Management Of Parotid Gland Tumors Research Articles

Beyond Ultrasound: Multimodal Cross-Sectional Imaging for Preoperative Imaging of Parotid Gland Tumors: A Primer for Radiology Trainees

Even if the management of parotid gland tumors depends on the histopathological subtype, preoperative imaging of parotid gland tumors is clinically relevant. Preoperative imaging gives insight into the differentiation between benign and malignant tumors, which might potentially decrease the number of unnecessary aggressive surgeries. Characteristic imaging findings on cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can help narrow the differential diagnosis and guide the further management of patients presenting with parotid masses. While MRI is imperative for the determination of perineural spread, which is frequently encountered with malignant parotid tumors, CT is important for the evaluation of osseous invasion. Furthermore, multi-parametric MRI protocols provide insights into the tumor behavior and internal composition, which is helpful in the case of benign mixed tumors and others. While distant metastasis is uncommon with parotid neoplasms, PET/CT provides a valuable tool for the improved evaluation of loco-regional and distant metastatic disease. This article discusses the imaging features of common benign and malignant parotid tumors.

Adding automated decision-tree models to multiparametric MRI for parotid tumours improves clinical performance

PurposeTherapeutic management of parotid gland tumours depends on their histological type. To aid its characterisation, we sought to develop automated decision-tree models based on multiparametric magnetic resonance imaging (MRI) parameters and to evaluate their added diagnostic value compared with morphological sequences. Methods206 MRIs from 206 patients with histologically proven parotid gland tumours were included from January 2009 to January 2018. Multiparametric MRI findings (including parameters derived from diffusion-weighted imaging [DWI] and dynamic contrast-enhanced [DCE]) were used to build predictive classification and regression tree (CART) models for each histological type. All MRIs were read twice: first, based on morphological sequence findings only, and second, with the addition of multiparametric sequences and CART findings. The diagnostic performance between these two readings was compared using ROC curves. ResultsCompared to morphological sequences alone, the addition of multiparametric analysis significantly increased the diagnostic performance for all histological types (p < 0.001 to p = 0.011), except for lymphomas, where the increase was not significant (AUC 1.00 vs. 0.99, p = 0.066). ADCmean was the best parameter to identify pleomorphic adenomas, carcinomas and lymphomas with respective cut-offs of 1.292 × 10–3 mm2/s, 1.181 × 10–3 mm2/s and 0.611 × 10–3 mm2/s, respectively. × 10–3 mm2/s. The mean extracellular-extravascular space coefficient was the best parameter to Warthin tumours from the others, with a cut-off of 0.07. ConclusionsThe addition of decision tree prediction models based on multiparametric sequences improves the non-invasive diagnostic performance of parotid gland tumours. ADC and extracellular-extravascular space coefficient are the two best parameters for decision making.

Clinical presentation and management of parotid gland tumors – A retrospective study in Northwestern Nigeria

Background: Parotid gland tumors are the most common major salivary gland tumors occurring in humans. Aim: This study aimed to evaluate the pattern of clinical presentation and management of parotid gland tumors in Northwestern Nigeria. Materials and Methods: In this retrospective study sociodemographics, nature of the lesion, fine-needle aspiration cytology result, surgical procedure, and complications of patients with parotid gland tumors were recorded and analyzed using SPSS version 25. Results: There were 31 (45.6%) males and 37 (54.4%) females in the age range of 17–72 years with a mean ± standard deviation of 49.03 ± 15.61 years. Benign tumors constitute the majority 50 (73.5%), with pleomorphic adenoma being the most common 46 (67.6%), whereas malignant tumors were 18 (26.5%), with adenoid cystic carcinoma being the most common 6 (8.8%). Superficial parotidectomy was the highest surgical procedure performed in 42 (70.6%) patients. Selective neck dissection was done in 5 (27.8%) cases and soft tissue reconstruction with deltopectoral flaps in 3 (16.7%) of the malignant cases. Transient facial nerve paralysis was seen in 14 (29.2%) and 8 (47.1%) of patients who had superficial and total parotidectomies, respectively. Permanent facial nerve paralysis was seen in all 5 (27.8%) patients who had radical parotidectomy. Conclusion: Pleomorphic adenoma was the most common parotid gland tumor, and superficial parotidectomy was the major surgical procedure performed. Facial nerve paralysis is an inevitable complication but can be minimized with meticulous surgical maneuver.

