Carcinoma Of Parotid Gland Research Articles

Epstein-Barr virus negative lymphoepithelial carcinoma of parotid gland – a case report with review of literature

Epstein-Barr virus negative lymphoepithelial carcinoma of parotid gland – a case report with review of literature

Therapeutic effect and prognostic factors for patients with mucoepidermoid carcinoma of parotid gland

Objective To study the therapeutic effect of adjuvant chemotherapy and radiotherapy after operation in patients with mucoepidermoid carcinoma of parotid gland, and to screen the indicators ralated to the prognosis of tumor. Methods Eighty patients with mucoepidermoid carcinoma of parotid gland in First People′ Hospital of Yibin of Sichuan Province from January 2005 to December 2009 were analysed retrospectively in our research. We studied the survival of patients who were treated wtih simple operation(30 cases) or postoperative adjuvant therapy(50 cases). Then we further analyzed the relationships between the prognosis of the patients and some variables (age, gender, smoking, alcohol drinking, lymph node metastasis, distant organ metastasis, treatment method, differentiation degree and T grading). Results Kaplan-Meier survival curves showed that patients with postoperative adjuvant therapy had longer PFS and OS than those without adjuvant therapy (94.4 months vs 69.3 months; 114.9 months vs 96.7 months), with statistical significance (χ2=11.246, P=0.001; χ2=15.803, P=0.001). COX univariate analysis showed that gender (χ2=22.346, P=0.000), smoking (χ2=7.891, P=0.041), lymph node metastasis (χ2=12.371, P=0.005), distant organ metastasis (χ2=9.813, P=0.002), treatment method (χ2=25.261, P=0.000), differentiation degree (χ2=4.361, P=0.006) and T grading (χ2=5.336, P=0.014) were related to the PFS of patients. COX multivariate analysis showed that lymph node metastasis (χ2=11.003, RR=2.827, 95%CI: 1.965-3.851, P=0.011), distant organ metastasis (χ2=7.611, RR=0.472, 95%CI: 0.240-0.775, P=0.016), treatment method (χ2=24.542, RR=5.390, 95%CI: 3.585-9.602, P=0.000), degree of differentiation (χ2=3.221, RR=2.118, 95%CI: 1.845-4.719, P=0.009) and T grading (χ2=4.336, RR=0.804, 95%CI: 0.681-0.916, P=0.024) were related to the PFS of patients. COX univariate analysis showed that smoking (χ2=4.551, P=0.008), alcohol drinking (χ2=11.742, P=0.048), lymph node metastasis (χ2=14.886, P=0.009), distant organ metastasis (χ2=6.713, P=0.005), treatment method (χ2=22.411, P=0.000), degree of differentiation (χ2=8.116, P=0.012) and T grading (χ2=14.443, P=0.035) were related to the OS of patients. COX multivariate analysis showed that lymph node metastasis (χ2=11.711, RR=2.985, 95%CI: 1.521-3.999, P=0.005), distant organ metastasis (χ2=5.390, RR=0.400, 95%CI: 0.201-0.793, P=0.009), treatment method (χ2=19.327, RR=5.086, 95%CI: 3.241-8.006, P=0.000), degree of differentiation (χ2=7.084, RR=2.301, 95%CI: 1.908-4.503, P=0.001) and T grading (χ2=13.229, RR=0.561, 95%CI: 0.348-0.867, P=0.040) were related to the OS of patients. Conclusion Adjuvant radiation and chemotherapy can obviously prolong the PFS and OS for the patients with mucoepidermoid carcinoma of parotid gland. Lymph node metastasis, distant organ metastasis, treatment method, differentiation degree and T grading can greatly influence the prognosis of patients with mucoepidermoid carcinoma of parotid gland, which can be used as independent prognostic indicators for the patients with mucoepidermoid carcinoma of parotid gland. Key words: Mucoepidermoid tumor; Treatment outcome; Prognosis

Implications of intraglandular lymph node metastases in primary carcinomas of the parotid gland.

