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Sample records for parotid gland surgery

  1. Accessory parotid gland tumors

    PubMed Central

    Ramachar, Sreevathsa M.; Huliyappa, Harsha A.

    2012-01-01

    Tumors of accessory parotid gland are considered in the differential diagnosis of a mid cheek mass. Parotidectomy is the procedure of choice. All pathological types of parotid main gland tumors occur in the accessory parotid gland also. Presenting as a mid cheek or infrazygomatic mass, the tumors of this accessory parotid gland are notorious for recurrences, if adequate margins are not achieved. We describe two such cases of such a tumor. 40-year-old male with a slowly progressive mid cheek mass was operated by a mid cheek incision. Histopathology of the tumor was pleomorphic adenoma. Facial nerve paresis recovered complelety in 6 months. A 52-year-old female with progressive mid cheek mass who underwent parotidectomy and neck dissection by a modified Blair's incision was diagnosed with extranodal marginal zone lymphoma with focal transformation to a diffuse large B-cell lymphoma. Chemotherapy with CHOP regime was initiated. There was no recurrence at 6 months of follow-up. Lymphoma of accessory parotid gland is a very rare tumor. Standard parotidectomy incision is advocated to prevent damage to facial nerve branches. PMID:23483721

  2. Ectopic thyroid tissue in the parotid salivary gland.

    PubMed

    Mysorekar, V V; Dandekar, C P; Sreevathsa, M R

    2004-09-01

    Benign ectopic thyroid tissue within the parotid salivary gland is very rare. A 32-year-old woman presented with a slowly-growing, painless mass in the parotid region. The mass, which was clinically diagnosed as a parotid tumour, was found at surgery to be cystic in nature. Histological examination showed thyroid tissue with secondary changes in the cyst wall and colloid in the lumen. On iodine isotope scan, the thyroid gland was found in its normal location. The possible origin of the ectopic thyroid tissue in the parotid salivary gland could be due to a common evolution of the thyroid and parotid glands, a heteroplasia or a metaplasia.

  3. Sialolipoma of the parotid gland.

    PubMed

    Doğan, Sedat; Can, Ilknur Haberal; Unlü, Ilhan; Süngü, Nuran; Gönültaş, Mehmet Alparslan; Samim, Ethem Erdal

    2009-05-01

    A 33-year-old male patient with a slow-growing, painless, well-circumscribed soft tissue mass on the left parotid region is presented. The clinical impression was that of a benign salivary gland tumor. The tumor was situated in the superficial lobe of the gland, and a superficial parotidectomy was performed, with preservation of the facial nerve. Histopathologic examination results revealed a sialolipoma of the parotid gland and a lesion that consisted of both mature adipose tissue and glandular elements. Sialolipomas share similar clinical features with conventional lipomas of the salivary glands. Preoperative diagnosis is generally difficult, and computed tomographic scanning is useful in defining these benign parotid gland masses. Superficial parotidectomy is the usual surgical treatment for parotid gland superficial lobe lipomas, with near-total absence of recurrence.

  4. [Tumor of the Parotid Gland].

    PubMed

    Pötzl, Teresa; Iselin, Sabine; Husner, Alexander

    2016-05-11

    Salivary gland tumors are a rare, histologically heterogeneous group of tumors which constitute approximately 4–6 % of all head and neck neoplasms. In 2/3 of cases they are benign, especially in the parotid gland. We report about a rare tumor of the parotid gland presenting as an extraskeletal chondroma. Histologically there were multiple S 100 protein-positive nests of chondrocytes. The externally completed cytology suspected a pleomorphic adenoma, nevertheless, the final histopathological findings showed another tumor entity.

  5. [Bilateral sarcoidosis of parotid glands].

    PubMed

    Hahn, Pernille; Krogdahl, Annelise; Godballe, Christian

    2012-04-23

    We describe an unusual case of sarcoidosis in which the patient presented with a bilateral swelling of the parotid salivary glands and no other manifestation of the disease. Sarcoidosis is a multisystem granulomatous disorder of unknown cause in which there may be multiple exocrine involvement, including the salivary glands. This case emphasises the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling. PMID:22533935

  6. [Oncocytic carcinoma of the parotid gland: a case report].

    PubMed

    Jiang, Richeng; Wang, Xin; Tong, Lingling

    2015-07-01

    Approximately 3% of all head and neck neoplasms originate in the parotid gland and less than 1% are oncocytic. We present the rare case of a 63-year-old woman with oncocytic carcinoma of the parotid gland with facial nerve invasion and discuss the characteristics of this rare entity. Based on the results of medical history, physical examination, computed tomography and postoperative histopathological diagnosis, oncocytic carcinoma of the parotid gland was diagnosed. Treatment involved complete parotid gland removal and right neck dissection. Adjuvant radiotherapy and chemotherapy were followed by operation. As of 9 months following surgery, no recurrence has been identified, but long-term results are undefined. PMID:26540931

  7. [Tumor of the Parotid Gland].

    PubMed

    Pötzl, Teresa; Iselin, Sabine; Husner, Alexander

    2016-05-11

    Salivary gland tumors are a rare, histologically heterogeneous group of tumors which constitute approximately 4–6 % of all head and neck neoplasms. In 2/3 of cases they are benign, especially in the parotid gland. We report about a rare tumor of the parotid gland presenting as an extraskeletal chondroma. Histologically there were multiple S 100 protein-positive nests of chondrocytes. The externally completed cytology suspected a pleomorphic adenoma, nevertheless, the final histopathological findings showed another tumor entity. PMID:27167480

  8. Sialolipoma of the parotid gland.

    PubMed

    Michaelidis, Ioannis George-Akrivos; Stefanopoulos, Panagiotis Konstantinos; Sambaziotis, Demetrios; Zahos, Marios Alexandros; Papadimitriou, George Alexandros

    2006-01-01

    A case of slow-enlarging mass of the parotid region in a 44-year-old male is presented, which proved to be a lipomatous tumour of the parotid gland. The clinical impression was that of a benign salivary gland tumour. The tumour was situated in the deep lobe of the gland, thus a total parotidectomy was performed, with preservation of the facial nerve. Microscopically the lesion was described as consisting of mature adipose tissue, which, however, encompassed both glandular elements and nerve bundles within it. This tumour has been recently recognized as a separate entity under the term 'sialolipoma'.

  9. Mycobacterium tuberculosis infection within parotid gland Warthin tumor.

    PubMed

    Ozcan, Cengiz; Apa, Duygu Düşmez; Aslan, Gönül; Gülhan, Stk; Görür, Kemal

    2008-11-01

    Tuberculosis of the parotid gland is extremely unusual. Tuberculosis comprises 2.5% to 10% of parotid gland lesions. Two clinical forms of parotid gland tuberculosis infection exist. One is a diffuse parenchymatous disease (either primary or secondary to nodal disease), resembling common infection. The second is a chronic, slow-growing, painless, and firm parotid mass mimicking a neoplasm. Most of these patients were diagnosed after parotid gland surgery and histopathologic evaluation. Warthin tumor is a well-known benign neoplasm of the salivary glands. It is the second most common tumor of the parotid gland. Mycobacterium tuberculosis within Warthin tumor is also unusual. Five cases with parotid gland tuberculosis within Warthin tumor were reported in the literature. In this report, we present a new patient with parotid gland tuberculosis within the Warthin tumor. This type parotid gland pathology is an extremely rare entity, and to the best of our knowledge, this is the second documented case using polymerase chain reaction. We also discussed the possible mechanisms of development of infection within Warthin tumor.