A Clinico-Pathological Study and Management of Parotid Tumours

Aim: The aim of the study is to know the incidence of parotid gland tumours with respect to age and sex, to study the various modes of clinical presentation of parotid tumours and to evaluate the various modes of surgery and outcome of surgical management of parotid gland tumours (both benign and malignant) at MRIMS, Hyderabad. Materials and methods: This study was conducted from July 2019 to July 2021 over a period of 2 years. 30 patients admitted in MRIMS with parotid gland neoplasm were included in this study. Inclusion criteria: All patients with parotid swelling due to parotid neoplasm were included. Exclusion criteria: All paediatric patients, patients with tumour like conditions and infectious causes of parotid gland were excluded. Results: The incidence of parotid tumours was highest in 3rd to 5th decade. Males were more affected than females. Majority of the tumours were benign in nature. All patients presented with swelling in parotid region (100%). Pain is always on account of malignant tumour. Pleomorphic adenoma was the commonest benign tumour. The treatment of choice of all benign tumours is superficial parotidectomy. All malignant tumours were subjected to post- operative radiotherapy. Commonest post-operative complication was facial nerve weakness.

An overview of cases of parotid gland tumors managed in a teaching hospital, North-west, Nigeria

&#x0D; &#x0D; &#x0D; &#x0D; Objective: Salivary gland tumors are mostly slow growing and painless. Majorities are located in the parotid glands and are benign. Treatment of these parotid tumors may endanger the facial nerve. This study evaluated the clinical presentation and management of parotid gland tumors in Kaduna, North-west, Nigeria.&#x0D; Methods: This was a retrospective study of patients that were treated for parotid gland tumors at the Maxillofacial Unit of Barau Dikko Teaching Hospital, Kaduna, North-west, Nigeria over a period of 13years (January 2008 to December, 2020). Patients’ records were analyzed for age, sex, clinical presentation, investigations, surgical management, histological diagnosis and outcome of treatment.&#x0D; Results: A total of 55 patients with parotid gland tumors were seen. Age range was 12 - 75 years with a mean of 45.5 (SD± 0.7) years. The male: female ratio was found to be 1.1: 1. Pleomorphic adenoma was the commonest tumour (n=28, 50.9%). Four (7.3%) patients who had been on antiretroviral medications were seen with massive tumors. Superficial parotidectomy was the commonest surgical procedure carried out in these patients. Patients with malignancies were referred for post-surgical radiotherapy. High early recurrences were noticed in patients who were retroviral positive.&#x0D; Conclusion: Pleomorphic adenoma was commonest tumors treated and superficial parotidectomy was the commonest surgical procedure performed for the treatment of parotid gland tumors. Post-operative radiotherapy as an adjunct was carried out in cases with diagnosis of malignant lesions.&#x0D; &#x0D; &#x0D; &#x0D;

Parotid Gland Tumors in Northern Greece: A 7-year Retrospective Study of 207 Patients.

&lt;b&gt;Introduction:&lt;/b&gt; Parotid gland neoplasms represent a heterogenous group of tumors, either benign or malignant. The diagnosis and management of parotid gland tumors is complicated by their relative infrequency and their diverse biologic behavior. &lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; The aim of this study is to investigate the epidemiological characteristics, the recurrence rates and the surgical approach employed for parotid gland tumors in Northern Greece. &lt;br&gt;&lt;b&gt;Material and methods:&lt;/b&gt; This is a single-center retrospective study. All patients admitted to the ENT department of "G. Papanikolaou" General Hospital of Thessaloniki from January 2012 to June 2019 with the diagnosis of parotid gland tumor were included in the study. Patients with incomplete charts and patients that underwent revision surgeries were excluded. Chi-squared tests were used to assess the associations between variables. &lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; A total of 207 patients with a mean age of 54.97 (range 16-91) were included in the study. Benign neoplasms accounted for 87.9% of the cases. Warthin's tumor was the most common neoplasm encountered, with an incidence of 46.8%, followed by pleomorphic adenoma (31.9%). There was a higher incidence of parotid gland tumors in males and smokers (P = 0.025, P = 0.001 respectively). The majority of the patients were treated with an extracapsular resection (60.4%) or with a partial superficial parotidectomy (22.6%). In 12 cases (5.7%), there was a recurrence of the lesion. The most common complications encountered were facial nerve injury, Frey's syndrome and hematoma formation. &lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Parotid gland tumors are typically benign, non-aggressive tumors, more frequently seen in men than women. There is a positive association between smoking and parotid gland tumor development. Comprehensive information regarding recurrence and complication rates is presented.