Assess the diagnostic and prognostic relevance of intraglandular lymph node (IGLN) metastases in primary parotid gland carcinomas (PGCs). Retrospective study at a tertiary referral university hospital. We reviewed the records of 95 patients with primary PGCs, treated at least surgically, between 1997 and 2010. We assessed the clinicopathological associations of IGLN metastases, their prognostic significance, and predictive value in the diagnosis of occult neck lymph node metastases Twenty-four (25.26%) patients had IGLN metastases. This feature was significantly more prevalent in patients with advanced pT status (P = .01), pN status (P < .01), and overall stage (P < .001); high-risk carcinomas (P = .01); as well as in patients with treatment failures (P < .01). IGLN involvement was significantly associated with decreased univariate disease-free survival (P < .001). Positive and negative predictive values and accuracy for IGLN involvement in the detection of occult neck lymph node metastases were 63.64%, 90.48%, and 84.91%, respectively. The diagnostic values were generally higher in patients with low-risk subtype of PGCs. IGLN involvement provides prognostic information and is associated with advanced tumoral stage and higher risk of recurrence. This feature could be used as a potential readout to determine whether a neck dissection in clinically negative neck lymph nodes is needed or not. 4.

Outcome analysis of 215 patients with parotid gland tumors: a retrospective cohort analysis.

BackgroundTo identify prognostic factors in patients with parotid gland carcinomas who were treated at the Princess Margaret Hospital.MethodsClinical outcome of two hundred fifteen patients with malignancies of the parotid gland was evaluated over a 16-year period.ResultsTwo-hundred-fifteen patients with adenoid cystic carcinoma (n = 20), adenocarcinoma (n = 19), acinic cell carcinoma (n = 62), basal cell adenocarcinoma (n = 7), carcinoma-ex-pleomorphic adenoma (n = 18), mucoepidermoid carcinoma (n = 70) and salivary duct carcinoma (n = 19) have been included. The 5- and 10-year overall and disease-free survivals were 80.62 %/69.48 % and 74.37 %/62.42 %, respectively. Multivariable analysis showed that age greater than 60 years, advanced pN classification, histopathological grade and the presence of lymphovascular invasion significantly worsened overall and disease-free survival. Univariable analysis revealed periparotid lymph node involvement was associated with decreased overall (p < 0.0001) and disease-free survival (p < 0.0001).ConclusionsIn addition to age, pN classification, histopathological grade, perineural invasion, and lymphovascular involvement, periparotid lymph node metastasis appears to be an important prognosticator in parotid gland malignancy.

A Case of Successful Treatment with Trastuzumab for Advanced Salivary Duct Carcinoma in the Accessory Parotid Gland with Multiple Bone Metastasis

A Case of Successful Treatment with Trastuzumab for Advanced Salivary Duct Carcinoma in the Accessory Parotid Gland with Multiple Bone Metastasis

Symptomatic Metastasis to the Pituitary Gland: A Report of Three Cases and Review of the Literature

Objective and importance: Symptomatic metastases to the pituitary gland are rare and often herald advanced systemic malignant disease. Distinguishing them from benign pituitary adenomas is challenging. The clinicoradiological features of three patients with pituitary metastases are presented. We also review the literature from 1970 to 2015 to formulate a diagnostic strategy. Clinical presentation: All patients were elderly with ages ranging from 65 to 82 years old. One had a previously undiagnosed prostatic carcinoma and two had known histories of primary gastric or parotid salivary gland carcinoma. Rapid visual deterioration was the most common symptom followed by ophthalmoplegia. Cranial diabetes insipidus (CDI) was observed after administrating hydrocortisone replacement in one patient. All patients had evidence of a solitary pituitary tumor on magnetic resonance imaging (MRI) of which two had discernible posterior pituitary signal changes. Trans-sphenoidal excision was performed for all patients with no procedure related complications. Two patients had visual improvement, but due to advanced systemic disease all succumbed within two months. A literature review of 475 pituitary metastases revealed that breast (37.1%) and bronchogenic carcinomas (22.1%) were the most frequently encountered primary malignancies. Among 290 symptomatic patients (22.1%) were the most frequently encountered primary malignancies. Among 290 symptomatic patients the commonest presentation was CDI (19.9%) and 12.1% had ophthalmoplegia. Of the 166 tumors with documented neuroimaging features, 31.3% had evidence of pituitary stalk thickening or enhancement followed by cavernous sinus invasion (30.1%) or was dumbbell shaped (27.7%). Conclusion: Diagnosing metastatic pituitary tumors is important for the treating clinician in order to avoid unnecessary surgical excision in patients with limited life expectancy. Patients older than 60 years, or with a history of cancer, presenting with CDI or ophthalmoplegia are red flag clinical features. For these patients we recommend investigations for occult primary malignancy when early posterior pituitary involvement orcavernous sinus invasion is demonstrated on MRI.