  10. Wide excision of accessory parotid gland with anterior approach.

    PubMed

    Choi, Hwan Jun; Lee, Young Man; Kim, Jun Hyuk; Tark, Min Seong; Lee, Jang Hyun

    2012-01-01

    Accessory parotid gland tissue has been described as salivary tissue adjacent to the Stensen duct that is distinctly separate from the main body of the parotid gland. Of all parotid gland tumors, 1% to 8% arise from the accessory parotid gland. Little is known about the accessory parotid gland, and it is seldom mentioned in the literature. Between 1999 and 2010, we have treated and followed 8 patients with tumors of the accessory parotid gland. There were 5 males and 3 females with a mean age of 35 years. They all presented with an asymptomatic cheek mass, and 4 of them underwent fine-needle aspiration. Ultrasound or computed tomographic scan was used in all patients. All the patients underwent surgical intervention with standard parotidectomy incision and anterior extension. The mean follow-up time was 44 months (range, 6-120 months). Seven patients had benign disease. Four cases were pleomorphic adenoma, and the remaining 3 benign cases were parotid cyst, basal cell adenoma, and hemangioma. Only 1 patient had a malignant tumor that was a lymphoepithelioma-like carcinoma. In 7 cases, wide excision (excision of mass and accessory lobe of the parotid gland) was done because of the intra-accessory parotid gland lesion. One patient had concomitant superficial parotidectomy because the tumor was located very close to and has involved the parotid gland proper. There was no serious postoperative complication and recurrence. Prudent preoperative diagnostic evaluation and meticulous surgical approach are the keys to successful management of midcheek lesions. A wide excision of the accessory lobe of the parotid gland can be a definitive surgery in case of solitary tumor with an intact parotid fascia, and wide excision with anterior approach through a standard parotidectomy incision is preferred to a direct incision over the mass.

  11. [Myoepithelioma of the parotid gland].

    PubMed

    Almela Cortés, R; García-Hirschfeld García, J M; Ramos López, B

    2002-01-01

    Myoepithelioma of the salivary gland is a benign tumor set up almost exclusively for myoepithelial cells. It is considered as the terminal form of the histopathologic spectrum of mixed tumors, but owing to its monomorphic appearance is considered an aside form. In this article is reported one myoepithelial case of the parotid gland and are also reviewed the published literature of this sort of neoplasms.

  12. Lymphoepithelial cyst of the parotid gland.

    PubMed

    Piattelli, A; Tetè, S

    1995-09-01

    Cystic lesions of the parotid gland are not common and are often erroneously diagnosed as benign tumors. Lymphoepithelial cysts are only rarely diagnosed in the parotid gland. The term "lymphoepithelial cyst" is used because it is a descriptive term and takes no account of the origin and development of these cysts. An origin from sequestered lymph nodes epithelium in the parotid gland may be a feasible explanation for the origin of these cysts.

  13. Nonlymphoid mesenchymal tumors of the parotid gland.

    PubMed

    Takahama, Ademar; León, Jorge Esquiche; de Almeida, Oslei Paes; Kowalski, Luiz Paulo

    2008-10-01

    Salivary gland tumors are uncommon and most of them are of epithelial origin. Mesenchymal tumors affecting the parotid are extremely rare, and we present a series of 19 cases. All parotid tumors (600 cases) treated at the Department of Head and Neck Surgery from A.C. Camargo Hospital, Brazil from 1953 to 2003 were reviewed and 19 cases of nonlymphoid mesenchymal origin were selected. The histological characteristics were reviewed and clinical features were obtained from the medical charts. 15 out of 19 were benign tumors, including 5 lymphangiomas, 5 neurofibromas, and one case each of schwannoma, lipoma, solitary fibrous tumor, meningioma and giant cell tumor. Four malignant tumors were classified as rhabdomyosarcoma, fibrosarcoma, Langerhans cell histiocytosis and endodermal sinus tumor. From the malignant cases, only the patient with fibrosarcoma died due the tumor, the other three are alive with no signs of recurrence. In our series of 600 cases of parotid gland tumors, nonlymphoid mesenchymal tumors corresponded to 3.16% (19 cases; 15 benign and 4 malignant). All cases were treated by surgery with no recurrences, except one case of fibrosarcoma whose patient died of distant metastasis.

  14. [Tumors of the parotid gland].

    PubMed

    Tresserra, L; Tresserra, F

    1997-09-01

    Tumors of the parotid are the most frequently encountered salivary gland tumors. Knowledge of the histology and anatomy of the salivary gland is important when considering the histiogenesis of salivary gland tumors, requiring close cooperation between the pathologist and the surgeon. Most tumors are benign epithelial formations. Pleomorphous adenomas predominate. Superficial lobectomy is adequate treatment. When the tumor involves a deep lobe, total parotidectomy is indicated. Treatment of malignant tumors depends on the histology, its TNM stage and other factors. Total parotidectomy with lymphadectomy and radiotherapy are needed in case of high grade malignancy. In children, vascular neoplasias are the most frequent, followed by malignant tumors. Their histological features and treatment are the same as for adults.

  15. A rare benign parotid gland tumor: angiomyolipoma.

    PubMed

    Lu, Dan; Yang, Hui; Liu, Shi Xi; Zhao, Yu; Chen, Fei

    2013-11-01

    Angiomyolipomas are benign neoplasms composed of smooth muscle, vasculature, and mature adipose tissue, which most commonly occur in the kidney and located in the head and neck region. A very rare neoplasm, there are only 3 cases of angiomyolipoma in the parotid gland that have been reported to date. Here, we report a case of a 38-year-old man who had a slow-growing mass in the parotid gland for the past 7 years. The results of a physical examination revealed a rubbery mass that was 2.5 cm in diameter in the below superficial lobe of the left parotid gland. A computed tomographic scan showed a heterogeneous and lobulated nodule with a well-defined margin, which was resected through partial parotidectomy with preservation of the facial nerve. A histologic finding revealed an angiomyolipoma of the parotid gland. In conclusion, angiomyolipoma should be considered in the differential diagnosis of rubbery parotid gland masses.

  16. Parotid gland biopsy for investigation of xerostomia.

    PubMed

    Ferguson, J W; Edwards, J L; Christmas, P I; Ferguson, M M

    1990-08-01

    A technique is described for biopsy of the parotid salivary gland under local anaesthesia, which has been undertaken for a series of 59 patients who presented with suspected inflammatory exocrinopathy. The procedure is reliable and is associated with negligible postoperative discomfort. The advantages of the technique suggest that parotid gland biopsy is an acceptable alternative to conventional lower lip biopsy of minor salivary glands in the investigation of xerostomia.

