Nasal Mucoepidermoid Carcinoma after Radiotherapy: Case Report

Introduction Mucoepidermoid carcinoma (MEC) is a tumor originated from the epitheliumof the glandular excretory ducts and has highly variable biological potential. It is the most prevalent cancer of the salivary glands. The present report aims to describe a case of nasal mucoepidermoid carcinoma that developed after adjuvant radiotherapy (RT) treatment of a recurrent pituitary macroadenoma. Case Report Male patient, 62 years old, presented with recurrent nasal epistaxis on the right, associated with intense pulsatile headache, visual analogical scale (VAS) 10/10, with improvement only with the use of opioids andmorphine. After undergoing oncological screening and study by imaging exams, the presence of an expansive seal lesion with suprasellar extension was seen, involving the medial wall of the cavernous segment of the right carotid artery and the anterior cerebral artery, as well as the presence of a new expansive lesion in the right nasal cavity, with ethmoid bone invasion superiorly and medial orbit wall invasion laterally, compressing the ipsilateral optic nerve canal. Discussion Sinonasal neoplasms represent a small portion of all malignancies of the upper aerodigestive tract, accounting for<5% of these neoplasms. The development of MEC involves risk factors such as occupational issues, history of trauma and surgery involving the nasal area, and radiation exposure, as in previous RT. Conclusion Mucoepidermoid carcinoma is an uncommon neoplasia and can be associated with RT treatment, as used in cases of recurrent pituitary macroadenoma. In general, surgical resection to obtain free margins of neoplastic tissue is the aimed treatment, seeking better prognosis.

Reconstrucción de cavidad oral con colgajo de músculo temporal: caso clínico / Reconstruction of oral cavity with temporal muscle flap: a clinical case

Objetivo: Describir la técnica de reconstrucción oral con colgajo de músculo temporal por resección de lesión oncológica. Caso clínico: Un paciente de sexo masculino, de 70 años de edad, fue derivado al Hospital Sirio Libanés desde la Facultad de Odontología de la Universidad de Buenos Aires con diagnóstico de carcinoma mucoepidermoide de siete meses de evolución, ubicado en el reborde alveolar del maxilar superior izquierdo, a nivel de las piezas dentarias 25 a 28. Se realizó la resección del tumor bajo anestesia general y la consiguiente reconstrucción del lecho mediante la técnica de reconstrucción oral con colgajo de músculo temporal. Conclusión: El colgajo temporomiofascial resultó ser versátil para la reconstrucción maxilofacial en lo que respecta a la proximidad, el tamaño, la fiabilidad de la vascularización y la facilidad de la técnica (AU)

Aim: To describe the temporalis myofacial flap technique for reconstruction in the maxillofacial region following oral cancer resection. Clinical case: A 70-year-old male patient was referred to the Sirio Libanés Hospital from the Dental School, University of Buenos Aires with a diagnosis of mucoepidermoid carcinoma with 7 months of evolution located in the alveolar ridge of the left upper jaw, at the level of teeth 25 to 28. The tumor was resected under general anesthesia and a rotational flap of the temporalis muscle was used for the reconstruction of the area. Conclusion: The temporalis flap was a versatile option for the reconstruction of maxillofacial defects due to its proximity to the oral cavity, the reliable vascularity and minor donor site morbidity (AU)

Warthin-like mucoepidermoid carcinoma of the parotid gland: a diagnostic and therapeutic dilemma

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor. Although the parotid gland is the most common site of involvement, other major salivary glands and the minor salivary glands­most commonly of the palate­also can be involved. The management of mucoepidermoid carcinoma depends on the grade of the tumor and the adequacy of resection. We present the case of a 56-year-old female presenting a painless progressive cheek mass over 2 months. Imaging and fine-needle aspiration cytology provided the diagnosis of Mucoepidermoid carcinoma. A superficial parotidectomy was done, and the histopathology revealed a predominantly cystic tumor with a bilayered epithelium of oncocytic and basal cells. Moderate nuclear pleomorphism with infiltration of atypical squamous cells in few glandular cysts was seen. Special staining revealed the presence of intracellular mucin. A diagnosis of Warthin-like variant of MEC was made, based on these findings. After the surgical procedures, the patient is disease-free at 8 months of follow-up. The Warthin-like variant is a rare variant of MEC with fewer than 10 cases described in the English literature. Various differential diagnoses include the malignant transformation of Wartin tumor (WT), squamous metaplasia of WT, and metastasis from a distant primary. We emphasize the role of routine microscopy in identifying rare variants of common malignancies. Even though translocation studies are helpful in diagnosis, the typical histopathological findings should confirm it.

