than those in other groups; NIC(AP) and NIC(VP) in group D were higher than those in other groups; and ICD in group B was a positive number. The difference in SACS(AP) and AUC(AP) in groups B and C, SACS(VP) and AUC(VP) in groups C and D, and ICD in groups A and C were not statistically significant. By contrast, the diffe-rence between the other groups was statistically significant (P<0.05). The difference in NIC(AP) between groups A and B and groups C and D and the difference in NIC(VP) between groups A and C, groups A and D, and groups B and C were statistically significant (P=0.005, 0.025, 0.002, 0.038, and 0.049, respectively).@*CONCLUSIONS@#Multi-quantitative parameters from spectral CT might be helpful in differentiating various types of parotid gland tumors.
Subject(s)
Humans , Diagnosis, Differential , Iodine , Parotid Gland , Tomography, X-Ray ComputedABSTRACT
El oncocitoma es un tumor benigno que afecta varios órganos como tiroides, paratiroides, riñón y glándulas salivales, que consiste en la proliferación de células oncocíticas producidas por una gran hiperplasia mitocondrial. El oncocitoma representa menos del 1 por ciento de todos lostumores de las gandulas salivales. Cuando en estudios por imágenes de glándula parótida se observen múltiples pequeños nódulos con unamasa sólida o quística, el diagnóstico de oncocitoma debe ser considerado, especialmente en pacientes de sesenta o más años. El objetivo de este artículo es la presentación de un caso de oncocitoma y analizar el estado de arte de los casos reportados en la temática.
The oncocytoma is a benign neoplastic tumor that occurs in several organs, including the thyroid gland, parathyroid gland, kidneys, and salivary glands consisting of a proliferation of oncocytic cells produced by a large mitochondrial hyperplasia. The oncocytoma accounts for less than 1% of the whole salivary gland tumors.When multiple small nodules are found in the parotid gland with a large solid or cystic mass that is evident on imaging, a diagnosis of oncocytoma should be considered, particularly in patients of sixty years of age or older. The objective of this article is the presentation of a case of oncocytoma and the state of art of reported cases in this field.
Subject(s)
Humans , Male , Aged , Adenoma, Oxyphilic/surgery , Adenoma, Oxyphilic/diagnostic imaging , Adenoma, Oxyphilic/pathology , Parotid Neoplasms/classification , Dental Service, Hospital , Diagnosis, Differential , Magnetic Resonance Imaging/methods , Oral Surgical Procedures/methods , RecurrenceABSTRACT
Objective Parotidectomy and superficial parotidectomy are traditional surgical treatment to the malignant parotid gland tumour although they have many defects.The aim of this study was to analyze the feasibility of individualized treatment to patient according to tumor`s size and TNM stage. Methods Thirty three patients with low grade malignant parotid gland tumours from Dec 2005 to Dec 2010 were recruited in the present study.All the patients received the territorial surgical resection firstly.Then, 9 cases re-ceived the expanded territorial surgical resection (1 case had recurrent probability, accepted adjuvant radiotherapy).Sixteen cases un-derwent parotidectomy with complete tumor resection ( 2 case had envelope invasion, accepted adjuvant radiotherapy) .Eight cases ac-cepted adjuvant radiotherapy(4 cases on T1 and T2 stage preserved facial nerve although the nerves adhering to tumors, and other 4 ca-ses on T4a stage accepted facial nerve excision ) . Results Follow up ranged from 3.5 to 8.5 years and no recurrences were docu-mented.9 patients who accepted territorial surgical resection showed fine facial symmetry.8 cases of them without adjuvant radiotherapy had good salivary secretion.Nine cases of other 24 patients showed temporary facial nerve injury and recovered within 1 to 4 months. Four cases with facial nerve excision showed permanental facial paralysis. Conclusion To protect the function of parotid gland to the greatest extent, the small low grade malignant parotid gland tumors without facial nerve invasion could have territorial surgical resection. Combined territorial surgical resection with postoperative adjuvant radiation therapy is useful to avoid the tumors recurrence and en-croachment of facial nerve to protect the facial nerve function.
