Parotid Gland Tumors Research Articles

Comparative Analysis of Fistula Development After Parotid Gland Surgery: Lateral Parotidectomy Versus Extracapsular Dissection Technique.

The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours. A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs). In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (ORadjusted = 2.6, 4.1% vs. 12.5%, p = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, p = 0.333). Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.

Revision parotidectomy - analysis of indications for the procedure and treatment results based on 10 years of follow-up in a single center.

<b>Introduction:</b> Surgical removal of recurrent parotid gland tumours is the first-line treatment but presents an increased risk of facial nerve injury and a considerable re-recurrence failure rate.<b>Aim:</b> Identification of individuals exposed to a higher risk of re-procedure, raising awareness in the preoperative setting, and proposing an optimal follow-up.<b>Methods:</b> The retrospective review included 72 patients treated with revision surgery in a single centre. The demographics, clinicopathologic variables, and operative details were analysed.<b>Results:</b> Recurrent pleomorphic adenoma (PA) was the main reason for reoperation (66.7%), followed by new monomorphic adenoma (13.9%), resection extension (12.5%), and malignancy recurrence (6.9%). Time to revision surgery was on average 68.6 months and was the shortest for extended resection cases (average 1.9 months). The period was substantially longer in recurrent PA (90.8 months). The final facial nerve function according to the House-Brackmann scale (HBS) decreased in 37% of patients after reoperation. The number of recurrences per patient ranged from one in 61% of cases to eight in a solitary case.<b>Conclusions:</b> The rate of revision parotid surgery was 8.4%. Negative margins at the first resection were not of protective significance. Recurrent PA was the main cause of revision surgery and over one-third of this cohort had a subsequent relapse. As many as 37% of patients experienced a decrease in facial nerve function following revision surgery.

MRI and CT imaging characteristics in parotid tumors with false-negative fine-needle aspirations

BackgroundsPreoperative imaging, particularly with magnetic resonance imaging (MRI) and computed tomography (CT) scans, plays a crucial role in distinguishing between benign and malignant parotid gland tumors, while the reliability of Ultrasound-Guided Fine Needle Aspiration (FNA) in diagnosing these masses remains a topic of debate.MethodsThis two-center retrospective analysis was conducted on 347 patients with parotid gland tumors who had FNA and preoperative imaging (CT or MRI). All patients underwent surgery and final histopathological examination was available, along with complete medical records between January 2008 and May 2023.ResultsAmong the 347 patients, 318 (92%) had benign and 10 (3%) had malignant tumors based on FNA, with 19 (5%) unsatisfactory specimens. Final histological diagnosis revealed 303 (87%) benign and 44 (13%) malignant lesions, with a false-negative rate of 10.6% for FNA. Multivariate analysis identified irregular shape and invasion as independent predictors of malignancy in patient with benign or unsatisfactory FNA results. The odds ratio for irregular shape was 3.06 and for invasion was 12.73.ConclusionImaging characteristics, such as irregular shape and invasion may indicate towards malignant parotid tumors, even in patients with false-negative benign findings in FNA.

A Case Report and Literature Review of Metastatic Small Cell Carcinoma in Parotid Gland

Small cell lung cancer usually presents as a progressive disease in over 70% of patients. Common organs of metastasis include the liver, adrenal glands, bones, and brain. However, metastasis to the parotid gland is uncommon, as it has been discussed only in case reports. Among all parotid tumors, small cell cancer is rare, seen in only 1.7%.A 60-year-old man presented with a slow-growing, painless tumor of the left parotid gland and peripheral facial paralysis. Neck ultrasound identified a solid mass in the left parotid gland with enlarged lymph nodes in the parotid gland and ipsilateral neck lymphadenopathies with pathologic features in levels 2 and 3. Chest computed tomography (CT) demonstrated subsegmental collapse in the lingula with peribronchial cuffing in this lobe and mild cylindrical bronchiectatic changes in the left lower lobe. CT also showed multiple mediastinal lymphadenopa thies in prevascular, paraaortic, and paratracheal spaces. Core needle biopsy was done, and initial analysis revealed small cell carcinoma in the left parotid gland. Immunohistochemical analysis of the specimen demonstrated and confirmed the diagnosis. The patient was then referred to the radiation oncology unit for treatment. Chemotherapy was initiated with a combination of cisplatin and etoposide. No complications of the chemotherapy were observed after three cycles; treatment and follow-up are ongoing. No irradiation was performed after evaluation by the radiation oncology department. Due to the advanced stage of his disease, treatment is set for palliative purposes only. Small cell lung cancer diagnosed from solitary metastasis to the parotid gland is very rare. Physicians should keep pulmonary origin in mind when faced with a parotid tumor, as without careful examination, the primary focus may be overlooked, negatively impacting survival rates and the prognosis of the patient. Overall, this finding carries a poor prognosis, but the mainstay of treatment is palliation with systemic chemotherapy and possibly irradiation to control symptoms

