BACKGROUND Lung cancer(LC)is the leading cause of malignancy-related deaths worldwide.The most common sites of metastasis include the nervous system,bone,liver,respiratory system,and adrenal glands.LC metastasis in th...BACKGROUND Lung cancer(LC)is the leading cause of malignancy-related deaths worldwide.The most common sites of metastasis include the nervous system,bone,liver,respiratory system,and adrenal glands.LC metastasis in the parotid gland is very rare,and its diagnosis presents a challenge.Here,we report a case of parotid metastasis in primary LC.CASE SUMMARY The patient was a 74-year-old male who was discovered to have bilateral facial asymmetry inadvertently two years ago.The right earlobe was slightly swollen and without pain or numbness.Computed tomography(CT)examination showed bilateral lung space-occupying lesions.Pulmonary biopsy was performed and revealed adenocarcinoma(right-upper-lung nodule tissue).Positron emission tomography-CT examination showed:(1)Two hypermetabolic nodules in the right upper lobe of the lung,enlarged hy-permetabolic lymph nodes in the right hilar and mediastinum,and malignant space-occupying lesion in the right upper lobe of the lung and possible metastasis to the right hilar and mediastinal lymph nodes;and(2)multiple hypermetabolic nodules in bilateral parotid glands.Parotid puncture biopsy was performed considering lung adenocarcinoma metastasis.Gene detection of lung biopsy specimens revealed an EGFR gene 21 exon L858R mutation.CONCLUSION This case report highlights the challenging diagnosis of parotid metastasis in LC given its rare nature.Such lesions should be differentiated from primary tumors of the parotid gland.Simple radiological imaging is unreliable,and puncture biopsy is needed for final diagnosis of this condition.展开更多
Introduction: The parotid tumors are benign or malignant, primary or secondary neoformations developed at the expense of the parotid gland. The aim of the present study was to describe the indications and results of p...Introduction: The parotid tumors are benign or malignant, primary or secondary neoformations developed at the expense of the parotid gland. The aim of the present study was to describe the indications and results of parotidectomies in the ENT department of the Idrissa Pouye General Hospital in Dakar. Patients & Methods: We conducted a retrospective study between January 1, 2004 and December 31, 2012, including all patients who had been consulted for a parotid tumor with or without histological evidence collected in the otolaryngology and anatomy-pathology department of the Idrissa Pouye General Hospital in Dakar. Results: We collected 31 patient files. The mean age was 47.45 years, with extremes of 16 and 74 years. Females predominated, with a sex ratio of 0.82. Swelling of the parotid region was the main reason for consultation in 100% of cases. Parotidectomy was the most frequently performed procedure, accounting for 41.93%. Benign tumors accounted for 72% of cases, the majority being pleomorphic adenomas (50%). The outcome was favorable in 67.74% of cases. Conclusion: Management of parotid tumors at HOGIP would be improved by informing and educating patients to consult early, and by upgrading the technical platform.展开更多
BACKGROUND Benign lymphoepithelial cyst(BLEC)of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus(HIV)-positive ad...BACKGROUND Benign lymphoepithelial cyst(BLEC)of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus(HIV)-positive adults and rarely in non-acquired immune deficiency syndrome patients.The main presentation is a slow-growing,painless mass,and secondary infection may cause acute inflammatory symptoms.CASE SUMMARY A 44-year-old Chinese male patient presented with a 1-year history of a mass in the left side of the neck.On physical examination,a mass similar in size and shape to a quail egg was found in the left parotid gland.The mass was tough,without tenderness,and easily moveable.The results of HIV tests,including antibody and nucleic acid tests and CD4+T cell examination,were negative.Imaging examination revealed a left parotid gland mass.The patient underwent surgical treatment,and BLEC was diagnosed based on postoperative pathology.After 2years of follow-up,the patient survived well without related discomfort.CONCLUSION The detailed characteristics of a BLEC in a patient without HIV infection contribute to an improved understanding of this rare disease.展开更多
BACKGROUND When a firm facial mass in the cheek region is associated with a high index of clinical suspicion of its being of parotid gland origin,preventive parotidectomy is invariably performed.We report a rare case ...BACKGROUND When a firm facial mass in the cheek region is associated with a high index of clinical suspicion of its being of parotid gland origin,preventive parotidectomy is invariably performed.We report a rare case of a schwannoma that was suspected to be of parotid gland origin in a patient,who underwent successful surgical management using a modified-Blair incision and superficial musculoaponeurotic system(SMAS)layer folding method.CASE SUMMARY A 27-year-old woman presented to the hospital for evaluation of a firm,fixed,non-tender mass(2.5 cm×3.5 cm),located anterior to the right ear,of 1 year’s duration.Contrast-enhanced facial computed tomography revealed a wellencapsulated,low-density mass adherent to the superficial lobe of the right parotid gland,with a high index of clinical suspicion of an accessory parotid gland mass.The patient was scheduled to undergo resection of the mass and superficial parotidectomy.She underwent surgery using a modified-Blair incision,and the SMAS layer was folded posteriorly to reconstruct the defect.Histopathological examination confirmed the diagnosis of a schwannoma.,and we observed no postoperative complications such as hematoma,infection,or abnormal facial expressions.The incision scar was unnoticeable 2 mo postoperatively,and the facial contour was maintained without any differences between the affected and unaffected sides.CONCLUSION We used a modified-Blair incision and SMAS layer folding method to achieve aesthetically good results following resection of a rare schwannoma with superficial parotidectomy in the cheek region.