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10.3969/j.issn.1007-3969.2013.04.011
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El condroma es una neoplasia benigna, de origen mesenquimatoso, constituida por tejido cartilaginoso, que en el área maxilofacial es rara. Su sitio más frecuente en el complejo craneofacial es la estructura ósea maxilar o mandibular, aunque también se han descrito condromas de los tejidos blandos. Clínicamente se presenta como una lesión de crecimiento lento, asintomático, no dolorosa, de consistencia duro elástica, con una gradual expansión. El tratamiento de elección es la resección quirúrgica. Se tuvo como objetivo publicar esta infrecuente ubicación de la neoplasia por la dificultad que se presenta al diagnóstico diferencial. Presentamos un caso clínico de un tumor localizado en el lóbulo profundo de la glándula parótida, cuyo diagnóstico inicial, tras la citología por aspiración con aguja fina, fue de adenoma pleomorfo, lo que se comprobó luego por examen histopatológico de la pieza quirúrgica que se trataba de un condroma. Se concluye que ante una tumoración de parótida, siempre debe tenerse en cuenta el condroma en el diagnóstico diferencial(AU)
The chondroma is a benign tumor of mesenchymal origin, consisted of a cartilaginous tissue, and occurs rarely in the maxillofacial area. Its most frequent site in the craniofacial complex is the maxillary bony structure, although chondromas of the soft tissues have also been described in the literature. From the clinical viewpoint, it appears as a painless, hard elastic lesion of slow asymptomatic growth, with gradual expansion. The treatment of choice is surgery. This paper presented a clinical case of a tumor located in the deep lobe of the parotid gland. The initial diagnosis, after the fine needle aspiration test, was pleomorphic adenoma, which was then subjected to histopathologic testing to obtain the final diagnosis of chondroma. Concluding that although uncommon in this localization, it should always be kept in mind as possible diagnosis. It was concluded that when facing an uncommon parotid tumor, one must take into account the possibility of a chondroma in the differential diagnosis(AU)
Subject(s)
Humans , Female , Adult , Parotid Neoplasms/pathology , Chondroma/surgery , Chondroma/diagnostic imaging , Diagnosis, DifferentialABSTRACT
Los linfomas de las glándulas salivales son una entidad poco frecuente, estimándose una incidencia del 5 por ciento. La localización más habitual es la glándula parótida, seguida de la submaxilary la sublingual. La mayoría de los linfomas parotídeos son linfomas no Hodgkin (LNH) y se consideran derivados del tejido linfoide asociado a mucosas (MALT). Infrecuentemente se han reportado estos casos y suelen ser subdiagnosticados por su presentación relativamente benigna, comportándose de forma localizada, de lento crecimiento, con varios años de evolución. Presentamos un caso clínico de linfoma tipo MALT de parótida de acuerdo a las características clínicas, histológicas e inmunohistoquímicas de este tumor. Además una revisión de la literatura de este caso.
Lymphomas of the salivary glands are a rare entity, with an estimated incidence of 5 percent. The most frequent location is parotid gland, followed by the submandibular and sublingual. The majority of parotid lymphomas are non-Hodgkin's lymphoma NHL and are considered derived from mucosa-associated lymphoid tissue (MALT). Infrequently these cases have been reported and are often underdiagnosed for their presentation is relatively benign, localized behaving, slow growing, with several years of evolution. We report a case of parotid MALT lymphoma according to the clinical, histological and immunohistochemical characteristics of this tumor. In addition, a literature review of this case.
Subject(s)
Humans , Male , Aged , Lymphoma, B-Cell, Marginal Zone/diagnosis , Parotid Neoplasms/diagnosis , Parotid Neoplasms/surgery , Parotid Neoplasms/radiotherapy , Parotid Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Lymphoma, B-Cell, Marginal Zone/surgery , Lymphoma, B-Cell, Marginal Zone/radiotherapy , Lymphoma, B-Cell, Marginal Zone/diagnostic imaging , Immunohistochemistry , Lymphoma, B-Cell, Marginal Zone/pathology , Parotid Neoplasms/pathologyABSTRACT
Los linfomas tipo MALT (tejido linfoideo asociado a mucosa), constituyen la variedad más recientemente descubierta de los linfomas no Hodgkin, tienen lugar fundamentalmente en la mucosa gástrica asociados a infección por Helycobacter pylori, y en la glándula tiroides en relación con la tiroiditis de Hashimoto. Sin embargo, internacionalmente se han descrito casos en glándulas salivales asociados a linfoadenitis. La naturaleza de la lesión a menudo no puede ser determinada solo por el estudio citológico; se hace necesario el análisis histopatológico para el diagnóstico definitivo en la mayoría de los casos. El presente estudio muestra un paciente masculino con aumento de volumen bilateral de ambas glándulas parótidas y diagnóstico citohistopatológico de un proceso linfoepitelial benigno, el cual desarrolló un linfoma tipo MALT en relación con la glándula parótida derecha(AU)
The lymphomas type MALT or the mucosa-associated lymphoid tissue, are the most recent variety of non-Hodgkin lymphomas present mainly in the gastric mucosa associated with Helycobacter pylori infection and in the thyroid gland in relation to Hashimoto's thyroiditis. Frequently the origin of this lesion can't be determined only by cytology study, thus it is necessary the histopathology analysis for a definitive diagnosis in most cases. Present paper includes the case of male patient with bilateral volume increase of both parotid glands and a diagnosis cytopathological of a benign lymphoepithelial process and the development of a type MALT lymphoma in relation to the right parotid gland(AU)
Subject(s)
Humans , Male , Middle Aged , Parotid Diseases/surgery , Salivary Gland Neoplasms/drug therapy , Lymphoma, B-Cell, Marginal Zone/diagnosisABSTRACT
PURPOSE: Pleomorphic adenoma is the most common benign neoplasm in parotid gland. Superficial parotidectomy was usually used to remove the pleomorphic adenoma. But, this method has to remove tumor with normal parotid tissue. Authors did lumpectomy to remove pleomorphic adenoma in parotid gland, because pleomorphic adenoma is wrapped in a capsule as it grows. The purpose of this study is to evaluate the efficacy of lumpectomy as a treatment of pleomorphic adenoma in parotid gland. METHODS: From 2002 to 2008, 8 patients underwent the lumpectomy of the pleomorphic adenoma in parotid gland. Occurrence of the complications and recurrance were evaluated. RESULTS: Patients were followed-up for a mean 45 months. There were no recurrance or no complication after lumpectomy. CONCLUSION: Authors suggest that the lumpectomy lead to decrese complications, recurrane and can be used as a procedure for the resection of pleomorphic adenoma in parotid gland.