A Case of Epithelial-myoepithelial Carcinoma of Parotid Gland that Caused Multiple Cranial Nerve Disorders

A Case of Epithelial-myoepithelial Carcinoma of Parotid Gland that Caused Multiple Cranial Nerve Disorders

多発脳神経障害をきたした耳下腺上皮筋上皮癌例

多発脳神経障害をきたした耳下腺上皮筋上皮癌例

耳下腺癌治療における長期治療成績

【背景】耳下腺癌手術における顔面神経温存については諸説ある。当院では顔面神経が腫瘍から剥離可能であれば可能な限り温存している。【対象】1997年から2014年に当院で根治治療を行った遠隔転移のない耳下腺悪性腫瘍59例を対象にretrospectiveに検討した。【結果】治療内容は手術47例，放射線治療 (RT) 5例，化学放射線同時併用療法 (CRT) 7例。32例に術後RT/CRTを施行した。5年/7年生存率は手術±術後RT/CRTが78%/69%，CRTが35%/35%，RTが20%/20%であった。顔面神経麻痺ありは顕微鏡的浸潤のみより生存率，局所制御率とも有意に不良であったが，神経浸潤陰性と顕微鏡的浸潤のみでは生存率，局所制御率，遠隔転移無出現率に有意差を認めなかった。【結論】顔面神経麻痺がなく神経が腫瘍から剥離可能であれば，術後RT/CRTの追加で顔面神経温存が可能であることが示唆された。

Salivary duct carcinoma of the parotid gland: A case report and review of the literature.

Salivary duct carcinoma (SDC) is a rare and aggressive parotid malignancy that most commonly affects males in the fifth and sixth decades of life. Histopathology specimens obtained from SDC patients demonstrate a resemblance to ductal carcinoma of the breast. Therefore, to distinguish SDC from breast ductal carcinoma, several immunohistochemical markers exist that may enable surgeons to make an accurate diagnosis. In this study, the case of a 54-year-old male with salivary duct carcinoma of the right parotid gland is presented. The results of the present case study revealed that the SDC sample was positive for the expression of human epidermal growth factor 2 (Her-2), cytokeratin (CK) 8/CK 18, p63, high molecular weight CK and calponin, and negative for expression of the estrogen receptor and progesterone receptor. Based on the result, an ipsilateral selective neck dissection followed by adjuvant post-operative radiation therapy was suitable at the primary treatment stage. At one year of follow-up, the patient was alive and free of recurrence. In advanced cases of SDC, treatment with anti-HER-2 monoclonal antibodies, such as trastuzumab, is recommended.

Diagnosis of mucoepidermoid carcinoma of parotid gland by virtual touch tissue quantification

Objective To explore the value of virtual touch tissue quantification(VTQ) in diagnosis of mucoepidermoid carcinoma (MECa) of parotid gland.Methods The sonographic and VTQ findings of 36 patients with MECa of parotid gland proved by pathology were analyzed retrospectively.The patients were divided into 3 groups according to pathology.50 normal subjects were choesn as control group.Results There were significant differences of shear wave velocity (SWV) between MECa groups and control group as well as among MECa groups (all P ＜0.01).Conclusions VTQ provides quantitative information about tissue stiffness which is useful for the diagnosis of MECa of parotid gland. Key words: Ultrasonography; Parotid neoplasms ; Carcinoma, Mucoepidermoid; Virtual touch tissue quantification

Clinical analysis on 61 cases of mucoepidermoid carcinoma of the parotid gland

Objective To summarize the clinicopathologic prognostic factors of mucoepidermoid carcinoma of the parotid gland which is the most common malignant tumor of the salivary.Methods 61 cases of mucoepidermoid carcinoma of the parotid gland hospitalized in The Affiliated Tumor Hospital of Guangzhou Medical University,from 1986 to 2010 were reviewed retrospectively.The cumulative survival rate was analyzed by Kaplan-Meier method.And then the factors were compared using the Log-rank test.While the influencing factors were screened by Cox proportional hazards model.Results The 5-and 10-year overall survival rates were 81.2％ and 74.9％,respectively.Multivariate analysis showed that margin positive was independently associated with decrease survival rates (P ＜ 0.05).Conclusion Surgery therapy was the principal treatment method for mucoepidermoid carcinoma of the parotid gland.Margin is independent factor affecting the prognosis. Key words: Parotid gland neoplasm; Mucoepidermoid carcinoma; Prognosis