Carcinoma mucoepidermoide bronquial: a propósito de dos casos clínicos / Bronchopulmonary mucoepidermoid carcinoma: apropos of two clinical cases

Resumen El carcinoma mucoepidermoide bronquial es una neoplasia infrecuente, representando el 0,1 a 0,2% de los tumores malignos primarios del pulmón. En general tiene un buen pronóstico, sin embargo, existe un subtipo de alto grado de pronóstico más ominoso. En este artículo se presentan dos casos clínicos de carcinoma mucoepidermoide bronquial de bajo grado, enfocado en su diagnóstico y manejo quirúrgico.

ABSTRACT Bronchopulmonary mucoepidermoid carcinoma is an uncommon neoplasm, accounting for 0.1 to 0.2% of primary malignant tumors of the lung. In general it has a good prognosis, however there is a subtype of high grade of more ominous prognosis. In this paper we present two clinical cases of low grade pulmonary mucoepidermoid carcinoma, focused on their diagnosis and surgical management.

Carcinoma mucoepidermoide bronquial en la infancia: Caso clínico / Bronchial mucoepidermoid carcinoma in childhood: Case report

Los tumores bronquiales son raros en los niños. La mayoría son malignos; el más común es el tumor carcinoide. Con menor frecuencia, se asienta en el árbol traqueobronquial el carcinoma mucoepidermoide. El carcinoma mucoepidermoide representa del 0,1% al 0,2% de los tumores malignos broncopulmonares. Se manifiesta con síntomas de obstrucción de la vía aérea y/o neumonías recurrentes. El diagnóstico precoz y el tratamiento adecuado son de gran importancia en el pronóstico. La broncoscopía con biopsia de la masa endobronquial es el método de elección para confirmar el diagnóstico. El tratamiento consiste en la resección quirúrgica de la lesión. Se presenta a una niña de 11 años con disnea de esfuerzo y tos debidas a un carcinoma mucoepidermoide bronquial de bajo grado de malignidad. Se describen las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de esta rara neoplasia en pediatría.

Bronchial tumors are rare in children. Most of them are malignant, being the carcinoid tumor the most common. Less frequently the mucoepidermoid carcinoma is found in the tracheobronchial tree. Mucoepidermoid carcinoma accounts for 0.1 to 0.2% of all malignant bronchopulmonary tumors. It manifests with symptoms of airway obstruction and/or recurrent pneumonias. Early diagnosis and appropriate treatment are of great importance in the prognosis. Bronchoscopy with biopsy of the endobronchial mass is the method of choice to confirm the diagnosis. Treatment consists of surgical resection of the lesion. We present an 11-year-old girl with dyspnea on exertion and cough due to a low malignant mucoepidermoid carcinoma of the bronchi. We describe the clinical manifestations, the diagnostic methods and the treatment of this rare neoplasia in pediatrics.

Reconstrucción de partes blandas faciales con colgajos cervicales. Presentación de dos casos / Reconstruction of facial soft parts with cervical flaps. Two cases presentation

La reconstrucción de importantes defectos de partes blandas en la región órbito-maxilo-malar continúa siendo un gran reto para el cirujano. En cirugía reconstructiva, por su parte, hay que abordar dos problemas fundamentales: la recuperación estética y la funcional. Por supuesto que ni el criterio estético ni funcional debe anteponerse al oncológico. En este trabajo se presentaron dos pacientes operados de carcinoma de la glándula parótida, reconstruidos con colgajos cervicales. El primero, con el cérvico-pectoral, y el segundo, con el fascio-cérvico-pectoral. Estos colgajos deberían ser considerados como una de las primeras opciones para reconstruir los defectos en la región maxilofacial, dado su predictibilidad, versatilidad y fácil disección.