Acinic cell carcinoma of left parotid gland: A case report

Acinic cell carcinoma (ACC) is an uncommon and gradually developing tumour primarily found in the major salivary glands, most frequently originating in the parotid gland and less commonly in the submandibular and sublingual glands. ACC represents 3 to 4% of parotid gland tumours, 2 to 6% of all salivary gland tumours, and 10 to 17% of all malignant tumours in the salivary glands.

Using Machine Learning on MRI Radiomics to Diagnose Parotid Tumours Before Comparing Performance with Radiologists: A Pilot Study.

The parotid glands are the largest of the major salivary glands. They can harbour both benign and malignant tumours. Preoperative work-up relies on MR images and fine needle aspiration biopsy, but these diagnostic tools have low sensitivity and specificity, often leading to surgery for diagnostic purposes. The aim of this paper is (1) to develop a machine learning algorithm based on MR images characteristics to automatically classify parotid gland tumours and (2) compare its results with the diagnoses of junior and senior radiologists in order to evaluate its utility in routine practice. While automatic algorithms applied to parotid tumours classification have been developed in the past, we believe that our study is one of the first to leverage four different MRI sequences and propose a comparison with clinicians. In this study, we leverage data coming from a cohort of 134 patients treated for benign or malignant parotid tumours. Using radiomics extracted from the MR images of the gland, we train a random forest and a logistic regression to predict the corresponding histopathological subtypes. On the test set, the best results are given by the random forest: we obtain a 0.720 accuracy, a 0.860 specificity, and a 0.720 sensitivity over all histopathological subtypes, with an average AUC of 0.838. When considering the discrimination between benign and malignant tumours, the algorithm results in a 0.760 accuracy and a 0.769 AUC, both on test set. Moreover, the clinical experiment shows that our model helps to improve diagnostic abilities of junior radiologists as their sensitivity and accuracy raised by 6 % when using our proposed method. This algorithm may be useful for training of physicians. Radiomics with a machine learning algorithm may help improve discrimination between benign and malignant parotid tumours, decreasing the need for diagnostic surgery. Further studies are warranted to validate our algorithm for routine use.

First experience using a plate for fixing histological specimens of parotid salivary gland tumors

Relevance. Accurately assessing all resection margins during the removal of parotid salivary gland tumors is crucial due to the risk of recurrence and the potential for benign processes to become malignant over time. Macroscopic specimens obtained during these surgeries are sent to the pathology laboratory in containers filled with fixative solution. During fixation, the soft tissue fragments, typically round in shape, can alter their configuration because of the tissue's heterogeneity. This can create challenges for the pathologist in properly orienting the surgical specimen, which in turn complicates the precise evaluation of the resection margins.Materials and methods. To address this issue, the "Plate for fixing histological specimens of parotid salivary gland tumors" (patented) was developed. Twenty cases of its clinical use were analyzed: the surgical material (parotid gland tissue containing a tumor) was sent to the pathology department, fixed on this plate to preserve its original anatomical orientation. A macroscopic and histological evaluation of the neoplasms was then carried out, with special attention given to the accurate identification of all resection margins. In all 20 clinical cases, the use of this invention improved the convenience for the pathologist in handling the excised tissue block by standardizing the method and clearly identifying the resection margins.Conclusion. The application of this invention enhances the accuracy of marking and evaluating the resection margins in parotid gland tumors.

MR Image Fusion-Based Parotid Gland Tumor Detection.