  17. Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible

    PubMed Central

    Bouhabel, Sarah; Oughton, Matthew Thomas

    2016-01-01

    Infection with nontuberculous mycobacteria (NTM) is uncommon in the head and neck; therefore there is no clear consensus on treating these infections. Our objective was to report our experience with a unique case of NTM infection of the parotid in an immunocompetent patient, in order to determine appropriate management through our experience with this pathology. A 57-year-old man, known for numerous comorbid diseases, presented to our institution complaining of right parotid swelling and pain. A computed tomography (CT) of the neck showed a multiloculated collection in the inferior portion of the right parotid gland, compatible with abscess formation. This abscess was drained by interventional radiology (IR) but required repeat drainage twice due to lack of initial improvement. He was treated with several antibiotics as culture results initially indicated Gram-positive bacilli and then Mycobacterium species, with final identification by a reference laboratory as Mycobacterium abscessus. Imipenem was initiated with amikacin and clarithromycin. His infection clinically and radiologically resolved after 5 months of antibiotherapy. In our case, the patient improved following intravenous antibiotic therapy. Our experience demonstrates that appropriate antibiotherapy can lead to resolution of Mycobacterium abscessus infection in the parotid without the risks associated with surgical intervention. PMID:27340407

  18. Deep-lobe parotid gland tumors.

    PubMed

    Batsakis, J G

    1984-01-01

    Fewer than 10% of all parotid gland tumors arise from the deep portion of the gland. The great majority are benign and are mixed tumors. Their clinical presentation in the parapharyngeal space is uncommon, but in the event, the principal differential diagnosis is the elimination of an oropharyngeal primary salivary gland tumor.

  19. [Diffuse hyperplastic oncocytosis of the parotid gland].

    PubMed

    Zagólski, Olaf; Czajecki, Krzysztof; Gajda, Mariusz

    2006-10-01

    An intracellular metabolic disturbance associated with mitochondriopathy, due to an age dependent metabolic defect, is suggested to cause metaplasia of salivary gland cells into oncocytes. The WHO classification of salivary gland diseases considers 3 oncocytic lesions: oncocytosis, oncocytoma and oncocytic carcinoma. In case of diffuse hyperplastic oncocytosis of the parotid gland, extensive metaplasia of acinic and ductal cells leads to transformation of nearly all cells of the gland into oncocytes, which is clinically characterised by swelling of the parotid gland, and is an extremely rare condition. A 82-year-old man (the eldest of all reported) presented with a 2-month history of increasing diffuse swelling of the left parotid gland, 6 cm in diameter. The mass was soft, painless to palpation and grew in the superficial lobe of the parotid gland. The patient underwent surgical removal of the lesion with wide margins of healthy tissue. Histopathological examination of the operative specimen disclosed oncocytosis of the salivary gland. The patient has been followed-up for 6 months. He is doing well without recurrence. Surgical removal of the diffuse hyperplastic oncocytosis of the parotid gland, with indications and extent of the resection like in benign tumors, was effective in the presented patient.

  20. Malignant lymphoma in the head and neck associated with benign lymphoepithelial lesion of the parotid gland.

    PubMed

    Sato, Katsuro; Kawana, Masahiro; Sato, Yuichiro; Takahashi, Sugata

    2002-04-01

    Lymphoepithelial lesion is a benign lymphoproliferative disease occasionally arises in the salivary glands, but association with malignant diseases or autoimmune diseases has also been discussed. We herein present three cases of malignant lymphoma arose in the parotid gland and the lacrimal gland, following parotid surgery for benign lymphoepithelial lesion (BLEL) of the parotid gland. Two cases had mucosa associated lymphoid tissue (MALT) lymphoma in the parotid gland; one arose in the ipsilateral parotid gland as a recurrent swelling, and the other arose in the contralateral parotid gland of the previous BLEL surgery. The third case of malignant lymphoma arose in the lacrimal gland on the ipsilateral side, and the following contralateral parotid gland remained BLEL. All three patients were female, and one patient had a past history of Sjögren's syndrome and Hashimoto's disease. All three patients were treated by chemotherapy and one patient received additional radiotherapy. To follow-up lymphoproliferative diseases in the salivary glands such as BLEL, careful observation should be made on the same gland, other major salivary glands, and other organs in the head and neck, especially in females with autoimmune diseases.

  1. [Dermoid cyst of the parotid gland].

    PubMed

    Trandafir, Violeta; Trandafir, Daniela; Ferariu, D; Boişteanu, Otilia; Haba, Danisia

    2011-01-01

    Dermoid cyst of the parotid gland is a rare clinical entity. Definitive clinical diagnosis is often difficult to determine preoperatively because of the lack of pathognomonic features. The most frequent location of a parotid dermoid cyst is a triangular area lying above the pinna. Imaging studies do not definitely diagnose a parotid dermoid cyst. Although parotid dermoid cyst is (generally) well-encapsulated, complete removal of the cyst wall is not sufficient to cure it, so it is mandatory to perform careful excision of the cyst by parotidectomy, in terms of preserving facial nerve integrity. Histopathology of the parotid gland tumor removed by parotidectomy makes a diagnosis of certainty, by revealing a cyst wall with keratinization of the squamous epithelium and the presence of skin annexes (hair follicles, sweat glands, sebaceous glands). We present a rare case of parotid dermoid cyst in a 21-year-old male patient with symptoms and imaging rather suggestive of arch I branchial cyst and a brief review of data in the medical literature of the last 20 years.

  2. Bilateral canalicular adenoma of the parotid gland.

    PubMed

    Liess, Benjamin D; Lane, Robert V; Frazier, Shellaine; Zitsch, Robert P

    2006-03-01

    Canalicular adenoma is a rare benign salivary gland tumor that occurs almost exclusively in the upper lip. Rarely, this benign tumor may occur multifocally in the oral cavity. We report a case of canalicular adenoma in bilateral parotid glands, discuss histological characteristics, and review this tumor.

  3. Sialadenoma papilliferum of the parotid gland.

    PubMed

    Kronenberg, J; Horowitz, A; Leventon, G

    1989-11-01

    Sialadenoma papilliferum is a rare, benign exophytic tumour of salivary glands. The preferred site of this tumour is usually the hard palate. A case of sialadenoma papilliferum occurring in the parotid gland of a 49-year-old man is presented; only one such case has been previously described.

  4. Chronic sclerosing sialadenitis of the parotid gland.

    PubMed

    de Vicente, Juan Carlos; López-Arranz, Elena; García, Juan; López-Arranz, Juan Sebastián

    2003-07-01

    Chronic sclerosing sialadenitis (Küttner's tumor) is a benign and chronic inflammatory condition of the submandibular gland that clinically cannot be easily distinguished from salivary malignant neoplasia. This is a report of a case of chronic sclerosing sialadenitis located as a solitary mass in an accessory parotid gland.