展开更多
Kimura’s disease is a rare chronic affection of unknown etiology, endemic in the far east with a net male predominance. We present the case of a 37-year-old female patient who developed a tumor process in the left pa...Kimura’s disease is a rare chronic affection of unknown etiology, endemic in the far east with a net male predominance. We present the case of a 37-year-old female patient who developed a tumor process in the left parotid region over a period of 3 years. A total left parotidectomy was performed with simple postoperative course. The anatomopathological study of the surgical specimen was in favor of Kimura’s disease. Through this case and a review of the literature, we present the main clinical, anatomopathological, therapeutic and evolutionary characteristics of this rare disease.展开更多
BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA see...BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA seems impossible. CASE SUMMARY We presented a case of a 54-year-old woman with a mass in the deep lobe of the right parotid gland involving the ipsilateral skull base and mastoid. The patient exhibited gradual right facial swelling but no other obvious symptoms. Combined resection of the total right parotid gland and partial skull base excision were performed. The biopsy conducted before the surgery and sections cut from intraoperatively obtained tissues were not definitive for identifying the character of the neoplasm. A final diagnosis of tubular BCA without malignant elements was established based on postoperative pathology results and immunohistochemical analysis. The tumour did not recur during the 12-mo follow-up period. CONCLUSION A diagnosis of BCA can only be established based on a histopathological examination after an excisional biopsy, and tubular BCA should carefully be considered as a destructive type.展开更多
Multiple parotid gland tumors are unusual. Warthin’s tumor is the most represented neoplasm in this condition. We present a case of bilateral synchronous pleomorphic adenoma affecting the parotid glands in a 28-year-...Multiple parotid gland tumors are unusual. Warthin’s tumor is the most represented neoplasm in this condition. We present a case of bilateral synchronous pleomorphic adenoma affecting the parotid glands in a 28-year-old woman. Clinically, the lesions were similar to solitary pleomorphic adenoma. Both lesions were diagnosed by fine-needle aspiration cytology. A total parotidectomy for left tumor and surgical enucleation for the right tumor, respectively, were performed with no facial nerves injury. A review of the pertinent literature is included.展开更多
Lipoma is a common benign tumor affecting the soft tissues arising in every location where fat is normally present. About 15% of lipomas occur in head and neck region. The lipoma of parotid gland is a rare entity, com...Lipoma is a common benign tumor affecting the soft tissues arising in every location where fat is normally present. About 15% of lipomas occur in head and neck region. The lipoma of parotid gland is a rare entity, comprising 0.6% - 4.4% of all parotid tumors. The etiology remains unclear. The case described a lipoma of the superficial lobe of the parotid gland in a 46-year-old male.展开更多
<strong>Aims:</strong> Superficial parotidectomy (SP) is a commonly performed procedure which traditionally requires a drain and overnight hospital stay. This series aimed to show the safety and efficacy o...<strong>Aims:</strong> Superficial parotidectomy (SP) is a commonly performed procedure which traditionally requires a drain and overnight hospital stay. This series aimed to show the safety and efficacy of drainless day case parotidectomy using ARTISS [Solution for Sealant] fibrin glue. <strong>Materials and Methods:</strong> Patients with a superficial parotid lump with benign preoperative sampling underwent an SP. We initially used both ARTISS and a drain, which was removed when output was <40 mls. ARTISS without drain was then introduced and once confident patients were sent home the same day. <strong>Objectives:</strong> We prospectively collected data and divided groups into ARTISS alone and ARTISS with a drain to compare patients’ length of stay and complication rates. <strong>Results:</strong> 88 patients were included;52 ARTISS alone, 22 as a day case. 42.3% of patients where ARTISS alone was used were discharged within 24 hours, with the remainder between 24 - 48 hours. Comparatively, no ARTISS and drain patients were discharged within 24 hours and 86.1% were discharged between 24 - 48 hours with the remainder over 48 hours. There were 3 postoperative haematomas and none in the drainless group;a statistically significant difference (<em>p</em> = 0.034). Of the 6 recorded salivary leaks, 4 were in the drain group and 2 in the ARTISS alone group (<em>p</em> > 0.05). <strong>Conclusions:</strong> Comparable complication rates and reduced length of stay suggest that ARTISS in SP is safe and effective. These findings stand to benefit both patients and the NHS by improving the patient journey and reducing overall costs.展开更多
AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were col...AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.展开更多
Facial nerve schwannoma occurring within the parotid gland is a rare tumour. We report a case of schwannoma within the parotid gland in a young female patient, who underwent ultrasound and magnetic resonanceimaging(MR...Facial nerve schwannoma occurring within the parotid gland is a rare tumour. We report a case of schwannoma within the parotid gland in a young female patient, who underwent ultrasound and magnetic resonanceimaging(MRI) and subsequent surgical excision of the lesion. The lesion showed hyperintensity on T2-weighted and diffusion-weighted MRI. There was no adjacent lymphadenopathy. Although hyperintensity on diffusionweighted MRI could suggest malignant tumours, the characteristic "string sign" provided the clue for the diagnosis of schwannoma.展开更多
BACKGROUND Warthin’s tumor(WT)is composed of several cysts that are lined with tall,bilayered oncocytic columnar cells and lymphoid stroma.Within WT,the two components rarely transform into carcinoma or lymphoma,and ...BACKGROUND Warthin’s tumor(WT)is composed of several cysts that are lined with tall,bilayered oncocytic columnar cells and lymphoid stroma.Within WT,the two components rarely transform into carcinoma or lymphoma,and when it does,carcinoma is the most common type.Approximately 28 cases of lymphoma with WT have been reported,most of which were non-Hodgkin lymphomas,and only a few cases were Hodgkin lymphomas.In the present report,we studied a case of diffuse large B cell lymphoma(DLBCL)arising from follicular lymphoma(FL)with WT in the parotid gland and its immunophenotypic and genetic features.CASE SUMMARY A 67-year-old man presented with a slowly enlarging right cheek mass for 12 years,and the mass began to change in size over a 2-mo time period.Over time,the patient felt mild local pain and right cheek discomfort.His medical history included a hepatitis B virus infection for 20 years and 30 years of smoking.Gross examination of the excised specimen showed a gray-red and gray-white appearance and a soft texture lobulated external surface neoplasm that measured 9 cm×8 cm×7 cm and was well circumscribed by relative normal parotid gland tissue.In cross section,the cut surfaces of the neoplasm were multicystic and had a homogeneous scaly appearance.A small fluid was discovered in the cyst.Bilateral oxyphilic,cuboidal or polygonal epithelium cells and lymphoid intraparenchymal components were observed.Many medium-to large-sized lymphoid cells were observed diffusely in part of the neoplasm,and a few secondary lymphoid follicles were observed at the center or edge of the neoplasm.Immunohistochemical staining showed that the columnar oncocytic cells were positive for AE1/AE3;neoplastic cells located in coarctate follicular were positive for CD20,Pax-5,bcl-2 and bcl-6;and the adjacent diffusely medium-to large-sized lymphoid cells were positive for Pax-5,bcl-6,CD20,MUM-1,bcl-2 and CD79a.The bcl-6(3q27)break-apart rearrangement was observed,and an Epstein Barr virus test was negative in the tumor cells.The patient survived 6 months after being diagnosed without any treatment.CONCLUSION WT-associated lymphoma is a very rare neoplasm in the parotid gland.Most cases are B cell non-Hodgkin lymphomas and involve middle-age and older males.This case highlights the extremely rare association of DLBCL arising from FL with WT and the importance of deliberate evaluation of the WT intraparenchymal stroma.Molecular detection techniques have potential advantages in the diagnosis of lymphoma with WT.展开更多
Summary: To investigate the relationship between proliferative capacity of salivary gland cells in contiguous acini of parotid tumors and recurrent neoplasma, DNA contents of 30 fresh specimens of parotid were studied...Summary: To investigate the relationship between proliferative capacity of salivary gland cells in contiguous acini of parotid tumors and recurrent neoplasma, DNA contents of 30 fresh specimens of parotid were studied by using cytometry in tumors, normal and shallow or deep lobe acini of the masses. The results showed that the DI was 1. 369, S % 16. 95, PI 26. 18 in malignant tumors; DI was 1. 171, S % 12. 41, PI 15. 54 in recurrent pleomorphic adenoma; DI was 1. 141, S % 12. 74, PI 13. 07 in pleornorphic adenoma, DI was 0. 999, S % 5. 10, PI 8. 00 in normal acini. Analysis of variance showed there was a significant difference (P<0. 01 ). The average DNA contents of shallow on deep lobe of contiguous tumors was 1. 08 in DI, 10. 65 in S %, 13. 49 in PI in malignant tumor, 1. 06 in DI, 8. 96 in S % and 9. 85 in PI in pleomorphic adenoma, which were all higher than in normal acini (P>0. 05). It was concluded that the levels of DI and S % of parotid tumor and its contiguous acini are related to degree of malignancy or recurrent condition of the tumors, suggesting contiguous acini of parotid tumors had the strong capacity of proliferation, which might play an important role in recurrent or malignant change of the parotid tumors.展开更多