The differentiation of benign and malignant parotid gland tumors is of major significance as it directly affects the treatment process. In addition, it is also a vital task in terms of early and accurate diagnosis of parotid gland tumors and the determination of treatment planning accordingly. As in other diseases, the differentiation of tumor types involves several challenging, time-consuming, and laborious processes. In the study, Magnetic Resonance (MR) images of 114 patients with parotid gland tumors are used for training and testing purposes by Image Fusion (IF). After the Apparent Diffusion Coefficient (ADC), Contrast-enhanced T1-w (T1C-w), and T2-w sequences are cropped, IF (ADC, T1C-w), IF (ADC, T2-w), IF (T1C-w, T2-w), and IF (ADC, T1C-w, T2-w) datasets are obtained for different combinations of these sequences using a two-dimensional Discrete Wavelet Transform (DWT)-based fusion technique. For each of these four datasets, ResNet18, GoogLeNet, and DenseNet-201 architectures are trained separately, and thus, 12 models are obtained in the study. A Graphical User Interface (GUI) application that contains the most successful of these trained architectures for each data is also designed to support the users. The designed GUI application not only allows the fusing of different sequence images but also predicts whether the label of the fused image is benign or malignant. The results show that the DenseNet-201 models for IF (ADC, T1C-w), IF (ADC, T2-w), and IF (ADC, T1C-w, T2-w) are better than the others, with accuracies of 95.45%, 95.96%, and 92.93%, respectively. It is also noted in the study that the most successful model for IF (T1C-w, T2-w) is ResNet18, and its accuracy is equal to 94.95%.

Ultrasonography-Guided Fine Needle Aspiration Cytology Versus Histopathology: Diagnostic Consistency in Salivary Gland Neoplasms.

Introduction Salivary gland lesions include a diverse range of histological types and biological behaviors, making accurate diagnosis and effective treatment challenging for specialists. Fine needle aspiration cytology (FNAC) plays a significant role in making preoperative diagnoses and further plans of surgery. In differentiating malignant from benign salivary gland tumors, the diagnostic accuracy of fine needle aspiration cytology (FNAC) is high. However, the final diagnosis is histopathological. The aim of this study is to correlate cytological and histopathological interpretations in salivary gland lesions. Materials and method Thirty patients were included in this study, all of them were diagnosed with salivary gland swellings and operated on in the ear, nose, and throat (ENT) department of Mata Gujri Memorial (MGM) Medical College, Kishanganj, in the northeastern region of India, between December 2020 and November 2022. Ultrasonography (USG) and computed tomography (CT) scans were performed in each case, and FNAC was done to make a preoperative diagnosis. After surgery, specimens were collected for histopathological examination. A correlation was then made between the findings of the preoperative cytological examination and the results of the postoperative histopathological examination. The comparison was performed using a 2×2 table, and the analysis of sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) was carried out using Microsoft Excel (MicrosoftCorp., Redmond, WA) and SPSS software (IBM SPSS Statistics, Armonk, NY). Results An equal number of male and female samples were included in the study, in which parotid involvement was predominant (60%). On FNAC, 53% of parotid gland tumors were found to be benign, whereas only 23.3% of submandibular gland tumors were benign. Pleomorphic adenoma was the most common finding. In the present study, the sensitivity, specificity, positive predictive value, and negative predictive value of USG-guided FNAC, compared to the gold standard histopathology, were 96%, 33.3%, 92.3%, and 50%, respectively. The diagnostic accuracy was found to be 89.3%. Conclusion The findings of this study suggest that FNAC is a reliable technique for the preoperative diagnosis of salivary gland tumors, as it is minimally invasive and offers valuable diagnostic information. An accurate cytological diagnosis can help avoid unnecessary surgery.