  5. Benign fibrous xanthoma of the parotid gland: a case report.

    PubMed

    Nilsen, R; Lind, O

    1978-11-01

    A fibrous xanthoma of the parotid gland is reported, the literature is reviewed with a discussion of the classification of such tumours. The present case is possibly the first report of a typical benign fibrous xanthoma of the parotid gland.

  6. Parotid gland metastasis originating from malignant meningioma.

    PubMed

    Dmytriw, Adam A; Gullane, Patrick; Bartlett, Eric; Perez-Ordonez, Bayardo; Yu, Eugene

    2013-01-01

    A case of malignant meningioma with metastasis to the parotid gland is reported. A 60-year-old woman with right-sided neurological symptoms secondary to malignant meningioma developed bilateral parotid masses with identical histology to the primary lesion. The primary lesion was differentiated from a benign oligodendroma with MRI, and the radiological features of this extraordinarily rare metastasis are chronicled with MRI and computed tomography.

  7. Canalicular adenoma of the parotid gland.

    PubMed

    Philpott, Carl M; Kendall, Charles; Murty, George E

    2005-01-01

    Canalicular adenomas are a rare form of benign tumour that occur in salivary glands, occurring mainly in the upper lip and minor salivary glands of the buccal mucosa. The authors report the fifth case and the first in the otorhinolaryngological literature of a canalicular adenoma of the parotid gland. Its specific histological features are difficult to detect on fine needle aspiration and its multifocal nature can lead to recurrence and this must be considered in the clinical management.

  8. Cavernous hemangioma of the parotid gland in adults

    PubMed Central

    Peral-Cagigal, Beatriz; Madrigal-Rubiales, Beatriz; Verrier-Hernández, Alberto

    2014-01-01

    Hemangiomas account for 0.4-0.6% of all tumors of the parotid gland and most of them occur in children, nevertheless in adults hemangiomas are very rare. We report the case of a 62 year old woman with a mass in the parotid right tail associated with fluctuating swelling episodes unrelated to meals and with a slowly progressive growth. The provisional diagnosis was a pleomorphic adenoma, so a right superficial parotidectomy was performed. During surgery, the macroscopic appearance makes suspect a vascular lesion. The histopathological result was a cavernous hemangioma. The classic clinical presentation of a parotid hemangioma is an intraglandular mass associated or not with skin lesions characterized by reddish macules and/or papules, and a vibration or pulsation when palpating the parotid region. In imaging tests, phleboliths could be observed which are very suggestive of a hemangioma or a vascular malformation. In the absence of these signs, the diagnosis could be difficult, particularly in an adult due to its low prevalence, with about 50 cases reported worldwide. However a hemangioma should be considered in the differential diagnosis of parotid tumors in adults. Key words:Cavernous hemangioma, parotid gland, superficial parotidectomy, pleomorphic adenoma. PMID:25674332

  9. Recurrent amyloid tumor of the parotid gland.

    PubMed

    Vavrina, J; Müller, W; Gebbers, J O

    1995-01-01

    A case of an organ-limited amyloid tumor of the left parotid gland is described with a history of recurrence. A slowly growing parotid mass was the only symptom. After 5.5 years following local excision, the patient was readmitted with a slowly growing recurrence in the superficial lobe of the previously treated gland. Lateral parotidectomy was performed with wide excision of the infiltrated tissue and preservation of the facial nerve. Primary amyloidosis of the AL type was confirmed with immunohistochemical studies revealing staining for lambda but not kappa light chains of immunoglobulins. There has been no clinical or laboratory evidence of systemic amyloidosis or recurrence after 2 years. To the best of our knowledge, this is the first report of a recurrent amyloid tumor of the parotid gland.

  10. Parotid gland tumors in a Korean population.

    PubMed

    Lee, Young Man; Choi, Hwan Jun; Kim, Joo Won; Kim, Jun Hyuk

    2012-05-01

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

  11. Sialolithiasis of an accessory parotid gland: an unusual case.

    PubMed

    Debnath, S C; Adhyapok, A K

    2015-09-01

    We report a rare case of sialolithiasis of an accessory parotid gland, which was located anteromedial to the masseter muscle and isolated from the main parotid gland. The calculus developed from this accessory gland, and the main gland was free of lithiasis and inflammation. To our knowledge, there is no reported case of 14 stones in an accessory parotid salivary gland. The calculus was removed through a standard incision without injury to the facial nerve or a salivary fistula. PMID:26048098

  12. A first branchial cleft anomaly within the parotid gland.

    PubMed

    Koltai, P J; Winkelmann, P E

    1980-01-01

    Although the parotid glands are affected more frequently by cysts and congenital lesions than other salivary glands, the benign multigerminal cyst arising from a duplication anomaly of the first branchial cleft within the parotid gland is extremely rare. Forty-two cases of this unusual cause of parotid swelling have been reported in the literature. An example of a first branchial cleft anomaly appearing clinically as a parotid tumor is reported.

  13. Sebaceous lymphadenoma of the parotid gland.

    PubMed

    Mishra, Aparajita; Tripathi, Kalpalata; Mohanty, Lity; Nayak, Manjulata

    2011-01-01

    Sebaceous lymphadenoma is a rare benign salivary gland tumor of uncertain histogenesis. We report such a case in a 37-year-old female presenting with a parotid swelling. Recognition of key histological features will readily allow differentiation of this neoplasm from its benign and malignant mimics. The prognosis is excellent following excision.

  14. Sebaceous adenoma of the parotid gland.

    PubMed

    de Vicente Rodríguez, Juan Carlos; Fresno Forcelledo, Manuel Florentino; González García, Manuel; Aguilar Andrea, Carolina

    2006-08-01

    Tumors of the salivary glands constitute an important field of oral and maxillofacial pathology. The majority of salivary gland neoplasms are benign, with malignant salivary tumors accounting for 15 to 32 percent. The most common site for salivary gland tumors is the parotid gland, accounting up to 80 percent of all cases. This article reports the pathologic picture in a case of sebaceous adenoma of the parotid gland. The tumor was composed of epithelial cells lining ducts and closely associated with broad areas of sebaceous differentiation. The growth pattern was predominantly cystic, with cavities filled with sebaceous material. Areas of oncocytic metaplasia were also seen. The presence of sebaceous glands in salivary neoplasms is frequent, however, and in spite of this, salivary neoplasms constituted partially or entirely of these cells are rarely observed. To the surgeon and pathologist, the major problem in dealing with sebaceous adenoma is the recognition of this rare entity, avoiding confusing with other more aggressive neoplasms. The treatment involves surgical excision. The addition of the current case to the previously published data brings the total number of parotid sebaceous adenoma to seven.