The reconstruction of important defects of soft parts in the orbital-maxillary-malar region is still a great challenge for the surgeon. Thus, in reconstructive surgery we have to approach two main problems: esthetic and functional recuperation. Of course, neither the esthetic nor the functional criteria should be placed before the oncological one. In this work we presented the cases of two patients operated of parotid gland carcinoma, reconstructed with cervical flaps; the first one, with the cervico-pectoral flap, and the second with the fascia-cervico-pectoral flap. These flaps should be considered one of the first options for reconstructing the defects of the maxilla-facial region, due to their predictability, versatility and easy dissection.

Resección transoral-transnasal de tumores del espacio parafaríngeo / Transoral-transnasal approach to parapharyngeal space tumors

Objetivos: Determinar la tasa de resección quirúrgica completa en tumores seleccionados del Espacio parafaríngeo tratados por vía transoral o transnasal o por ambas. Diseño: descriptivo, retrospectivo. Materiales y métodos: Se incluyeron en este estudio los pacientes que tuvieron neoplasias localizadas en el espacio parafaríngeo y que fueron tratados con cirugía por vía transoral o transnasal. El abordaje transoral consistió en realizar una incisión con cauterio en la zona de mayor protrusión del tumor (pilar amigdalino y paladar), disección de la mucosa y del tumor de los planos profundos, traccionándolo hacia la cavidad oral. Para disecar el límite superior (rinofaringe) y lateral se utilizaron endoscopios que fueron introducidos por la incisión y por la cavidad nasal. El abordaje transnasal consistió en realizar una incisión en la pared lateral de la rinofaringe y disecar el tumor del plano profundo traccionándolo hacia el cavum. Resultados: Fueron tratados 3 pacientes por vía transoral y uno por vía endonasal por padecer tumores del espacio parafaríngeo. Tres tumores se originaron en glándulas salivales menores localizadas una en el espacio. Preestiloideo (1/3), otra en el espacio masticador (1/3) y otra en el sector superior del espacio preestiloideo (1/3). La histología dio como resultado dos adenoma pleomorfo y un carcinoma mucoepidermoide de bajo grado (1/3). (Está bien así? Qué es 1/3?). Una neoplasia se originó en el lóbulo profundo de la parótida y se extendió al espacio preestiloideo, su histología fue carcinoma mucoepidermoide de grado moderado. Conclusiones: La tasa de resección completa en pacientes con tumores del espacio parafaríngeo seleccionados tratados por vía transoral y endonasal fue del 100%. (AU)

Objectives: To determine the rate of complete surgical resection in parapharyngeal space selected tumors treated with transoral and / or transnasal approach. Design: Descriptive, retrospective. Materials and methods: Patients who had tumors localized in parapharyngealspace and who were treated with transoral or transnasal surgery. were included in this study. The transoral approach consisted in performing an incision with cautery in the area of greates tumor protrusion (tonsillar pillar and palate), dissection of the mucosa and tumor of the deep planes, pulling it into the oral cavity. To dissect the upper limit (nasopharynx) and lateral we used endoscopes that were inserted by the incision and the nasal cavity. The transnasal approach consisted in making an incision in the side wall of the nasopharynx and dissect the tumor of the deep plane pulling it towards the cavum. Results: Three patients were treated with transoral and one byendonasalapproacheswho had parapharyngeal space tumors. Three tumors originated in minor salivary glands located in prestyloidspace (1/3), masticator space (1/3) and upper sector of pree-styloid space (1/3). Histology was in two pleomorphic adenoma, and another onelow degree mucoepidermoid carcinoma (1/3). A neoplasm was originated in the deep lobe of the parotid gland and was extended to the prestyloid space, was a moderate degree of mucoepidermoid carcinoma. Conclusions: Complete resection rate in patients with selected parapharyngeal space tumors, treated by transorally and endonasal approach was 100%. (AU)

Rehabilitación clínica de un defecto maxilar / Clinical rehabilitation of a maxillary defect