PREVALENCE OF PAROTID TUMORS AMONG YEMENI PATIENTS IN SANA'A CITY, YEMEN

Background and aims: Parotid gland tumors (PGT) are a moderately scarce group of tumors with a broad range of histopathological manifestations and clinical characteristics. To date, most epidemiological studies on salivary gland tumors including PGT are limited in Yemen and this is one of the first studies, so the aim of the study was to determine the prevalence of different tumors affecting the parotid glands and the effect of age and sex on their distribution. Methods: Epidemiological information as well as demographic data, anatomical site, and histological analysis of PGT were analyzed. The data analyzed included age, sex, site, and histological diagnosis. Data were collected from all histopathological centers covering the majority of Sana'a city between 2019 and 2023. Results: A total of 284 cases- 69% benign and 31% malignant tumors were examined. Both benign and malignant tumors showed a little male inclination (52.5%) and a peak occurrence between the third and fifth decade. Malignant tumors make up 31% of patients, while benign tumors make up 69%. Mucoepidermoid carcinoma (36.4%) and adenoid cystic carcinoma (11.4%) are two common malignant tumor types. Benign parotid tumors include pleomorphic adenoma (71.4%) and Warthin tumors (11.2%) of benigns. Other malignants and benigns are less frequent. Conclusions: This study presents the first prospective study to date to analyze PGT data from health centers spread across Sana'a city. These results should serve the same as the basis for prospect studies assessing the epidemiological geography of these tumors in Sana'a in particular and Yemen in general. Peer Review History: Received 18 May 2024; Reviewed 12 July 2024; Accepted 23 August; Available online 15 September 2024 Academic Editor: Dr. Nuray Arı, Ankara University, Turkiye, ari@ankara.edu.tr Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Asmaa Ahmed Mohamed Ahmed Khalifa, Pharos University, Alexandria, Egypt, asmaa.khalifa@pua.edu.eg Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com

Striated duct adenoma: The cytological description of a rareentity.

Striated duct adenoma is a benign salivary gland tumour recently recognized by the World Health Organization. To date, no report has described the cytological features of this entity. We report the case of a 60-year-old woman with a tumour in the right parotid gland with a diameter greater than 2.4 cm confirmed by imaging tests. Two fine-needle aspiration cytologies (FNAC) were performed with inconclusive results, reporting epithelioid and spindle-shaped cellularity, with little stroma, and nuclei with abundant pseudoinclusions. Myoepithelioma and Schwannoma were proposed as differential diagnoses. An immunocytochemical panel was performed, showing positivity for S-100, SOX10, CK7 and vimentin, and negativity for both myoepithelial (p63 and calponin) and thyroid markers. In the absence of a conclusive diagnosis, the patient accepted surgery. The biopsy results confirmed diagnosis of striated duct adenoma, with immunohistochemical features superimposable to cytology. Little information is available in the literature, both on biopsy and, more strikingly, on cytology of this neoplasm. The aim of this work is to provide cytological characteristics that allow diagnosis of this entity with FNAC and thus avoid unnecessary surgeries.

Research progress in accessory parotid gland tumor surgery

In salivary gland disease, accessory parotid gland (APG) lesions are relatively low, and tumor is the most common manifestation. Currently, surgery is the primary treatment method for APG tumors. Although numerous surgical procedures are available, there is no standard protocol. Due to the location of the APG in the midcheek area, the complications and aesthetic concerns connected with conventional surgery for treating APG tumors sometimes cause significant distress to patients. With the progress of medical technology as well as improving patients' aesthetic and functional requirements, surgical excision methods and incision design are constantly improving. More beautiful and minimally invasive treatments, such as concealed transoral approach and endoscopically aided extracapsular dissection of APG, have been gradually developed. This review focuses on surgical techniques, benefits, and drawbacks of APG tumor surgery that have been carried out and provides an outlook based on the preliminary application of endoscopically assisted accessory parotid tumor resection.

Machine learning-assisted diagnosis of parotid tumor by using contrast-enhanced CT imaging features

PurposeThis study aims to develop a machine learning diagnostic model for parotid gland tumors based on preoperative contrast-enhanced CT imaging features to assist in clinical decision-making. Materials and methodsClinical data and contrast-enhanced CT images of 144 patients with parotid gland tumors from the Peking University School of Stomatology Hospital, collected from January 2019 to December 2022, were gathered. The 3D slicer software was utilized to accurately annotate the tumor regions, followed by exploring the correlation between multiple preoperative contrast-enhanced CT imaging features and the benign or malignant nature of the tumor, as well as the type of benign tumor. A prediction model was constructed using the k-nearest neighbors (KNN) algorithm. ResultsThrough feature selection, four key features—morphology, adjacent structure invasion, boundary, and suspicious cervical lymph node metastasis—were identified as crucial in preoperative discrimination between benign and malignant tumors. The KNN prediction model achieved an accuracy rate of 94.44 %. Additionally, six features including arterial phase CT value, age, delayed phase CT value, pre-contrast CT value, venous phase CT value, and gender, were also significant in the classification of benign tumors, with a KNN prediction model accuracy of 95.24 %. ConclusionThe machine learning model based on preoperative contrast-enhanced CT imaging features can effectively discriminate between benign and malignant parotid gland tumors and classify benign tumors, providing valuable reference information for clinicians.