  15. Sebaceous Carcinoma of the Parotid Gland: A Case Report

    PubMed Central

    Takada, Yohei; Kawamoto, Kohei; Baba, Susumu; Takada, Tomoko; Inoue, Toshiya; Tomoda, Koichi

    2015-01-01

    Background Primary sebaceous carcinoma of the parotid gland is extremely rare, and because of its rarity, clinicopathological characteristics and histogenesis are not fully understood. Methods Here, we report a patient who presented with a left infra-auricular painless mass. We present the histological features and discuss possible optimal treatments based on previous literature. Results The mass was suspected to be a myoepithelial tumor or possibly a pleomorphic adenoma. Initially, the mass was resected with preservation of the facial nerve, but this caused facial palsy. Because the histological examination showed a sebaceous carcinoma and a part of the mass could be remaining on the facial nerve, additional surgery was performed, and the facial nerve was reconstructed with cervical nerve. Follow-up after 7 months showed no sign of recurrence of metastasis. Conclusion We encountered a rare sebaceous carcinoma of the parotid gland. Additional surgery was performed because preoperative diagnosis was difficult. PMID:25848361

  16. Giant pleomorphic adenoma of the parotid gland.

    PubMed

    Takahama, Ademar; da Cruz Perez, Danyel Elias; Magrin, José; de Almeida, Oslei Paes; Kowalski, Luiz Paulo

    2008-01-01

    Pleomorphic adenoma is the most common type of all benign and malignant salivary gland tumors, involving more frequently the parotid gland. It is a benign tumor with a slow and continuous growth that without treatment can reach an enormous size. We present a case of a giant pleomorphic adenoma in a 78-year-old man with a history of more than 30 years of a growing lesion in the parotid gland. Clinical examination revealed a giant mass on the right side of the face, however without any sign of facial nerve damage. The tumor was completely resected by total parotidectomy and preservation of the facial nerve. Macroscopically, the tumor measured 28 cm and weighed 4.0 Kg. On the histological examination there was a predominance of epithelial and myoepithelial cells in a hyaline and myxoid stroma. It was not found any area of malignant transformation. In the post-operatory the aesthetic and functional results were excellent.

  17. Giant Pleomorphic Adenoma of the Parotid Gland.

    PubMed

    Sajid, Muhammad; Rehman, Sajid; Misbah, Junaid

    2015-10-01

    Salivary gland tumours are a relatively rare entity. Pleomorphic adenoma is the most common amongst these, comprising 60 - 70% of all parotid tumours. Pleomorphic adenomas are benign and tend to increase in size slowly. Here we are presenting a case of giant pleomorphic adenoma of the parotid, being the largest in size to be excised in Pakistan in recorded literature measuring 24 x 22 x 12 cm and weighing 1.8 kgs. Superficial parotidectomy was done with an excellent cosmetic outcome. PMID:26522191

  18. Syncronized Warthin's tumor in bilateral parotid gland and nasopharynx.

    PubMed

    Güçlü, Oğuz; Muratlı, Aslı; Karatağ, Ozan; Dereköy, Fevzi Sefa; Uludağ, Ahmet

    2012-01-01

    Warthin's tumor is a benign salivary gland tumor of the parotid gland. Although bilateral or multicentric involvement of the parotid gland is common, extraparotid involvement is seen rarely. The nasopharynx is an unusual region for extraparotid involvement. In this article, we present a 52-year-old male case with a synchronized Warthin's tumor in the bilateral parotid gland and nasopharynx, and we discuss the clinical management of the disease.

  19. Diffuse hyperplastic oncocytosis of the parotid gland.

    PubMed

    Loreti, A; Sturla, M; Gentileschi, S; Bracaglia, R; Prat, Y; Fadda, G; Farallo, E

    2002-03-01

    Oncocytic tumours rarely affect the major salivary glands, accounting for less than 1% of all salivary-gland tumours. The World Health Organisation classification groups these tumours into three principal types: diffuse oncocytosis, focal adenomatous oncocytic hyperplasia and oncocytoma. Diffuse hyperplastic oncocytosis is the rarest lesion: only six cases have been previously reported in the literature. This condition of putative hyperplastic pathogenesis follows a benign course, whereas oncocytomas may recur after excision. No metastatic dissemination or recurrence of diffuse hyperplastic oncocytosis has been reported. We present and discuss a new case of diffuse hyperplastic oncocytosis of the parotid gland.

  20. [Adenolymphoma of the parotid gland].

    PubMed

    Osellame, M; De Martini, E; Balotta, F; Lavorato, F

    1980-05-15

    Three personal cases of adenolymphoma of the parotid are described and attention is drawn to the rarity and benign nature of this form. Its anatomical and pathological features are discussed, along with the various theories concerning its histogenesis. Of these, the salivary theory is the most widely accepted. Lastly, an account is given of the symptoms (primarily consisting of cosmetic damage), differential diagnosis, and treatment (simple enucleation). The long-term prognosis is always good. Recurrences (also benign) are very rare.

  1. Prophylaxis against Frey's syndrome in parotid surgery.

    PubMed

    Bonanno, P C; Palaia, D; Rosenberg, M; Casson, P

    2000-05-01

    In 1990 the authors reported their preliminary study of the prevention of Frey's syndrome in 55 patients utilizing a superficial musculoaponeurotic system (SMAS) flap in parotid gland surgery. During the past 10 years, numerous studies have supported their original thesis that interposition of living tissue between the resected gland bed and the skin could prevent the development of this complication. The authors have expanded their own patient population and now consider this a definitive study on the prevention of Frey's syndrome. A total of 160 patients are presented with a follow-up period of 5 to 22 years. All patients underwent subtotal or total parotidectomy performed by one of the authors. A history was acquired and testing for Frey's syndrome (Minor's starch iodine test) was performed. As a result of this approach, and in spite of the intensive search for it, no cases of Frey's syndrome were encountered. The hoped-for secondary benefit of preventing the postparotidectomy retromandibular depression was somewhat less satisfactory, although most patients remain satisfied with their appearance. The debilitating symptoms in Frey's syndrome, which is reported to have an incidence of 5% to 50% in the typical parotidectomy patient, can be avoided with thoughtful preoperative planning. The authors favor an aesthetic incision followed by the development of an SMAS flap. The parotidectomy is then performed using the surgeon's preferred technique. The SMAS flap is then placed into the bed of the resected parotid gland. This institutes a protective tissue barrier guarding against the aberrant anastomotic communication between the postganglionic secretomotor fibers intended for the parotid gland, and the now adjacent sweat glands. Their patient population is large enough to provide significant evidence that Frey's syndrome can be prevented, compared with a meta-analysis of parotid patients in multiple other studies in the literature. Assuming the patient's history and

  2. Adenoid cystic carcinoma of the accessory parotid gland.

    PubMed

    Baklacı, Deniz; Güngör, Volkan; Özcan, Müge; Yılmaz, Yavuz Fuat; Ünal, Adnan; Çolak, Aysel

    2015-01-01

    Accessory parotid gland is a small salivary gland tissue separated from main part of parotid gland. It is located on the masseter muscle anterior to the Stensen's duct. Tumors of accessory parotid gland are rare. In this article, we report an unusual case of adenoid cystic carcinoma involving accessory parotid gland. The patient presented with a progressively growing mass in the middle portion of her cheek. She underwent a partial parotidectomy including both the superficial and accessory lobes. The histopathologic diagnosis was adenoid cystic carcinoma of cribriform type. PMID:26476520

  3. Malignant oncocytic tumour of the parotid salivary gland.

    PubMed

    Leventon, G; Katz, D R; Bell, C D

    1976-03-01

    A 49-year-old man developed a tumour mass in his right parotid salivary gland nine years after a histologically proven benign mixed tumour of the same salivary gland had been surgically removed. Radical resection of the right parotid salivary gland and associated lymph nodes and soft tissues of the neck was performed. The parotid tumour was composed of oncocytic cells which infiltrated the surviving salivary gland tissue. Most of the excised lymph nodes contained metastatic deposits of oncocytic cells identical to the tumour seen in the parotid. There are no previous reports of the occurrence of both pleomorphic adenoma and malignant oncocytoma in the same salivary gland.