Las pérdidas parciales o totales del maxilar y de otros tejidos vecinos crean grandes defectos, estableciendo una comunicación entre la cavidad bucal y nasal que comprometen la función y la estética, con impacto psicológico sobre la persona afectada, limitando sus posibilidades y disminuyendo su calidad de vida. Los defectos en la región maxilofacial pueden tener orígenes congénitos y adquiridos (traumáticos, oncológicos, patológicos u otros). La mayoría de los defectos maxilares tienen origen oncológico. El tratamiento quirúrgico de los tumores del maxilar, seno y fosas nasales, deja como secuela una pérdida de tejido de diferente magnitud. Las personas que han padecido este tipo de tratamiento quirúrgico deben ser rehabilitadas con una prótesis obturatriz. El objetivo de este trabajo fue presentar el caso clínico de una paciente con defecto maxilar de origen oncológico, rehabilitada con una prótesis obturatriz definitiva con bulbo obturador rígido, hueso.

Mucoepidermoid Carcinoma of Palate: A Case Report.

The most common types of salivary gland tumors are the pleomorphic adenoma and the mucoepidermoid carcinoma (MEC). MEC mainly occurs in the parotid gland; intraorally MEC appears as asymptomatic swellings in minor salivary glands, most commonly occurs on palate. It shows a variety of biological behaviors and variable natural history. Clinical, radiological and histopathological findings of palatal MEC in a young woman presented here. Surgical resection was done. Follow-up of one and half year did not show any recurrence.

Lesiones intraorales de glándulas salivales menores / Intraoral lesions of minor salivary glands: analysis of 59 patients

Background: Most salivary gland lesions are benign. Tumors are uncommon. Pleomorphic adenoma and cystic adenoid carcinoma are the most common benign and malignant lesions. Aim: To assess the incidence management and evolution of intraoral lesions among patients consulting in a head and neck surgical service. Material and Methods: Retrospective review of medical records of patients consulting for intraoral lesions of minor salivary glands between 1975 and 2009 in a head and neck surgical service. Results: Thirty five females and 24 males are reported. Forty eight (81 percent) had benign lesions. Of these, 35 (73 percent). were non neoplastic lesions. Eleven patients had malignant lesions. Of these, four (36 percent) had a mucoepidermoid carcinoma, two (18 percent) had an adenoid-cystic carcinoma, two (18 percent) had an acinous cell carcinoma and one patient each had an undifferentiated carcinoma, an adenocarcinoma and an epidermoid carcinoma. Conclusions: In this series of patients, benign lesions predominated. Benign lesions were excised and the management of malignant lesions depended on the type of tumor.

Introducción: Las lesiones de glándulas salivales menores son en su mayoría benignas. Los tumores son infrecuentes y conforman un grupo heterogéneo, siendo el adenoma pleomorfo la neoplasia benigna más frecuente y el carcinoma adenoideo-quístico el tumor maligno más encontrado. Objetivos: El propósito de este estudio es evaluar la incidencia, manejo y evolución de las lesiones intraorales de glándulas salivales menores en el Servicio de Cirugía de Cabeza y Cuello del Hospital Barros Luco-Trudeau. Material y Método: Se presenta estudio retrospectivo de 59 casos tratados entre 1975 y 2009 en dicho hospital. Resultados: Encontramos 35 mujeres y 24 hombres. En 48 pacientes (81,3 por ciento) se encontró lesiones benignas, de las cuales 35 (73 por ciento) correspondieron a lesiones no neoplásicas y 13 (27 por ciento) a neoplasias. Las neoplasias malignas fueron 11 (18,6 por ciento del total), 4 (36,3 por ciento) con Ca mucoepidermoide, 2 (18 por ciento) con Ca adenoideo-quístico, 2 (18 por ciento) con Ca de células acinosas, 1 (9 por ciento) con Ca indiferenciado, 1 (9 por ciento) con adenocarcinoma y 1 (9 por ciento) con Ca epidermoide. Conclusiones: Las lesiones de glándulas salivales menores en nuestro hospital se caracterizan por ser predominantemente benignas. Se encontró similar frecuencia de tumores benignos y malignos. Predominó el adenoma pleomorfo entre los primeros y el carcinoma mucoepidermoide entre los segundos. Los tumores benignos, luego de su extirpación, se manejaron con cierre del lecho tumoral mediante rotación de colgajos locales de mucosa oral para cobertura y, en algunos casos, cierre por segunda intención. La evolución fue en general excelente. En el caso de los tumores malignos, el manejo dependió de Ia histología.