The Role of Fine Needle Aspiration Cytology and Frozen Section Histopathology in the Management of Parotid Gland Tumours: A 5- Year Experience in a UK Teaching Hospital

The Role of Fine Needle Aspiration Cytology and Frozen Section Histopathology in the Management of Parotid Gland Tumours: A 5- Year Experience in a UK Teaching Hospital

Diagnostic accuracy and utility of fine-needle aspiration cytology in therapeutic management of parotid gland tumours

Introduction and objectivesThe utility of fine-needle aspiration cytology (FNAC) in parotid tumours remains widely debated. This study aims to evaluate the accuracy of FNAC in diagnosing parotid tumours. Materials and methodsWe performed a retrospective analysis of patients with tumour disease of the parotid gland treated at a Portuguese Oncology Institute, over a period of 25 years. The preoperative FNAC results were compared with the final histopathological diagnosis. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FNAC for malignancy. Association between malignancy on histopathology and FNAC results were evaluated with the Chi-square test. ResultsThe study sample consisted of 155 patients (77 males and 78 females) with a mean age of 56.6±17.0 years. In 27 cases (17.4%), the FNAC result was indeterminate. In this group of patients there was a higher proportion of malignancy on histology (48.1%) (X2; p<0.001). In the group with a conclusive result on FNAC, the sensitivity and specificity of FNAC for malignancy was 66.7% and 99.0%, respectively. PPV was 94.1% and NPV was 92.8%. ConclusionsA benign result on FNAC should be used with caution, due to its low sensitivity for malignancy. An indeterminate result on FNAC should raise suspicion for a malignant tumour.

Diagnostic accuracy and utility of fine-needle aspiration cytology in therapeutic management of parotid gland tumours

Introduction and objectivesThe utility of fine-needle aspiration cytology (FNAC) in parotid tumours remains widely debated. This study aims to evaluate the accuracy of FNAC in diagnosing parotid tumours. Materials and methodsWe performed a retrospective analysis of patients with tumour disease of the parotid gland treated at a Portuguese Oncology Institute, over a period of 25 years. The preoperative FNAC results were compared with the final histopathological diagnosis. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FNAC for malignancy. Association between malignancy on histopathology and FNAC results were evaluated with the Chi-square test. ResultsThe study sample consisted of 155 patients (77 males and 78 females) with a mean age of 56.6±17.0 years. In 27 cases (17.4%), the FNAC result was indeterminate. In this group of patients there was a higher proportion of malignancy on histology (48.1%) (X2; p<0.001). In the group with a conclusive result on FNAC, the sensitivity and specificity of FNAC for malignancy was 66.7% and 99.0%, respectively. PPV was 94.1% and NPV was 92.8%. ConclusionsA benign result on FNAC should be used with caution, due to its low sensitivity for malignancy. An indeterminate result on FNAC should raise suspicion for a malignant tumour.

Corrélation cyto-histologique dans la prise en charge des tumeurs parotidiennes : étude rétrospective de 160 cas

The aim of this study was to correlate the cytological and histological results and evaluate the diagnostic performance of fine-needle aspiration cytology (FNAC) in the management of parotid gland tumors. This retrospective study included 160patients with a parotid gland tumor who underwent fine-needle aspiration and parotidectomy surgery between January2005 and August2016 at the Limoges university hospital center. On 160fine-needle aspirations performed, fine-needle aspiration diagnoses were: 77benign lesions, 35malignant lesions and 48non-diagnostic cases. Final histological diagnosis revealed there were 113benign lesions and 47malignant lesions. A hundred and one cytological diagnoses were accurate over 112contributive fine-needle aspirations: seven false-negative cases and 4false-positive cases were observed. The sensitivity, specificity, and accuracy were 82, 95 and 90% respectively for fine-needle aspiration, and 83, 95 and 92% respectively for association of fine-needle aspiration and magnetic resonance imaging. Diagnostic concordance between fine-needle aspiration and final histology for malignant lesions was 78%. A greater number of contributive fine-needle aspirations was observed among experimented operators. Fine-needle aspiration is a reliable, safe and effective diagnostic tool that allows good differentiation between malignant and benign diagnosis in the preoperative management of parotid gland tumors. The association of fine-needle aspiration and magnetic resonance imaging (MRI) can improve diagnostic performance.

Parotid Gland Surgery for Benign Tumours: Have We Come Full Circle?