  4. Late recurrence of acinic cell carcinoma of the parotid gland.

    PubMed

    Miki, H; Masuda, E; Ohata, S; Komaki, K; Hirokawa, M; Uehara, H; Asano, H; Monden, Y

    1999-08-01

    Acinic cell carcinoma of the salivary glands is a rare cancer representing a low grade malignancy. The recurrence of a tumor is sometimes encountered, usually within 5 years of initial operation. We describe an unusual recurrence after a long interval following primary surgery. In 1987, a 60-year-old woman underwent excision of a mass in the superficial lobe of the right parotid gland under the preoperative diagnosis of a benign tumor. A histologic diagnosis of acinic cell carcinoma was made by examining sections from the resected mass. The patient noted several small nodules in the right parotid region in 1995, but she did not visit our clinic until 1998 when tenderness developed. A locally recurrent tumor and cervical lymph nodes containing metastases were resected and postoperative radiotherapy was given 11 years after the first operation. At least 10 years of follow-up may be necessary for patients with acinic cell carcinoma because of slow-tumor growth.

  5. Partial irradiation of the parotid gland.

    PubMed

    Eisbruch, A; Ship, J A; Kim, H M; Ten Haken, R K

    2001-07-01

    Recent efforts to reduce xerostomia associated with irradiation (RT) of head and neck cancer include the use of conformal and intensity-modulated RT (IMRT) to partly spare the major salivary glands, notably the parotid glands, from a high radiation dose while treating adequately all the targets at risk of disease. Knowledge of the dose-volume-response relationships in the salivary glands would determine treatment planning goals and facilitate optimization of the RT plans. Recent prospective studies of salivary flows following inhomogeneous irradiation of the parotid glands have utilized dose-volume histograms (DVHs) and various models to assess these relationships. These studies found that the mean dose to the gland is correlated with the reduction of the salivary output. This is consistent with a pure parallel architecture of the functional subunits (FSUs) of the salivary glands. The range of the mean doses, which have been found in these studies to cause significant salivary flow reduction is 26 to 39 Gy. PMID:11447580

  6. Brucella melitensis infection within warthin tumor of the parotid gland.

    PubMed

    Horasan, Elif Sahin; Vaysoğlu, Yusuf; Unal, Murat; Uğuz, Mustafa; Kaya, Ali

    2011-09-01

    Brucellosis is a zoonotic systemic infectious disease, and multiorgan involvement is commonly seen, but involvement of the neck is a rare presentation of brucellosis. Granulomatous infections of the parotid gland are extremely rare. Warthin tumor is a well-known benign neoplasm of the salivary glands. In this report, we describe a Warthin tumor associated with Brucella melitensis in the same parotid gland.

  7. Hamartomatous angiolipoma of the parotid gland (sialoangiolipoma).

    PubMed

    Maiorano, Eugenio; Capodiferro, Saverio; Fanelli, Benito; Calabrese, Luca; Napoli, Anna; Favia, Gianfranco

    2008-03-01

    Mesenchymal tumors of the salivary glands are rare and mostly localized to the parotid gland. We report on the clinico-pathological features of a distinct parotid tumor occurred in a newborn, showing glandular structures admixed with mature lipocytes and blood vessels in variable proportions. This was a well-circumscribed and slowly growing nodule of the superficial parotid lobe, mostly reddish in color with white-yellowish striations. Microscopically, a distinct lobular architecture was evident, along with normal-appearing acinar and ductal structures with interposed loose fibrous stroma. The latter contained aggregates of mature lipocytes and variably sized blood vessels. The morphological features of the lesion reported herein recapitulate those of sialolipoma but also include the presence of a prominent vascular component intimately admixed with both the glandular and the adipose tissues. At variance with salivary lipoadenoma, the glandular component in the current case distinctly showed all the cellular components of normal salivary (serous) glands. In consideration of the young age of the patient, the minimal growth rate and the histological features of the lesion, we hypothesize a hamartomatous origin for this lesion and propose the designation of sialoangiolipoma.

  8. Carcinoma in basal cell adenoma of the parotid gland.

    PubMed

    Nagao, T; Sugano, I; Ishida, Y; Matsuzaki, O; Konno, A; Kondo, Y; Nagao, K

    1997-01-01

    Malignant transformation of basal cell adenoma (BCA) of the parotid gland is rarely reported, and when occurred, may principally become manifest as a malignant basaloid tumor, i.e. basal cell adenocarcinoma or adenoid cystic carcinoma. We describe herein three cases of non-basaloid carcinoma arising in BCA. The incidence of this malignant tumor was 0.2% of all parotid gland tumors and 4.3% of BCAs in our series. One case was salivary duct carcinoma showing histologic evidence of transition between malignant and benign elements. The remaining two cases were well-encapsulated parotid gland tumors, which were composed of BCA and scattered foci of malignant transformation. Malignant components were adenocarcinoma, not otherwise specified (NOS), and sometimes intermixed with neoplastic myoepithelial cells included BCA cells. These two cases were regarded to be intracapsular carcinoma in BCA. BCA components showed solid, tubular and trabecular arrangements. The patients' prognosis was quite variable among these three cases; the first case died of disease after 27 months, whereas the latter two cases are alive and well for 4 and 10 years after surgery. Ki-67 labeling index indicated that cell proliferative activity was at least five times higher in carcinomas than BCAs. Non-basaloid carcinomas such as salivary duct carcinoma or adenocarcinoma, NOS, do develop in BCAs as in the case of a pleomorphic adenoma with malignant transformation, though the incidence may be extremely rare.

  9. Correlations between the clinical, histological and neurophysiological examinations in patients before and after parotid gland tumor surgery: verification of facial nerve transmission.