Low grade mucoepidermoid carcinoma in a setting of Warthin's tumor.

Warthin's tumor also known as papillary cystadenoma lymphomatosum is a common benign salivary gland neoplasm that occurs exclusively in parotid gland. Rarely, the tumor can undergo carcinomatous or lymphomatous transformation of epithelial or lymphoid component, respectively. Herein, we describe a case of 55-year-old female who had undergone parotidectomy for a rapidly growing tumor in the right parotid gland. The case was diagnosed as mucoepidermoid carcinoma developed in a setting of Warthin's tumor based on the histomorphology, special staining characters, and immunohistochemical findings. The pathogenesis and differential diagnoses of such rare malignancy has been discussed briefly.

Mucoepidermoid carcinoma of the submandibular gland in a 6yr old boy

Mucoepidermoid carcinoma [MEC] of the salivary glands are rarely found in childhood we report the case of a 6-year old boy presenting with 2-month history of submandibular swelling. In oral examination, a non-tender, firm mass was detected in the submandibular region involving the left cheek and left angle of the mandible. It was firm in consistency with obvious areas of multiple nodularity along the inferior border of the mass. Clinically there were no palpable lymph nodes. Radiographs revealed a radiolucent lesion in the left body of the mandible. The tumor showed sheets and nests of predominantly epidermoid cells along with occasional large pale mucous-like cells and frosted-glass appearance infiltrating the fibro-connective tissue. The lesion was diagnosed as mucoepidermoid carcinoma, high grade type

Carcinoma mucoepidermoide central mandibular: presentación de dos casos / Mandibular central mucoepidermoid carcinoma: report of two cases

Los carcinomas mucoepidermoides centrales de los maxilares son lesiones raras. Comprenden el 15 por ciento de todos los tumores malignos que se presentan en los maxilares. A la fecha hay sólo alrededor de 200 casos publicados en la bibliografía. Se presentan dos casos de pacientes tratados en 2005-2006. Los carcinomas mucoepidermoides de los maxilares provocan síntomas inespecíficos y deben ser diagnosticados por biopsia incisional. Su tratamiento primario es quirúrgico, permaneciendo aún poco claro el rol de terapéuticas adyuvantes.

Variante oncocítica del carcinoma mucoepidermoide / Oncocyte variant of mucoepidermoid carcinoma

El carcinoma mucoepidermoide es el más común de todos los tumores malignos de glándulas salivales, constituye el 30 por ciento de ellos. Aproximadamente la mitad de los casos (53 por ciento) ocurre en las glándulas salivales mayores. El 45 por ciento predomina en glándula parótida, el 7 por ciento en la submandibular y el 1 por ciento en la glándula sublingual. Este tumor se presenta con más frecuencia en el sexo femenino (3:2) y en la quinta década de la vida. Múltiples variantes, con diferentes rangos de diferenciación han sido descritas, se incluyen: la oncocítica, esclerosante, uniquística, sebácea, de células claras, células globosas de alto grado, células fusocelular y psamomatosa. El carcinoma mucoepidermoide variante oncocítica es un subtipo raro que puede mostrar prominentes cambios oncocíticos. Se reporta un caso de carcinoma mucoepidermoide variante oncocítica de alto grado histológico. El índice de Ki 67 fue del 5 por ciento, el tumor fue negativo para C-erb2 y presentó inmunorreactividad para E-caderina y Syndecan-1(AU)

The mucoepidermoid carcinoma is the commonest of all malignant tumors of salivary glands, accounting for the 30 percent of them. Approximately the half of cases (53 percent) occurs in the major salivary glands. The 45 percent has predominance in parotid gland, the 7 percent in the submandibular one, and the 1 percent in the sublingual gland one. This type of tumor is more frequent in female sex (3-2) and at fifth decade of life. Multiple variants with different ranks have been described including the oncocyte, sclerosant, unicystic, sebaceous, of clear cells, high degree spherical cells, fusocellular and psammomatous. The mucoepidermoid carcinoma, oncocyte variant, is an unusual subtype that may to shows significant oncocyte changes. Authors report a case of histological high degree mucoepidermoid carcinoma. The rate of Ki 67 was of 5 percent, the negative tumor for C-erb2 and had immunoreaction to E-caderine and Syndecan-1(AU)