고악성도 이하선암종에서 임상적으로 경부 임파선 전이가 없는 환자의 예방적 경부청소술의 필요성: 예비 연구

Background and Objectives: Lymph node metastases has a high prognostic value in patients with parotid gland carcinoma. However, a consensus regarding the indication of elective neck dissection (END) has not been reached. Most authors have advocated performing a neck dissection based on the histology of the primary parotid carcinoma and the tumor grade. Materials and Methods: A retrospective analysis was undertaken targeting 16 patients who were previously treated for primary carcinoma of the parotid gland with a clinically negative neck at Department of Otorhinolaryngology?Head and Neck Surgery. Eleven patients with high grade parotid carcinoma except two cases of the adenoid cystic carcinoma and three cases of low grade parotid carcinoma were evaluated to identify occult neck metastases. Results: Lymph node metastasis was detected in one (9.1 %) of the 11 patients with high grade parotid carcinoma who underwent elective neck dissection. One case of positive lymph node was squamous cell carcinoma as primary parotid cancer (33.3 %). Conclusions: Elective neck dissection seems to be necessary for the treatment of high grade parotid cancer with squamous cell carcinoma. However, there may be controversy over the cases of high grade parotid cancer except for the squamous cell carcinoma. (J Clinical Otolaryngol 2014;25:44-48)

Phase I dose-escalation and -expansion study of buparlisib (BKM120), an oral pan-Class I PI3K inhibitor, in patients with advanced solid tumors

The pan-Class I PI3K inhibitor buparlisib (BKM120) has shown activity in a range of preclinical cancer models. This first-in-man study was initiated to identify the maximum tolerated dose (MTD) of buparlisib (100 mg/day) and to assess safety and preliminary efficacy. Patients with advanced solid tumors (N = 83) enrolled in a Phase I dose-escalation and -expansion study of single-agent buparlisib. Patients in the dose-expansion arm (n = 43) had tumor samples with PIK3CA and/or PTEN alterations. The most common cancers were colorectal (n = 31) and breast cancer (n = 21). Median number of prior antineoplastic regimens was four (range: 1-12). Grade 3/4 adverse events (AEs) included asthenia (12.0 %) and performance status decrease (9.6 %). Treatment-related AEs (all grades) included decreased appetite, diarrhea, nausea (each in 33 % of patients), hyperglycemia (31 %) and rash (29 %). One confirmed partial response (PR; triple-negative breast cancer) and three unconfirmed PRs (parotid gland carcinoma, epithelioid hemangiothelioma, ER + breast cancer) were reported. Tumor molecular status did not predict clinical benefit in the full study cohort, or among the colorectal or breast cancer subpopulations. Pharmacodynamic biomarkers ((18)F-FDG-PET, C-peptide, pS6) demonstrated dose-dependent changes; however, tumor heterogeneity precluded a clear correlation with clinical benefit. Buparlisib was well tolerated up to the 100 mg/day dose and showed preliminary activity in patients with advanced cancers. Future studies in more homogeneous patient populations will evaluate buparlisib in combination with other agents and further investigate the use of predictive biomarkers.

A rare and unusual case of acinic cell carcinoma of parotid gland evaluated by F-18 FDG PET/CT

Acinic Cell Carcinoma (ACC) is a rare parotid gland tumour. In this case, we present F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) images of a 75 year old male with a history of metastatic ACC. The patient was iniatially diagnosed in 2009 after he received multiple surgeries secondary to local recurrences. The patient was also treated with chemoradiation. PET/CT was performed as part of the treatment strategy evaluation. PET/CT demonstrated brain metastasis, multiple pulmonary metast a tic nodules, multiple hepatic metastasis, hilar, pleural and mesenteric masses and multiple osseous metastasis. Although ACC is a low grade malignancy, it has a tendency to recur and metastasize. In this case, we report diffuse metastatic disease of ACC. Hence, we conclude PET/CT could be a very valuble tool managing the disease.