    PubMed

    Wiertel-Krawczuk, Agnieszka; Huber, Juliusz; Wojtysiak, Magdalena; Golusiński, Wojciech; Pieńkowski, Piotr; Golusiński, Paweł

    2015-05-01

    Parotid gland tumor surgery sometimes leads to facial nerve paralysis. Malignant more than benign tumors determine nerve function preoperatively, while postoperative observations based on clinical, histological and neurophysiological studies have not been reported in detail. The aims of this pilot study were evaluation and correlations of histological properties of tumor (its size and location) and clinical and neurophysiological assessment of facial nerve function pre- and post-operatively (1 and 6 months). Comparative studies included 17 patients with benign (n = 13) and malignant (n = 4) tumors. Clinical assessment was based on House-Brackmann scale (H-B), neurophysiological diagnostics included facial electroneurography [ENG, compound muscle action potential (CMAP)], mimetic muscle electromyography (EMG) and blink-reflex examinations (BR). Mainly grade I of H-B was recorded both pre- (n = 13) and post-operatively (n = 12) in patients with small (1.5-2.4 cm) benign tumors located in superficial lobes. Patients with medium size (2.5-3.4 cm) malignant tumors in both lobes were scored at grade I (n = 2) and III (n = 2) pre- and mainly VI (n = 4) post-operatively. CMAP amplitudes after stimulation of mandibular marginal branch were reduced at about 25 % in patients with benign tumors after surgery. In the cases of malignant tumors CMAPs were not recorded following stimulation of any branch. A similar trend was found for BR results. H-B and ENG results revealed positive correlations between the type of tumor and surgery with facial nerve function. Neurophysiological studies detected clinically silent facial nerve neuropathy of mandibular marginal branch in postoperative period. Needle EMG, ENG and BR examinations allow for the evaluation of face muscles reinnervation and facial nerve regeneration.

  10. Oncocytic mucoepidermoid carcinoma of the parotid gland.

    PubMed

    Hamed, G; Shmookler, B M; Ellis, G L; Punja, U; Feldman, D

    1994-03-01

    Oncocytic mucoepidermoid carcinoma of the salivary gland is rare. We describe a 60-year-old woman who presented with a slowly growing left parotid mass. The patient underwent a total parotidectomy, and her postoperative course was uneventful. The gland was enlarged and showed a partially cystic mass containing clear mucoid material. Microscopically, the entire mass showed variably sized cysts lined predominantly with oncocytes and a few mucous goblet cells. Histochemical stains for mitochondria, such as phosphotungstic acid-hematoxylin, confirmed the presence of oncocytes. The recognition of this variant is important, since most of the other primary oncocytic lesions of the salivary glands are benign. The tumor in this case is considered to be a low-grade carcinoma; therefore, complete surgical excision and long-term clinical follow-up are adequate management.

  11. Post-traumatic Lipoma of the Parotid gland

    PubMed Central

    Rehal, Satnam Singh; Alibhai, Mustansir; Perera, Esther

    2016-01-01

    Lipoma of the parotid gland is a rare entity. Trauma with soft tissue haematoma formation and subsequent lymphatic effusion, fat necrosis and lipoma formation have been postulated as an aetiological pathway. We report a case of a post-traumatic lipoma of the parotid gland to add to the available literature on this uncommon pathology. PMID:27106616

  12. [Inflammatory pseudotumor of the parotid gland].

    PubMed

    Hellín Meseguer, D; Merino Gälvez, E; Gil Vélez, M; Pastor Mas, A; Ruíz Macía, J A; Hernández, J E

    1996-01-01

    An inflammatory pseudotumor is a rare clinicopathologic condition of unknown etiology and benign course, mimicking sometimes other malignant entities under the clinic and pathologic viewpoint. Our case sitting inside the left parotid salivary gland in an 70-year-old male, was at first diagnosed as epidermoid carcinoma and consequently operated. The biopsy disclose in the mass removed a pseudotumor measuring 3 cm diameter not malignant, lodging inside a microscopic growth of Warthin type. Revue of the literature, of diagnostic findings and mode of management, suggering besides its possible etiopathogenic relation with the inflammatory pseudotumor.

  13. [Parapharyngeal oncocytoma of the parotid gland].

    PubMed

    Carluccio, F; Amendola, S

    1996-02-01

    Oncocytic tumors rarely occur in major salivary glands and generally account for less than 1% of all salivary tumors. Oncocytomas are infrequent tumors that most commonly arise in the salivary, thyroid, parathyroid and pituitary glands, kidneys and pancreas. They are rarely malignant. Oncocytic differentiation may also occur focally in a benign or a malignant epithelial tumor, such as a thyroid adenoma, papillary cystadenoma lymphomatosum and mixed tumors of salivary glands, malignant carcinoids of the bronchus, adrenal cortical carcinoma, and renal cell carcinoma. The term oncocytoma refers to a single neoplasm contrast to nodular oncocytic hyperplasia, which refers to two or more distinct tumor nodules, and to oncocytic mucoepidermoid carcinomas, where there is evidence of infiltrative growth and malignant of clinical behavior. We here report surgical treatment and light and electron microscopical findings obtained in the case of an oncocytoma of the parapharyngeal prestyloid space in a 62-year-old man who was admitted to our Department because of a slowly enlarging, painless mass in the pharyngeal extension of the right parotid gland. The mass has distorted the isthmus of the fauces, compressing the contra lateral pharyngeal-palatal plica. A total right parotidectomy which spared the branches of the facial nerve was performed. During the operative procedure, tissue was removed for frozen-section examination. The patient had an uneventful post-operative course. For all that has previously been written about oncocytic tumors, relatively very little is known of their etiology. In the past a correlation was made between the etiology and the history of direct or indirect radiation exposure. As oncocytic metaplasia and oncocytomas are often seen most in older individuals, the oncocyte was previously regarded as a "functional exhaustion" of a normal cell. As far as we concerned, the preferred method of surgically exposing the parapharyngeal-prestyloid space is that of

  14. Lymphoepithelial lesion of the parotid gland.

    PubMed

    Goto, T K; Shimizu, M; Kobayashi, I; Chikui, T; Kanda, S; Toshitani, K; Shiratsuchi, Y; Yoshida, K

    2002-05-01

    We describe a case of lymphoepithelial lesion of the parotid gland, also known as salivary lymphoepithelial lesion. Lymphoepithelial lesions are usually seen in conjunction with autoimmune disease of the salivary glands and these lesions do not always remain benign. Our case consisted of two masses that had different imaging features. Moreover, we could investigate the changes of the size and internal architecture on imaging due to the postponement of surgical intervention on the masses. At review 6 months later, the size of the masses had increased. The aims of this paper were to: (1) investigate the contribution of gray-scale sonography, power Doppler sonography, magnetic resonance imaging, and computed tomography to the diagnosis; and (2) consider the appropriate imaging modality to follow-up this case to monitor for recurrence or malignant transformation.

