Vascular Abnormalities of the Parotid Region: An Uncommon Presentation of a Common Condition-A Case Series.

A variety of non-neoplastic diseases and benign and malignant lesions may involve parotid glands. In clinical practice, effective diagnosis is crucial to ensure proper treatment and achieve a good therapeutic effect. Unclear anamnesis and short medical history are factors that make diagnosis difficult, especially when cancer should be excluded. We present a case series of four patients who reported to the outpatient clinic with a unilateral nodule in the parotid region. The clinical presentation prevented an unequivocal diagnosis. The suspicion of a neoplastic disease resulted in profound diagnostics, including repeated cytology, ultrasound and magnetic resonance examination. Combining all the acquired information and follow-up, or a histopathologic examination, facilitated the final diagnosis. In all cases, thrombosis was diagnosed. We then analysed the diagnostic process and the associated difficulties. When thrombosis in vascular malformation occurs in the parotid region, it may have an unclear clinical and radiological presentation. Such an image can imitate both benign and malignant tumours. Ambiguous imaging in conjunction with blood cells in cytology should result in the inclusion of thrombosis in vascular malformations in the differential diagnosis.

Synchronous bilateral multifocal basal cell adenomas of the parotid gland-a case report.

BACKGROUND: Bilateral parotid gland tumors account for up to 3% of cases. In this group, the vast majority are Warthin's tumors. However, bilateral presentations of other parotid gland tumor entities is also possible, an example of which is a basal cell adenoma (BCA). Bilateral BCA is extremely rare, which could cause misdiagnosing it as a Warthin tumor. CASE PRESENTATION: The current study reports the unique case of a 48-year-old woman who presented with a 6-month history of slowly growing masses located bilaterally in the parotid region, surgically treated with 5-year follow-up (no recurrence, normal facial nerve function). Magnetic resonance imaging (MRI) revealed three lesions: two in the superficial and deep lobes of the right parotid gland, and one in the superficial lobe of the left parotid gland. A total parotidectomy with facial nerve preservation was performed on the right side, and superficial parotidectomy on the left side 6 months later. Histopathological examination confirmed that all three tumors were BCAs. Molecular analysis didn't show any strong, potential of unknown clinical significance in the studied sample. CONCLUSIONS: Multifocal bilateral lesions of the parotid gland are usually Warthin tumors. Detailed preoperative diagnostics including MRI and histopathological examination is essential to avoid misdiagnosing BCA and Warthin tumors. To our best knowledge, no case of synchronous bilateral multifocal basal cell adenomas of the parotid gland has been reported in English literature so far.

Value of dynamic contrast enhanced MRI in differential diagnostics of Warthin tumors and parotid malignancies.

To define an algorithm for differential diagnostics of parotid malignancies and Warthin tumors (WTs) based on dynamic contrast enhanced MRI (DCE-MRI). 55 patients with parotid tumors treated surgically were analyzed. Of which, 19 had parotid malignancy and 36 had WTs confirmed with postoperative histopathological examination. Accuracy of DCE-MRI parameters (Tpeak and WR) was compared with the histopathological diagnosis. ROC analysis was performed to determine sensitivity and specificity of DCE-MRI with various Tpeak and WR cut-off values. WT showed significantly lower median Tpeak and higher median WR than malignant lesions. The cut-off values for Tpeak and WR providing maximum sensitivity (84.2%) and specificity (86.1%) for malignant tumors were Tpeak > 60 s and WR ≤ 30%. Different diagnostic algorithm, i.e., lower cut-off value for Tpeak (Tpeak = 60 s), increases sensitivity of DCE-MRI in differentiating parotid malignancies from WTs. However, WR > 30% seems to be a key diagnostic criterion for benign lesions. Precise and reliable preoperative diagnostics of parotid tumors aids in careful surgical planning, thereby assisting in achieving sufficient surgical resection margins and facial nerve preservation.

[Malignant and non-malignant cartilaginous tumours of the larynx]. / Zlosliwe i niezlosliwe guzy chrzestne krtani.

INTRODUCTION: Cartilaginous tumours of the larynx are rare. They usually involve cricoid cartilage, less frequently thyroid cartilage and other cartilages. The most significant clinical manifestations are hoarseness, dyspnea, dysphagia or a neck mass. On physical examination, tumour is found as a bulge with intact mucosa or a tumour situated in a part of the larynx also with fixation. CT scanning is the mainstay of radiographic imaging. The histopathologic diagnosis is made after the surgical excision. Prognosis for survival is good. The recurrences occur very often, also with malignant transformation and require laryngectomy. MATERIAL: We presented 11 patients (including symptoms, involved cartilage, laryngoscopy examination, histopathologic diagnosis, treatment and the follow-up). RESULTS: 6 patients manifested hoarseness, 5 dyspnea, 3 dysphagia, 1 neck mass as the first symptom. In laryngoscopy a tumour with intact mucosa was situated in subglottis - 5 patients, in supraglottis - 2 patients and in half of the larynx with fixation - 4 patients. The majority of tumours involved the cricoid cartilage - in 9 cases, the rest arytenoid and epiglottic cartilage. The histopathology diagnosis were given after surgery, only in one case after biopsy. There were 7 patients with chondrosarcoma and four with chondroma. We did not observe lymph node or distant metastases. All patients were treated surgically. Follow-up of patients with chondrosarcoma were 5 to 17 years without recurrence. However, two recurrences of chondroma appeared to be chondrosarcomas and required laryngectomy.