An analysis of health-related quality of life in children and adolescents after parotidectomy based on patient-reported outcomes.

To assess health-related quality of life (HRQoL) and its influencing factors in these pediatric patients undergoing parotidectomy. This was a cross-sectional study that included 37 children and adolescents (≤ 19years) with parotid gland tumors who were treated in Sichuan Cancer Hospital between January 2006 and November 2021. HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The Wilcoxon rank sum test was used to analyze the factors influencing patients' HRQoL. 37 children and adolescents were included in the study, including 22 cases of benign tumors and 15 cases of malignant tumors. All patients underwent surgery, and some patients with malignant tumors received radiotherapy or chemotherapy. Malignancy, permanent facial palsy, and Frey syndrome were associated with worse HRQoL in children and adolescents with parotid gland tumors. Radiotherapy and no cervical lymph node dissection were associated with worse HRQoL in pediatric patients with malignancy. The surgical approach of parotid is not a factor influencing HRQoL. Factors associated with HRQoL in children and adolescents with parotid gland tumors include pathological types, permanent facial palsy, and Frey syndrome. In addition, factors affecting patients with malignancy include lateral lymph node dissection and radiotherapy.

A Case of Facial Nerve Schwannoma Presenting as a Rapidly Growing Parotid Gland Tumor

A Case of Facial Nerve Schwannoma Presenting as a Rapidly Growing Parotid Gland Tumor

ISOLATED TUBERCULOSIS OF PAROTID GLAND:A COMMON DISEASE AT AN UNCOMMON LOCATION WITH REVIEW OF LITERATURE

Tuberculosis infection is a common health problem in developing countries like India which is caused by Mycobacterium tuberculosis (MTB). It commonly affects the pulmonary system. Although it can affect any organ of the body but salivary glands especially the parotid gland arethe rarest entity that is involved in tuberculosis. Less than 200 cases have been reported in literature till now and mostly diagnosed in post-parotidectomy specimens. Generally, it presents with a painless growing mass and hence, its clinical diagnosis is challenging and may be misdiagnosed as it can mimic parotid gland neoplasm on physical examination. Radiological investigations such as ultrasonography (USG) and computed tomography (CT) are not much beneficial. In such cases, fine needle aspiration cytology (FNAC) is the preliminary step for the workup of the patients. Histologically diagnosis is confirmed by the presence of well-formed epithelioid cell granuloma and acid-fast bacilli (AFB) stain is positive for tubercular bacilli. Here we report a case of tubercular parotitis in a 50-year-old female diagnosed on histopathological examination and patient treated with anti-tubercular therapy (ATT) successfully.

Heterotopic salivary duct inclusions in Warthin tumor – A cryptic histological finding involved in its pathogenesis

Warthin tumor (WT) is the second most common benign parotid gland tumor after pleomorphic adenoma. WT is characterized by cystic and papillary proliferation of a two-layered oncocytic epithelium supported by lymphoid tissue. Heterotopic salivary duct inclusions (SDIs) are frequently observed in lymph nodes (LNs) of WT (SDI/LNs), and are thought to be the origin of WT. If this is true, SDIs should also persist in the lymphoid tissue of WT itself (SDI/WT), as a missing link between SDIs and WTs, but studies of this issue are limited. From 2008–2023, 138 WT cases were surgically excised at our hospital. SDI/LNs and SDI/WTs were histologically examined. Of 100 WT cases with LNs, SDI/LNs were observed in 67 cases (67 %). SDI/WTs were detected in 114 of 138 cases (82.6 %), including 107 of 127 smokers (84.3 %) and 7 of 11 never-smokers (63.6 %). SDI/WTs were located mainly in the subcapsular lymphoid tissue and often surrounded by a fibrous coat resembling salivary excretory ducts. This study revealed a high incidence of SDIs in WT itself, strongly supporting the theory that WT develops from heterotopic salivary ducts.