Definitive diagnosis of parotid gland masses is required optimal management planning and for prognosis. There is controversy over whether fine needle aspiration cytology(FNAC) or ultrasound guided core biopsy(USCB) sh...Definitive diagnosis of parotid gland masses is required optimal management planning and for prognosis. There is controversy over whether fine needle aspiration cytology(FNAC) or ultrasound guided core biopsy(USCB) should be the standard for obtaining a biopsy. The aim of this review is to assess the current evidence available to assess the benefits of each technique and also to assess the use of intra-operative frozen section(IOFS). Literature searches were performed using pubmed and google scholar. The literature has been reviewed and the evidence is presented. FNAC is an accepted and widely used technique. It has been shown to have variable diagnostic capabilities depending on centres and experience of staff. USCB has a highly consistent diagnostic accuracy and can help with tumour grading and staging. However, the technique is more invasive and there is a question regarding potential for seeding. Furthermore, USCB is less likely to be offered as part of a one-stop clinic. IOFS has no role as a first line diagnostic technique but may be reserved as an adjunct or for lesions not amenable to percutaneous biopsy. On balance, USCB seems to be the method of choice. The current evidence suggests it has superior diagnostic potential and is safe. With time, USCB is likely to supplant FNAC as the biopsy technique of choice, replicating that which has occurred already in other areas of medicine such a breast practice.展开更多
Proline contents of parotid glands (PG) in pigs constantly increase after the inclusion of different amounts of ripe hulled acorns in the diet providing high polyphenols levels. The dose-response relationship was esti...Proline contents of parotid glands (PG) in pigs constantly increase after the inclusion of different amounts of ripe hulled acorns in the diet providing high polyphenols levels. The dose-response relationship was estimated on natural hydrolizable tannins (expressed as tannic acid equivalent TAE) amounts of 25.8 to 36.1 g TAE/kg DM in experimental diets. Macroscopic and histological morphometry of parotid glands greatly varied according to feed intake and dosages of TAE ingested. The PG response (hypertrophy grade) on acorns’ tannins content in the diet was positively correlated (R2 = 0.748): the response to the protein precipitating activity (PPA) of tannins consisted of a functional parotidomegaly (hypertrophy), 1.34 up to 3.55 folds than control PGs, following an oral dosage 0.596 up 1.72 TAE g·kg body weight·d-1 respectively, after one week exposure.展开更多
Pleomorphic adenoma is the most common benign parotid gland tumor. Although its local recurrence rate is known to be high, the recurrence extending to the cervical region is rare. Here we report a case of a young fema...Pleomorphic adenoma is the most common benign parotid gland tumor. Although its local recurrence rate is known to be high, the recurrence extending to the cervical region is rare. Here we report a case of a young female (25 years old) with pleomorphic adenoma of the parotid gland which showed multiple recurrences through facial to cervical regions over a span of eight years. We also discuss how this benign tumor with a high recurrence rate has been treated in other cases, and how it should be treated.展开更多
Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosi...Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosis. Methods: We present a case of a 71-year-old male with an enlarging left neck mass over several months. CT showed both a parapharyngeal space mass and a separate level II neck mass. Results: The patient underwent resection of the left parapharyngeal mass and ipsilateral selective level II-IV lymphadenectomy. The final pathologic diagnosis was metastatic high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma. Conclusions: We describe a novel presentation of high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma as a metastatic parapharyngeal mass.展开更多
This paper reports two seronegative cases of parotid swelling following MMR vaccination,which contains Hoshino strain of mumps virus.This study showed a high,(5%) potential reactogenicity induced by Hoshino strain of ...This paper reports two seronegative cases of parotid swelling following MMR vaccination,which contains Hoshino strain of mumps virus.This study showed a high,(5%) potential reactogenicity induced by Hoshino strain of current MMR vaccine administered in Iranian EPI.The rate of complication of parotid swelling following national immunization against mumps is more than natural infection.Based on the results of this report, there is the first report of occurrence of parotid swelling 31 days following MMR vaccination.This reaction or complication may not be dependent on the vaccine dose,because one of cases presented parotid swelling following taking one fifth of conventional dose of vaccine.It must be considered this strain may be with high rate of complication and be the subject of change of mumps strain of this vaccine in national immunization program of Iran.展开更多
