Primary malignant parotid epithelial neoplasm: nodal metastases and management.

Abstract

This article presents a summary of the recent publications on the diagnosis and management of primary malignant parotid epithelial neoplasm, with special emphasis on evaluation and treatment of nodal metastases. Pathologists are challenged with making a diagnosis, classification and grading of salivary gland cancers. The unpredictable behaviour of this disease has been documented by clinicians reporting aggressiveness and variations in disease patterns within a single-cancer subgroup. Surgeons have identified a high incidence of occult nodal disease both at the primary site and the neck, which has frequently been understaged both clinically and on imaging in the presurgical workup. The significance of a high incidence of occult nodal disease both at the primary site and the neck is that a more aggressive therapeutic strategy must be directed/advised by the multidisciplinary clinical team, to the disease located in the head and neck, thus improving likely cure, preventing local and distant disease failure.