Parotid gland surgery has been described for over two centuries. The surgical philosophies in management of parotid gland tumors started off in the 18th century from a conservative approach of simple enucleation so as to minimize post-operative facial nerve palsy rate. This occurred, as there was a lack of understanding of surgical anatomy of the parotid gland and facial nerve. However unacceptably high recurrence rates ensued and this encouraged the further study of parotid gland anatomy till the 1950s when, deriving from a better understanding of the surgical anatomy, superficial parotidectomy with facial nerve identification and preservation became the new standard of care. This method then evolved to a partial superficial parotidectomy as this slightly more conservative approach allowed adequate parotid tumour resection with low recurrence rates and yet minimising post-operative complication such as Frey's syndrome. Over the last two decades, a more conservative approach known as an extracapsular dissection of parotid tumour emerged in certain high-volume centers as an alternative to a partial superficial parotidectomy. These centers published better post-operative results with lower postoperative facial nerve palsy rates, less Frey's syndrome and faster patient recovery. Dissection of parotid tumours via this technique involves following a plane close to the tumour and is similar to enucleation in terms of its conservative approach with very significant differences post-operatively. This article presents a summary on the surgical philosophies pertaining to parotid gland surgery since its inception two centuries ago.

Parotid Gland Tumors in a Korean Population

Salivary gland tumors occur in about 3% of the head and neck tumors, and among the salivary gland tumors, parotid gland tumor occurs in about 80%. Because of its low frequency and small cases, it is hard to establish the epidemiologic characteristics of the tumors. This study was performed retrospectively from February 1987 to August 2010. There were 95 male, and 76 female patients. Most of the patients complained of the painless and progressively enlarged mass in the preauricular area. Peak incidence of benign parotid gland tumor was at the fifth decade of life. In the malignant tumors, peak age in males was the eighth decade, and peak age in females was from the third to the fifth decade of life, which was relatively younger and has a broad range of spectrum. Pleomorphic adenoma was the most common benign tumor of the 93 cases (61.6%) followed by Warthin tumor, occurring in 20 cases (13.2%). Squamous cell carcinoma, reported in 6 cases (30%), is the most frequent. Mucoepidermoid carcinoma was the second leading tumor. In conclusion, parotid gland tumor incidence was found to be higher in males. Pleomorphic adenoma was the most commonly encountered type of parotid gland neoplasms, which is in agreement with findings from all of the published literature from all over world. In contrast to most of the previous studies, squamous cell carcinoma was the most frequent malignant tumor found. Based on the data in this study, it has significant clinical respect and is helpful in the management of parotid gland tumors in Orientals.

The Value of Pre-Operative Fine-Needle Aspiration Biopsy in Planning the Management of Parotid Gland Tumours

In a review of 85 patients with palpable parotid tumours managed at the Kuwait Cancer Control Centre during a 5-year period, the value of fine-needle aspiration biopsy (FNAB) has been evaluated and compared with the final histopathological assessment. The results indicate that FNAB has good accuracy in discriminating between benign and malignant lesions; there was no false-positive diagnosis of malignancy, and the malignancy false-negative rate was 7%. In addition, there is a high correlation between FNAB and histopathology in the various subclassifications of malignant parotid tumours. Tuberculous lymphadenitis, which is common in this part of the world and where surgical exploration should be avoided, was accurately diagnosed in all cases. There was the same high accuracy rate with inflammatory lesions. It is therefore concluded that a thorough clinical examination along with FNAB is adequate for the diagnosis of parotid tumours.

耳下せんしゅようと顔面神経の位置関係の判定法 マイオモニターを利用した１方法

In the surgical management of parotid gland tumors, it is very important to know the relationships beteen tumors and facial nerves preoperatively. However, it is not always easy to understand the relations precisely.In this study, the relationships in 10 patients with benign parotid tumors were evaluated by a myomonitor. The result was that the relationships evaluated by the myomonitor were precicely same as the surgical findings in all cases.This method is simple and useful to predict the relationships between benign parotid tumors and facial nerves preoperatively.

Surgical management of parotid gland tumors

Surgical management of parotid gland tumors

Surgical Management of Parotid Gland Tumors

Surgical Management of Parotid Gland Tumors

Surgical Management of Parotid Gland Tumors

Surgical Management of Parotid Gland Tumors

Surgical management of parotid gland tumors.

A retrospective look at a twenty-year experience with parotid tumors and the initial surgical treatment of both benign and malignant lesions led us to question superficial lobectomy as the treatment of choice in the extirpation of parotid neoplastic tissue. This may represent a local or regional experience. It is hoped, however, that these findings will stimulate others to examine their results, so that we may get a more comprehensive picture of the adequacy of superficial parotid gland lobectomy in treating parotid tumors.