Snakebite is a common medical emergency in India.Unusual complications may occur after viper bite.Bilateral parotid enlargement after viper bite is a rare entity.An 18-year old gentleman presented to our hospital with...Snakebite is a common medical emergency in India.Unusual complications may occur after viper bite.Bilateral parotid enlargement after viper bite is a rare entity.An 18-year old gentleman presented to our hospital with history of viper bite.On examination he had cellulitis of right lower limb.He developed swelling of both the parotid glands 12 h after admission.He developed coagulopathy,acute renal failure and died within 48 h of hospital admission.Development of parotid swelling after snake bite is associated with poor prognosis.This case is found worth reporting as it is an unusual complication having prognostic value.展开更多
Sonography was performed on 104 cases with parotid tumors. The shape, boundary and internal echoes were related to the malignancy of the tumor. The diagnostic criteria of parotid tumors were proposed. The sonograms of...Sonography was performed on 104 cases with parotid tumors. The shape, boundary and internal echoes were related to the malignancy of the tumor. The diagnostic criteria of parotid tumors were proposed. The sonograms of 32 surgical specimens of parotid tumors were compared with histopathologic findings to investigate the pathologic bases of various sonograms. The boundary echoes were related to integrity of the capsule of the tumor. The internal echoes were related to internal structures of the tumor.展开更多
文摘BACKGROUND Lung cancer(LC)is the leading cause of malignancy-related deaths worldwide.The most common sites of metastasis include the nervous system,bone,liver,respiratory system,and adrenal glands.LC metastasis in the parotid gland is very rare,and its diagnosis presents a challenge.Here,we report a case of parotid metastasis in primary LC.CASE SUMMARY The patient was a 74-year-old male who was discovered to have bilateral facial asymmetry inadvertently two years ago.The right earlobe was slightly swollen and without pain or numbness.Computed tomography(CT)examination showed bilateral lung space-occupying lesions.Pulmonary biopsy was performed and revealed adenocarcinoma(right-upper-lung nodule tissue).Positron emission tomography-CT examination showed:(1)Two hypermetabolic nodules in the right upper lobe of the lung,enlarged hy-permetabolic lymph nodes in the right hilar and mediastinum,and malignant space-occupying lesion in the right upper lobe of the lung and possible metastasis to the right hilar and mediastinal lymph nodes;and(2)multiple hypermetabolic nodules in bilateral parotid glands.Parotid puncture biopsy was performed considering lung adenocarcinoma metastasis.Gene detection of lung biopsy specimens revealed an EGFR gene 21 exon L858R mutation.CONCLUSION This case report highlights the challenging diagnosis of parotid metastasis in LC given its rare nature.Such lesions should be differentiated from primary tumors of the parotid gland.Simple radiological imaging is unreliable,and puncture biopsy is needed for final diagnosis of this condition.
文摘Introduction: The parotid tumors are benign or malignant, primary or secondary neoformations developed at the expense of the parotid gland. The aim of the present study was to describe the indications and results of parotidectomies in the ENT department of the Idrissa Pouye General Hospital in Dakar. Patients & Methods: We conducted a retrospective study between January 1, 2004 and December 31, 2012, including all patients who had been consulted for a parotid tumor with or without histological evidence collected in the otolaryngology and anatomy-pathology department of the Idrissa Pouye General Hospital in Dakar. Results: We collected 31 patient files. The mean age was 47.45 years, with extremes of 16 and 74 years. Females predominated, with a sex ratio of 0.82. Swelling of the parotid region was the main reason for consultation in 100% of cases. Parotidectomy was the most frequently performed procedure, accounting for 41.93%. Benign tumors accounted for 72% of cases, the majority being pleomorphic adenomas (50%). The outcome was favorable in 67.74% of cases. Conclusion: Management of parotid tumors at HOGIP would be improved by informing and educating patients to consult early, and by upgrading the technical platform.
基金Supported by Zunyi Medical College Research Start Fund,No.2017CK-1130-038。
文摘BACKGROUND Benign lymphoepithelial cyst(BLEC)of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus(HIV)-positive adults and rarely in non-acquired immune deficiency syndrome patients.The main presentation is a slow-growing,painless mass,and secondary infection may cause acute inflammatory symptoms.CASE SUMMARY A 44-year-old Chinese male patient presented with a 1-year history of a mass in the left side of the neck.On physical examination,a mass similar in size and shape to a quail egg was found in the left parotid gland.The mass was tough,without tenderness,and easily moveable.The results of HIV tests,including antibody and nucleic acid tests and CD4+T cell examination,were negative.Imaging examination revealed a left parotid gland mass.The patient underwent surgical treatment,and BLEC was diagnosed based on postoperative pathology.After 2years of follow-up,the patient survived well without related discomfort.CONCLUSION The detailed characteristics of a BLEC in a patient without HIV infection contribute to an improved understanding of this rare disease.