Subject(s)
Humans , Adenoma, Pleomorphic , Mastectomy, Segmental , Parotid GlandABSTRACT
Generally we use the preauricular incision to access and remove the parotid gland tumor. But the preauricular approach has some complications such as damage of facial nerve and sensory nerve, Frey's syndrome, and postoperative scar. Especially, the postoperative scar can often cause an unesthetic result and mental stress in young patients. Therefore, if we avoid preauricular incision to be performed outside of tragus, the postoperative scar would be hardly remarkable, and patients would be satisfied cosmetically. We performed surgical excision using a modified endaural and neck approach in a 21-year-old female with a pleomorphic adenoma and 15-year-old male with a neurofibroma occured in the parotid gland. A new, modified endaural and neck approach is a combined method of the modified endaural incision by Starck et al and Gutierrez's neck extension. We obtained an adequate access and the cosmetically acceptable postsurgical scar. The postoperative scars were hidden in the external ear and the hairline. Moreover, except the neck dissection can this approach be applied to the surgery of temporomandibular joint as well as the parotid gland tumor.
Subject(s)
Adolescent , Female , Humans , Male , Young Adult , Adenoma, Pleomorphic , Cicatrix , Ear, External , Facial Nerve , Neck Dissection , Neck , Neurofibroma , Parotid Gland , Sweating, Gustatory , Temporomandibular JointABSTRACT
Background: Parotid gland tumor is a quite common pathology in salivary gland tumor. The exact diagnosis for parotid gland tumors has an important significance because it will help to plan appropriate surgical strategies. Objective: To remark some characteristics of ultrasonographic image of the parotid gland tumors and evaluate the role of ultrasonography in diagnosis of the parotid gland tumors. Subject and methods: A cross-sectional, descriptive study was conducted on 24 patients with parotid gland tumors, operated on at the Department of Plastic and Maxilofacial Surgery of Hospital 103 and the Department of Odonto - Stomatology of Ha Dong General Hospital, Hanoi from January, 2007 to July, 2008. Results: The size of tumors was 2-4cm (58.33%), 21/24 of tumors were in superficial lobe areas. 46.66% of pleomorphic adenomas had a lobulated shape. 2/3 of Warthin\u2019s tumors had an oval shape. 79.17% of the benign lesions were well-defined. 87.5% of all tumors had echogenicity decreased. Almost equal percentages of Warthin\u2019s tumors were echogenicity decreased and structure in heterogeneous. Conclusion: Ultrasonography is a useful method in the diagnosis of the parotid gland tumors, helping to determine clearly the natural basis of some tumors and contributing to early screening for acute parotid gland tumors.
Subject(s)
UltrasonographyABSTRACT
This is a case report of salivary gland tumors developed at buccal fat pad and masseteric area which are considered rare and characterized by asymptomatic mid-cheek mass. Three cases were diagnosed as accessory parotid gland tumor and the other 3 cases as minor salivary gland tumor with tissue pathology. Accessory parotid gland lies 6 mm anterior to the main parotid gland and accessory parotid gland tumors represent 1% of all parotid tumor. It can be managed solely by resection of the accessory parotid gland without superficial or total parotidectomy. Minor salivary gland tumors represent 10-20% of all salivary gland tumor and are usually found on the palate, paranasal sinuses and cheek. Buccal minor salivary gland tumors are usually found incidentally as submucosal mass at buccal mucosa and managed by wide excision including 1-2 cm free margin through intra-oral approach. This paper reviews our experience with these unusual tumors in terms of clinical manifestation, radiologic findings and the acceptable surgical management.