Joint use of skull base surgery in a case of pediatric parotid gland carcinoma.

Parotid gland carcinoma is extremely rare in children. We report a case of pediatric parotid gland carcinoma with extensive infiltration into surrounding tissues including the skin and temporomandibular joint capsule at initial examination. Total resection of the parotid gland was conducted together with skull base surgery and mandibular dissection. The patient was a 14-year-old girl. In addition to the skin and temporomandibular joint, infiltration into the anterior wall of the external auditory meatus and masseter muscle was also seen, and T4N0M0 stage IV parotid carcinoma was diagnosed. Skin was resected together with the pinna, and temporal craniotomy and skull base surgery were performed to resect the temporomandibular joint capsule and external auditory meatus en bloc, and mandible dissection was conducted. Facial nerves were resected at the same time. Level I to level IV neck dissection was also conducted. A latissimus dorsi myocutaneous flap was used for reconstruction. The postoperative permanent pathology diagnosis was high-grade mucoepidermoid carcinoma with a low-grade component. Postoperatively, radiotherapy at 50 Gy alone has been conducted, with no recurrence or metastasis observed for over 4 years.

A rare case of iliac crest metastasis from acinic cell carcinoma of parotid gland

A case of acinic cell carcinoma of the right parotid gland metastasizing to the right iliac crest is presented. Generally, for this rare low-grade malignant salivary gland neoplasm, 20% of cases may have local recurrences whereas about 10% of cases have distant metastases. They may arise many years after the initial presentation of the original tumor. The most frequent locations are the cervical lymph nodes, liver, lungs, contralateral orbit and bones. Occurrence in the appendicular skeleton is very rare and in our knowledge this is the first report of metastases to the pelvis.

EP-1124: Long-term outcomes and prognostic factors of surgery followed by radiation therapy for parotid gland carcinomas

EP-1124: Long-term outcomes and prognostic factors of surgery followed by radiation therapy for parotid gland carcinomas

Mucoepidermoid Carcinoma of Parotid Gland

Objectives: Present a case of mucoepidermoid carcinoma of the left parotid gland, which has been removed surgically. Methods: A thirty-five year-old gentleman presented with swelling of the left cheek for 6 months. The swelling was gradually increasing and painless; the patient had facial weakness since childhood. A swelling 3x2 cm was seen in the parotid area, which was normothermic, non-tender, firm in consistency, not fluctuant, and fixed to the skin. The facial nerve was intact, and the regional lymph nodes were not palpable. Results: Excisional biopsy was done. The histopathology revealed mucoepidermoid carcinoma of low grade. Repeated ultrasound showed normal echogenicity of the left parotid gland and no discrete nodule seen. One cm hypoechoic mass was seen in the subcutaneous tissue of the left cheek, which indicates a residual mass or postoperative fibrosis. Magnetic resonance imaging of the parotid glands showed one cm mass of the left cheek. The patient had excisional biopsy and transposition flap of the left cheek. The lesion excised with 5 mm clear radial margins and 5 mm clear deep layer. The zygomatic branch of the VII cranial nerve was sacrificed because it was intralesional. Transposition of S-shaped flap was created and fixed through layers. Conclusions: A case of excised parotid mucoepidermoid carcinoma was presented; the patient was disease free at 79 months. Clinical stage and histological grade of mucoepidermoid carcinoma are the main prognostic factors.

Mucoepidermoid carcinoma: A yet unreported cancer associated with familial adenomatous polyposis

Turcot's syndrome is a rare clinical syndrome, characterized by the association between familial adenomatous polyposis (FAP) and a primary central nervous system tumour. Gardner's syndrome is characterized by the association between FAP and several tumour types such as multiple osteomas, fibromas, epidermoid cysts and desmoid tumours. We report here the case of a twenty-six year-old woman with a history of both Turcot's and Gardner syndromes. She had a family history of adenomatous polyposis with a mutation in the APC (Adenomatous Polyposis Coli) gene. At the age of 26, she presented a mucoepidermoid carcinoma of the right parotid gland in which the MECT1-MAML2 fusion was showed. We discuss the possible addition of this latter cancer type in the definition of Gardner's syndrome.