基金Supported by Soonchunhyang Research Fund,No.2023-0030.
文摘BACKGROUND When a firm facial mass in the cheek region is associated with a high index of clinical suspicion of its being of parotid gland origin,preventive parotidectomy is invariably performed.We report a rare case of a schwannoma that was suspected to be of parotid gland origin in a patient,who underwent successful surgical management using a modified-Blair incision and superficial musculoaponeurotic system(SMAS)layer folding method.CASE SUMMARY A 27-year-old woman presented to the hospital for evaluation of a firm,fixed,non-tender mass(2.5 cm×3.5 cm),located anterior to the right ear,of 1 year’s duration.Contrast-enhanced facial computed tomography revealed a wellencapsulated,low-density mass adherent to the superficial lobe of the right parotid gland,with a high index of clinical suspicion of an accessory parotid gland mass.The patient was scheduled to undergo resection of the mass and superficial parotidectomy.She underwent surgery using a modified-Blair incision,and the SMAS layer was folded posteriorly to reconstruct the defect.Histopathological examination confirmed the diagnosis of a schwannoma.,and we observed no postoperative complications such as hematoma,infection,or abnormal facial expressions.The incision scar was unnoticeable 2 mo postoperatively,and the facial contour was maintained without any differences between the affected and unaffected sides.CONCLUSION We used a modified-Blair incision and SMAS layer folding method to achieve aesthetically good results following resection of a rare schwannoma with superficial parotidectomy in the cheek region.
文摘Kimura’s disease is a rare chronic affection of unknown etiology, endemic in the far east with a net male predominance. We present the case of a 37-year-old female patient who developed a tumor process in the left parotid region over a period of 3 years. A total left parotidectomy was performed with simple postoperative course. The anatomopathological study of the surgical specimen was in favor of Kimura’s disease. Through this case and a review of the literature, we present the main clinical, anatomopathological, therapeutic and evolutionary characteristics of this rare disease.
文摘BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA seems impossible. CASE SUMMARY We presented a case of a 54-year-old woman with a mass in the deep lobe of the right parotid gland involving the ipsilateral skull base and mastoid. The patient exhibited gradual right facial swelling but no other obvious symptoms. Combined resection of the total right parotid gland and partial skull base excision were performed. The biopsy conducted before the surgery and sections cut from intraoperatively obtained tissues were not definitive for identifying the character of the neoplasm. A final diagnosis of tubular BCA without malignant elements was established based on postoperative pathology results and immunohistochemical analysis. The tumour did not recur during the 12-mo follow-up period. CONCLUSION A diagnosis of BCA can only be established based on a histopathological examination after an excisional biopsy, and tubular BCA should carefully be considered as a destructive type.
文摘Multiple parotid gland tumors are unusual. Warthin’s tumor is the most represented neoplasm in this condition. We present a case of bilateral synchronous pleomorphic adenoma affecting the parotid glands in a 28-year-old woman. Clinically, the lesions were similar to solitary pleomorphic adenoma. Both lesions were diagnosed by fine-needle aspiration cytology. A total parotidectomy for left tumor and surgical enucleation for the right tumor, respectively, were performed with no facial nerves injury. A review of the pertinent literature is included.
文摘Lipoma is a common benign tumor affecting the soft tissues arising in every location where fat is normally present. About 15% of lipomas occur in head and neck region. The lipoma of parotid gland is a rare entity, comprising 0.6% - 4.4% of all parotid tumors. The etiology remains unclear. The case described a lipoma of the superficial lobe of the parotid gland in a 46-year-old male.
文摘<strong>Aims:</strong> Superficial parotidectomy (SP) is a commonly performed procedure which traditionally requires a drain and overnight hospital stay. This series aimed to show the safety and efficacy of drainless day case parotidectomy using ARTISS [Solution for Sealant] fibrin glue. <strong>Materials and Methods:</strong> Patients with a superficial parotid lump with benign preoperative sampling underwent an SP. We initially used both ARTISS and a drain, which was removed when output was <40 mls. ARTISS without drain was then introduced and once confident patients were sent home the same day. <strong>Objectives:</strong> We prospectively collected data and divided groups into ARTISS alone and ARTISS with a drain to compare patients’ length of stay and complication rates. <strong>Results:</strong> 88 patients were included;52 ARTISS alone, 22 as a day case. 42.3% of patients where ARTISS alone was used were discharged within 24 hours, with the remainder between 24 - 48 hours. Comparatively, no ARTISS and drain patients were discharged within 24 hours and 86.1% were discharged between 24 - 48 hours with the remainder over 48 hours. There were 3 postoperative haematomas and none in the drainless group;a statistically significant difference (<em>p</em> = 0.034). Of the 6 recorded salivary leaks, 4 were in the drain group and 2 in the ARTISS alone group (<em>p</em> > 0.05). <strong>Conclusions:</strong> Comparable complication rates and reduced length of stay suggest that ARTISS in SP is safe and effective. These findings stand to benefit both patients and the NHS by improving the patient journey and reducing overall costs.