Areal differences in the rate of operative care for cancer of the head and neck within one hospital district in Northern Finland

Abstract Aim The relationship between socioeconomic status (SES) and cancers of the head and neck has been described previously. The present study investigated areal differences in the rate of operative care of cancers of the head and neck in terms of SES and rural–urban areas. Methods This retrospective cohort study included operations performed in Northern Finland between 1 January 2014 and 31 December 2019. SES and the rurality of the residence was determined using postal codes. Results Patients from the low-income areas were older and had higher American Society of Anesthesiologists classification than patients from middle- and high-income areas. The number of operated thyroid and parotid gland tumours was higher in the high-income areas (n = 36 [33.0%] vs n = 21 [18.8%] and n = 330 [28.6%], p = 0.049). Patients living in low- or median-income areas were more likely to live in rural areas than patients living in high-income areas (n = 55 [49.1%] and n = 62 [59.0%] vs n = 44 [40.4%], p = 0.024). The age-weighted rate of operations was higher in low-income areas than in high-income areas (29.3 [23.9–29.3] vs 17.9 [14.5–21.2]), and the age-weighted rate of free-flap surgery was highest in the low-income areas (16.8 [12.4–21.2] vs 8.2 [5.7–10.6] and 9.6 [7.0–12.1] /100,000 inhabitants/year). Conclusion There are significant areal differences in the rate of ablative head and neck surgery. Significantly higher rates were found in low-income areas and in rural areas.

Diagnostic performance of MRI-based radiomics models using machine learning approaches for the triple classification of parotid tumors

Rationale and objectivesPreoperative differentiation of malignant tumors (MT), pleomorphic adenomas (PA), and other benign tumors of the parotid gland is critical to clinical strategy, this study aimed to develop and validate a T2-weighted image (T2WI) based radiomics model through machine learning approaches for the triple classification of parotid gland tumors. Materials and methodsWe retrospectively enrolled 147 patients from January 2010 to July 2022. T2WIs were used to extract radiomics features. Max-Relevance and Min-Redundancy (mRMR) and Extreme Gradient Boosting (XGBoost) algorithms were used to select features. Using a 5-fold cross-validation strategy, radiomics models were constructed using a Support Vector Machine (SVM), Logistic Regression (LR), and k-Nearest Neighbor (KNN) for the triple classification of parotid tumors. The three models were evaluated and compared using the receiver operator characteristic (ROC) curve, sensitivity, specificity, and accuracy. ResultsA total of 1057 radiomics features were extracted, and 8 features were selected to developed the radiomics model, including First-order Median, First-order Skewness, First-order Minimum, Original_shape_Flatness, Glcm Inverse Variance, Glcm Inverse Variance, Glszm Low Gray Level Zone Emphasis, and Glszm Small Area Low Gray Level Emphasis. The mean area under the curves (AUCs) for the radiomics models in training and validation sets through LR, SVM and KNN were 0.85 and 0.80, 0.85 and 0.80 and 0.83 and 0.79, respectively. ConclusionThe T2WI-based radiomics models through LR, SVM and KNN demonstrated good performance in the triple classification of parotid tumors.

Could Obesity Be Related to the Increasing Incidence of Warthin Tumors?

Background: The number of patients diagnosed with Warthin tumors (WTs) has increased significantly in recent years. The association of obesity as measured by body mass index (BMI) with the incidence of WTs remains unclear. This retrospective study aims to compare the BMI and other clinical factors of patients diagnosed with WTs to those with other benign epithelial parotid gland tumors. Methods: Over a 24-year period, 465 cases of benign epithelial parotid gland tumors were treated in our department. Of these, 155 (33.3%) were diagnosed as WTs. The results of the WT group were compared with those of another benign epithelial parotid gland tumor. Results: The mean BMI of WT patients was 27.3, which was significantly higher than in other benign tumors (25.52; p < 0.001). Furthermore, statistically significant correlations were observed, including a higher incidence of WT in males (p < 0.001), in the elderly (p < 0.001), and in cigarette smokers (p < 0.001). Additionally, a higher prevalence of other head and neck cancers was confirmed in patients with WTs (p = 0.004); Conclusions: This study supports the multifactorial etiology of WT development. Among these factors, smoking, advanced age, and obesity have been identified as factors associated with the development of WT, which might be due to chronic inflammation linked to obesity.