Ten-year follow-up of a case series of primary epithelial neoplasms of the lacrimal gland: clinical features, surgical treatment and histopathological findings / Dez anos de acompanhamento de uma série de casos de neoplasias epiteliais primárias da glândula lacrimal: características clínicas, tratamento cirúrgico e achados histopatológicos

PURPOSE: To describe and analyze the features of a cases series of patients with primary epithelial neoplasms of the lacrimal gland, its surgical treatment, and histopathological findings. METHODS: Retrospective evaluation of files from patients with primary epithelial neoplasms of the lacrimal gland in the period from 1997 to 2007. All patients with primary epithelial tumors of the lacrimal gland were included in this study. Data on gender, age, clinical features, surgical treatment, histopathological findings and follow-up were collected. The slides with histological sections of the tumors were reviewed by the same pathologist. RESULTS: During the study period, there were 12 patients, 5 (41.7 percent) with benign tumors, all pleomorphic adenomas (benign mixed tumor) and 7 (58.3 percent) with malignant neoplasms, thus distributed: four cases of adenoid cystic carcinoma, two of mucoepidermoid carcinoma and one carcinoma expleomorphic adenoma. Globally, patients mean age was 54.1 years-old (ranging from 14 to 70 years-old), with mean age of 52.4 years-old (ranging from 14 to 65 years-old) for benign neoplasms, and 55.3years-old for malignant neoplasms (ranging from 26 to 70 years-old). Clinical follow-up information, ranging from 2 to 10 years-old, was available for all patients. Three patients developed distant metastasis and died of disease. CONCLUSIONS: The most frequent primary epithelial neoplasms of the lacrimal gland were pleomorphic adenoma and adenoid cystic carcinoma during the study period. Malignant tumors were more frequent than benign tumors. The histopathological diagnosis and the disease initial stage can play a significant role in patient's survival.

OBJETIVO: Descrever e analisar as características de uma série de casos de portadores de neoplasias epiteliais primárias da glândula lacrimal, o tratamento cirúrgico, assim como os achados histopatológicos. MÉTODOS: Avaliação retrospectiva dos arquivos de pacientes com neoplasias epiteliais primárias da glândula lacrimal, no período de 1997 até 2007. Todos os pacientes com tumores epiteliais primários da glândula lacrimal foram incluídos neste estudo. Foram analisados os dados sobre sexo, idade, características clínicas, tratamento cirúrgico, achados histopatológicos e seguimento dos pacientes. As lâminas com secções histológicas dos tumores foram revisadas pelo mesmo patologista. RESULTADOS: No período do estudo, foram encontrados 12 pacientes, sendo 5 (41,7 por cento) portadores de tumores benignos, todos adenomas pleomórficos (tumor benigno misto), e 7 (58,3 por cento) com neoplasias malignas, assim distribuídos: quatro casos de carcinoma adenóide cístico, dois de carcinoma mucoepidermóide e um de carcinoma ex-adenoma pleomórfico. Analisando-se de modo global, a idade média dos portadores foi de 54,1 anos (variando de 14 a 70 anos); com média de idade de 52,4 anos (variando de 14 a 65 anos) para neoplasias benignas, e 55,3 para neoplasias malignas (variando de 26 a 70 anos). Informações do seguimento, variando de 2 a 10 anos, estavam disponíveis para todos os pacientes. Três pacientes desenvolveram metástases distantes e morreram devido à doença. CONCLUSÕES: A maioria das neoplasias epiteliais primárias da glândula lacrimal foi o adenoma pleomórfico e o carcinoma adenóide cístico no período de estudo. Os tumores malignos foram mais frequentes que os benignos. O diagnóstico histopatológico e o estadiamento inicial da doença podem desempenhar uma papel significante na sobrevida do paciente.