文摘AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.
文摘Facial nerve schwannoma occurring within the parotid gland is a rare tumour. We report a case of schwannoma within the parotid gland in a young female patient, who underwent ultrasound and magnetic resonanceimaging(MRI) and subsequent surgical excision of the lesion. The lesion showed hyperintensity on T2-weighted and diffusion-weighted MRI. There was no adjacent lymphadenopathy. Although hyperintensity on diffusionweighted MRI could suggest malignant tumours, the characteristic "string sign" provided the clue for the diagnosis of schwannoma.
文摘BACKGROUND Warthin’s tumor(WT)is composed of several cysts that are lined with tall,bilayered oncocytic columnar cells and lymphoid stroma.Within WT,the two components rarely transform into carcinoma or lymphoma,and when it does,carcinoma is the most common type.Approximately 28 cases of lymphoma with WT have been reported,most of which were non-Hodgkin lymphomas,and only a few cases were Hodgkin lymphomas.In the present report,we studied a case of diffuse large B cell lymphoma(DLBCL)arising from follicular lymphoma(FL)with WT in the parotid gland and its immunophenotypic and genetic features.CASE SUMMARY A 67-year-old man presented with a slowly enlarging right cheek mass for 12 years,and the mass began to change in size over a 2-mo time period.Over time,the patient felt mild local pain and right cheek discomfort.His medical history included a hepatitis B virus infection for 20 years and 30 years of smoking.Gross examination of the excised specimen showed a gray-red and gray-white appearance and a soft texture lobulated external surface neoplasm that measured 9 cm×8 cm×7 cm and was well circumscribed by relative normal parotid gland tissue.In cross section,the cut surfaces of the neoplasm were multicystic and had a homogeneous scaly appearance.A small fluid was discovered in the cyst.Bilateral oxyphilic,cuboidal or polygonal epithelium cells and lymphoid intraparenchymal components were observed.Many medium-to large-sized lymphoid cells were observed diffusely in part of the neoplasm,and a few secondary lymphoid follicles were observed at the center or edge of the neoplasm.Immunohistochemical staining showed that the columnar oncocytic cells were positive for AE1/AE3;neoplastic cells located in coarctate follicular were positive for CD20,Pax-5,bcl-2 and bcl-6;and the adjacent diffusely medium-to large-sized lymphoid cells were positive for Pax-5,bcl-6,CD20,MUM-1,bcl-2 and CD79a.The bcl-6(3q27)break-apart rearrangement was observed,and an Epstein Barr virus test was negative in the tumor cells.The patient survived 6 months after being diagnosed without any treatment.CONCLUSION WT-associated lymphoma is a very rare neoplasm in the parotid gland.Most cases are B cell non-Hodgkin lymphomas and involve middle-age and older males.This case highlights the extremely rare association of DLBCL arising from FL with WT and the importance of deliberate evaluation of the WT intraparenchymal stroma.Molecular detection techniques have potential advantages in the diagnosis of lymphoma with WT.
文摘Summary: To investigate the relationship between proliferative capacity of salivary gland cells in contiguous acini of parotid tumors and recurrent neoplasma, DNA contents of 30 fresh specimens of parotid were studied by using cytometry in tumors, normal and shallow or deep lobe acini of the masses. The results showed that the DI was 1. 369, S % 16. 95, PI 26. 18 in malignant tumors; DI was 1. 171, S % 12. 41, PI 15. 54 in recurrent pleomorphic adenoma; DI was 1. 141, S % 12. 74, PI 13. 07 in pleornorphic adenoma, DI was 0. 999, S % 5. 10, PI 8. 00 in normal acini. Analysis of variance showed there was a significant difference (P<0. 01 ). The average DNA contents of shallow on deep lobe of contiguous tumors was 1. 08 in DI, 10. 65 in S %, 13. 49 in PI in malignant tumor, 1. 06 in DI, 8. 96 in S % and 9. 85 in PI in pleomorphic adenoma, which were all higher than in normal acini (P>0. 05). It was concluded that the levels of DI and S % of parotid tumor and its contiguous acini are related to degree of malignancy or recurrent condition of the tumors, suggesting contiguous acini of parotid tumors had the strong capacity of proliferation, which might play an important role in recurrent or malignant change of the parotid tumors.