Parotid neoplasms: analysis of 600 patients attended at a single institution / Neoplasias de parótida: análise de 600 pacientes atendidos em uma única instituição

Salivary gland tumors are rare, generally benign and affect mainly the parotid gland. AIM: The purpose of this study was to retrospectively analyze all cases of parotid tumors treated at our institution from 1953 to 2003. METHODS: All patients with primary parotid tumors were selected; clinical and histopathological data were analyzed and described. RESULTS: 600 cases of parotid tumors were selected; 369 were benign and 231 were malignant. Pleomorphic adenoma was the most frequent benign tumor. The most common malignant tumor was the mucoepidermoid carcinoma. Therapy in most cases consisted of parotidectomy. Adjuvant therapy - mainly radiotherapy - was used in some cases with malignant tumors. The incidences of local, regional and distant recurrences of malignant tumors were 10 percent, 8 percent and 9 percent. CONCLUSION: Patients with parotid tumors treated at our institution were mainly adults, with marginally more female patients. Benign tumors were mostly the pleomorphic adenoma, which were more frequent than malignancies. Most of the patients were treated by partial or total parotidectomy. Adjuvant therapy, mainly radiotherapy, was used in selected malignant cases.

Os tumores de glândula salivar são raros e acometem principalmente a parótida, sendo a maioria de natureza benigna. OBJETIVOS: Avaliar todos os casos de tumor de parótida atendidos na nossa instituição, durante o período de 1953 a 2003. Estudo Retrospectivo. CASUÍSTICA E MÉTODOS: Todos os pacientes com tumores primários de parótida foram selecionados e os dados clínicos e histopatológicos foram analisados e descritos. RESULTADOS: Foram selecionados 600 casos, sendo 369 benignos e 231 malignos. Dentre os tumores benignos, o adenoma pleomorfo foi o mais comum, e dentre os malignos, o carcinoma mucoepidermoide. A principal modalidade de tratamento foi a parotidectomia e em alguns casos malignos, terapias adjuvantes, principalmente a radioterapia, foram aplicadas. Os índices de recorrência local, regional e à distância dos tumores malignos foram de 10 por cento, 8 por cento e 9 por cento, respectivamente. CONCLUSÕES: O perfil dos pacientes com tumor de parótida foi formado predominantemente por adultos e discreta predileção pelo gênero feminino. Os tumores benignos foram os mais frequentes. A maioria dos pacientes foram tratados por parotidectomia parcial ou total. O uso de terapias adjuvantes, principalmente a radioterapia, foi reservada para casos específicos de tumores malignos.

Carcinoma mucoepidermoide del labio superior: nueva alternativa para su reconstrucción / Mucoepidermoid carcinoma of superior lips: new alternative for reconstruction

Presentamos un caso en el cual planteamos el diseño de un nuevo colgajo de espesor total del carrillo, con la finalidad de reconstruir en un solo paso el labio superior, en lesiones que ocupen más del 1/3 de la longitud del labio superior. Paciente masculino de 6 años, con lesión maligna de glándulas salivales menores del tipo carcinoma mucoepidermoide, que puede ser localizado en el labio superior siendo poco frecuente. Explicamos el diseño de este colgajo el cual permite, la reconstrucción del labio superior en todo su espesor en un solo paso; incluyendo, piel, músculo y mucosa, mediante el diseño de colgajo en isla del carrillo, este mantendría su nutrición a partir de las ramas de la arteria infraorbitaria ipsilateral. Con un aceptable resultado cosmético, y mantiene una buena apertura oral, sin sacrificar los márgenes de resección, no se coloca en riesgo el control local y la curabilidad del paciente.

We present a case in which we would like to expose the design of a new cheek’s thick flap in order to reconstruct in just one step the superior lip when it has been damaged more than 1/3 of it. Patient 6 years old male with malignant lesion of the minor’s salivary glands muco-epidermoid carcinoma type, that can be found in the superior lip and is less frequent. We present a new flap that allow to reconstruct of the entire superior lip in all its extension, including skin, muscle and mucous in one step. Through the design of the island cheek flap, this would keep its nutrition for the infraorbitary ipsilateral arterial branches. This flap gives acceptable cosmetic results besides keeping a good opening of the oral cavity, without sacrificing the resection borders, in a way that local control and the curability of the patient is not put at risk.

Quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms

This study was aimed at assessing the quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms (MSGN). Twelve patients (10 women and 2 men, mean age: 49.4 years) with histopathologic diagnosis of pleomorphic adenoma (PA, 3 cases), polymorphous low-grade adenocarcinoma (PLGA, 2 cases), cystic adenoid carcinoma (CAC, 4 cases), and muco-epidermoid carcinoma (MEC, 3 cases) were evaluated. All of them were treated by surgical excision; patients with CAC received radiotherapy as well. The patients’ quality of life was evaluated through a self-administered questionnaire concerning their physical well-being, emotional status, normal daily activities, and family relationships. The results showed that patients with MEC - the youngest among all patients - reported a significantly greater worsening of their physical well-being and emotional status after treatment as compared with patients treated for PA (P < 0.05), and also of their functional activities as compared with those treated for PA and PLGA (P < 0.05). In conclusion, age of development of the neoplasm and type of disease produce more impact on patients’ quality of life than does the therapy’s degree of aggression.

Este estudo teve por objetivo avaliar a qualidade de vida em pacientes submetidos a tratamento cirúrgico para neoplasias de glândulas salivares menores (NGSM). Doze pacientes (10 mulheres e 2 homens, idade média de 49,4 anos) com diagnóstico histopatológico de adenoma pleomórfico (AP, 3 casos), adenocarcinoma polimorfo de baixo grau de malignidade (APBG, 2 casos), carcinoma adenóide cístico (CAC, 4 casos), e carcinoma muco-epidermóide (CME, 3 casos) foram avaliados. Todos os pacientes foram tratados por excisão cirúrgica; pacientes com CAC receberam radioterapia complementar. A qualidade de vida dos pacientes foi avaliada através de um questionário de auto-avaliação referente ao bem-estar físico, estado emocional, atividades normais diárias, e relações familiares. Os resultados mostraram que os pacientes com CME - os mais jovens entre todos os pacientes - relataram uma piora significativamente maior em seu bem-estar físico e estado emocional após o tratamento quando comparados com pacientes tratados de AP (P < 0,05), e também em suas atividades funcionais quando comparada com indivíduos tratados de AP e APBG (P < 0,05). Em conclusão, a idade de desenvolvimento da neoplasia e o tipo de doença produzem maior impacto na qualidade de vida do paciente do que faz o grau de agressão do tratamento.

Carcinoma mucoepidermóide cutâneo primário na região cervical / Primery cutaneous mucoepidermoid carcinoma in the cervical region

Os autores descrevem o caso de um indivíduo do gênero masculino, 31 anos, que foi atendido no ambulatório de Cirurgia de Cabeça e Pescoço do Hospital de Câncer de Pernambuco, com história de tumoração próxima à cicatriz cirúrgica na face posterior do pescoço a cujo anátomo-patológico (AP) foi seringoma condróide maligno, há cinco meses da consulta. Foi submetido à exérese e reconstrução com retalho miocutâneo com trapézio, cujo AP revelou carcinoma mucoepidermóide com margens e bases livres. Os autores fazem breve revisão de literatura ressaltando a raridade da localização do tumor

Carcinoma mucoepidermóide / Mucoepidermoid carcinoma

O carcinoma mucoepidermóide é uma neoplasia infreqüente da árvore traqueobrônquica e de etiologia ainda indeterminada. Sua localização endobrônquica preferencial freqüentemente causa sintomas respiratórios obstrutivos e pneumopatias de resolução lenta. Normalmente, são tumores de crescimento lento, mas que podem apresentar comportamento agressivo, com invasão local e metástases para linfonodos, dependendo das suas características histopatológicas. O tratamento de eleição é o cirúrgico, com ressecção completa, seja através de lobectomia ou broncotomia e broncoplastia. O prognóstico dependerá do grau de diferenciação celular desses tumores. Relata-se um caso dessa rara neoplasia descrevendo suas características clínicas, radiológicas e o tratamento cirúrgico