文摘Definitive diagnosis of parotid gland masses is required optimal management planning and for prognosis. There is controversy over whether fine needle aspiration cytology(FNAC) or ultrasound guided core biopsy(USCB) should be the standard for obtaining a biopsy. The aim of this review is to assess the current evidence available to assess the benefits of each technique and also to assess the use of intra-operative frozen section(IOFS). Literature searches were performed using pubmed and google scholar. The literature has been reviewed and the evidence is presented. FNAC is an accepted and widely used technique. It has been shown to have variable diagnostic capabilities depending on centres and experience of staff. USCB has a highly consistent diagnostic accuracy and can help with tumour grading and staging. However, the technique is more invasive and there is a question regarding potential for seeding. Furthermore, USCB is less likely to be offered as part of a one-stop clinic. IOFS has no role as a first line diagnostic technique but may be reserved as an adjunct or for lesions not amenable to percutaneous biopsy. On balance, USCB seems to be the method of choice. The current evidence suggests it has superior diagnostic potential and is safe. With time, USCB is likely to supplant FNAC as the biopsy technique of choice, replicating that which has occurred already in other areas of medicine such a breast practice.
文摘Proline contents of parotid glands (PG) in pigs constantly increase after the inclusion of different amounts of ripe hulled acorns in the diet providing high polyphenols levels. The dose-response relationship was estimated on natural hydrolizable tannins (expressed as tannic acid equivalent TAE) amounts of 25.8 to 36.1 g TAE/kg DM in experimental diets. Macroscopic and histological morphometry of parotid glands greatly varied according to feed intake and dosages of TAE ingested. The PG response (hypertrophy grade) on acorns’ tannins content in the diet was positively correlated (R2 = 0.748): the response to the protein precipitating activity (PPA) of tannins consisted of a functional parotidomegaly (hypertrophy), 1.34 up to 3.55 folds than control PGs, following an oral dosage 0.596 up 1.72 TAE g·kg body weight·d-1 respectively, after one week exposure.
文摘Pleomorphic adenoma is the most common benign parotid gland tumor. Although its local recurrence rate is known to be high, the recurrence extending to the cervical region is rare. Here we report a case of a young female (25 years old) with pleomorphic adenoma of the parotid gland which showed multiple recurrences through facial to cervical regions over a span of eight years. We also discuss how this benign tumor with a high recurrence rate has been treated in other cases, and how it should be treated.
文摘Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosis. Methods: We present a case of a 71-year-old male with an enlarging left neck mass over several months. CT showed both a parapharyngeal space mass and a separate level II neck mass. Results: The patient underwent resection of the left parapharyngeal mass and ipsilateral selective level II-IV lymphadenectomy. The final pathologic diagnosis was metastatic high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma. Conclusions: We describe a novel presentation of high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma as a metastatic parapharyngeal mass.
基金deputy research of Shahr-e-kord University of Medical Sciences for their financial supports
文摘This paper reports two seronegative cases of parotid swelling following MMR vaccination,which contains Hoshino strain of mumps virus.This study showed a high,(5%) potential reactogenicity induced by Hoshino strain of current MMR vaccine administered in Iranian EPI.The rate of complication of parotid swelling following national immunization against mumps is more than natural infection.Based on the results of this report, there is the first report of occurrence of parotid swelling 31 days following MMR vaccination.This reaction or complication may not be dependent on the vaccine dose,because one of cases presented parotid swelling following taking one fifth of conventional dose of vaccine.It must be considered this strain may be with high rate of complication and be the subject of change of mumps strain of this vaccine in national immunization program of Iran.
文摘Snakebite is a common medical emergency in India.Unusual complications may occur after viper bite.Bilateral parotid enlargement after viper bite is a rare entity.An 18-year old gentleman presented to our hospital with history of viper bite.On examination he had cellulitis of right lower limb.He developed swelling of both the parotid glands 12 h after admission.He developed coagulopathy,acute renal failure and died within 48 h of hospital admission.Development of parotid swelling after snake bite is associated with poor prognosis.This case is found worth reporting as it is an unusual complication having prognostic value.
文摘Sonography was performed on 104 cases with parotid tumors. The shape, boundary and internal echoes were related to the malignancy of the tumor. The diagnostic criteria of parotid tumors were proposed. The sonograms of 32 surgical specimens of parotid tumors were compared with histopathologic findings to investigate the pathologic bases of various sonograms. The boundary echoes were related to integrity of the capsule of the tumor. The internal echoes were related to internal structures of the tumor.