  15. Surgical Treatment of Rare Sclerosing Polycystic Adenosis of the Deep Parotid Gland

    PubMed Central

    Umezawa, Hiroki; Ohashi, Ryuji; Peng, Wei-Xia; Naito, Zenya; Ogawa, Rei

    2016-01-01

    Summary: We experienced a rare case of sclerosing polycystic adenosis (SPA) arising in a parotid gland. A 33-year-old man who underwent unspecified surgery for a lesion in the left parotid gland 23 years ago presented with a lesion on the same site. Computed tomography scan revealed an encapsulated 3 × 2 cm lesion. Intraoperative findings showed that the tumor was embedded deep in the parotid gland. Marginal tumor excision was performed to preserve the facial nerve. Histopathological and immunohistochemical findings led to the final diagnosis of SPA. The surgery was not associated with any other complications. To date, 28 months after surgery, recurrence has not been observed. The treatment protocol of SPA has not yet been established. To make plastic surgeons familiar with this disease, we describe this case, which was successfully treated without any complications. PMID:27257575

  16. Unilateral parotid gland involvement with synchronous multiple Basal cell adenomas.

    PubMed

    Ozcan, Cengiz; Apa, Duygu Düsmez; Vayisoglu, Yusuf; Görür, Kemal

    2007-11-01

    Basal cell adenoma (BCA) is a rare benign epithelial tumor of the salivary gland. BCA is seen most frequently in the parotid gland and less commonly in the submandibular gland and minor glands of the upper lips, oral cavity, and hard palate. Salivary gland tumors are observed as single tumors in one salivary gland. Double or multiple tumors of the salivary gland tumors are unusual and metachronous or bilateral salivary gland tumors are more observed than synchronous or unilateral tumors. The most commonly seen multiple tumor unilaterally or bilaterally is the Warthin's tumor. A 65-year-old woman with a painful, slowly enlarging mass in front of the left ear, which was present for 6 months, was evaluated. Physical examination revealed two solid and well-delineated masses in the preauricular region, which were 1.5 x 1 cm in diameter and in the tail of the parotid gland, which is 2.5 x 2 cm in diameter. Excision of the superficial lobe of the parotid gland was performed. The macroscopic examination of the specimen showed the two discrete nodular masses. Histologic examination of the two nodular solid lesions was reported as BCA. Multiple synchronous nonmembranous-type BCAs of the unilateral parotid gland is a rare entity. More extensive excision of the parotid gland tumor, careful macroscopic perioperative examination of the surgical specimen, and histologic evaluation of all surgical specimens might be necessary for reducing revision operations and surgical complications.

  17. Extranodal Marginal Zone Lymphoma of the Parotid Gland.

    PubMed

    Aydın, Sedat; Demir, Mehmet Gökhan; Barışık, Nagehan Özdemir

    2016-07-01

    Non Hodgkin lymphomas correspond to 25 % of all head and neck cancers. These rare tumors only include less than 5 % of malign tumors in parotid region. Differential diagnosis of these tumors cover many malign and benign tumors of the parotid gland. Definite diagnosis depends on sufficient tissue material of parotidectomy specimen. Treatment modality is surgical removal of the lesion with or without additional radiation and chemotherapy depending on the stage of the tumor. Prognosis is better than other forms of the B-cell lymphoma. We present a 54 year old woman who suffered from progressively and slowly growing mass on parotid region, without any inflammatory disease or chronic infection, diagnosed with mucosa associated lymphoid tissue lymphoma of the parotid gland. Parotid gland was totally excised by superficial parotidectomy and there is no recurrence after 5 years postoperative period. PMID:27408468

  18. [Oncocytoma of the parotid gland: a case report].

    PubMed

    Diouf, M S; Claros, P; Claros, A

    2012-01-01

    Oncocytoma is a rare benign salivary gland tumour with an incidence rate about 1-2%. It is located in the parotid gland in 82% of cases. The aging mitochondrial hypothesis could explain the predilection between 70 and 90 years. Clinical and radiological features of the parotid oncocytoma are not different from those of the others parotid benign tumors. We report a case of oncocytoma of the left parotid gland in a 69 years woman in whom fine needle aspiration cytology (FNAC) was for a pleomorphic adenoma. Through this case we highlight the importance of histopathology in the positive diagnosis of parotid oncocytoma as well as in it's differential diagnosis and also the place of FNAC.

  19. Inflammatory pseudotumor of the parotid gland.

    PubMed

    Barrios-Sánchez, Gracia M; Dean-Ferrer, Alicia; Alamillos-Granados, Francisco J; Ruiz-Masera, Juan José; Zafra-Camacho, Francisco M; García de Marcos, José A; Calderón-Bohórquez, José M

    2005-01-01

    Inflammatory pseudotumor is a term that refers to a reactive pseudoneoplastic disorder that can appear in different locations of the human body. The lung is the most frequently affected organ. The etiology is still unknown. It affects individuals of both sexes and of a wide range of ages. The diagnosis is still difficult and it is based on the histological examination of the lesions composed of four cell-types: histiocytes, myofibroblasts, plasma cells and lymphocytes. With regard to the treatment regimes there is no agreement. Treatment ranges from surgical excision to radiotherapy, chemotherapy or steroids. The purpose of this article is to report one case of inflammatory pseudotumor located in the parotid gland and to make a special point of the difficulty in arriving at a correct diagnosis in order to achieve the most adequate treatment.

  20. Obtaining parotid saliva specimens after major surgery.

    PubMed

    Good, Marion; Wotman, Stephen; Anderson, Gene Cranston; Ahn, Sukhee; Cong, Xiaomei

    2004-10-01

    The purpose of this study was to develop and test a standard method of collecting saliva from postoperative patients. Saliva was collected from patients following major abdominal surgery from both parotid glands in intraoral cups and measured in milliliters. Trained research nurses stimulated saliva production with lemon juice and collected saliva at 4 time points on postoperative day 2. Collection time was measured with a stopwatch, and flow rate was calculated by dividing the amount in milliliters by collection time in minutes. Attrition was 9% due to ineligibility after enrollment and 1 withdrawal. In participating patients (n = 68), there were 272 tests planned and 28% were missing. The reasons were postoperative health problems, hospital discharge, and not wanting to be bothered. When saliva collection attempts were made, three-fourths were successful, but the remainder resulted in "dry mouth." Milliliters, minutes, and flow rate were calculated with and without those with dry mouth. Mean flow rates were 0.23 to 0.33 ml/min excluding those with dry mouth and 0.17 to 0.24 ml/min including those with dry mouth. Saliva variables were correlated with antihypertension medications, opioids, opioid side effects, and length of surgery, but statistically significant correlations were not found consistently at all 4 time points. The findings suggest that nurse-researchers studying biological markers can successfully collect saliva from postoperative patients if they recognize the difficulties and make efforts to minimize and control for them.

  1. Intraductal papilloma of the parotid gland in a child.

    PubMed

    Noseri, Hulya; Erden, Tulay; Toros, Sema; Habesoglu, Mehmet; Egeli, Erol; Aker, Fugen; Cetin, Senay

    2007-11-01

    Intraductal papillomas are rare benign tumors, most commonly encountered in minor salivary glands and rarely in major salivary glands. They are cystic, solitary neoplasm that arise from ductal epithelium and produce painless swelling. We report a case of intraductal papilloma of the parotid gland in a child.

  2. Solitary fibrous tumor of the parotid gland: Case report.

    PubMed

    Sousa, Alexandre A; Souto, Giovanna R; Sousa, Isabela A; Mesquita, Ricardo A; Gomez, Ricardo S; Jham, Bruno C

    2013-10-01

    Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually develops in the pleura and peritoneum. The head and neck region is involved in only 6% of the cases. Involvement of the parotid gland is a rare phenomenon, with only 24 cases reported in the literature. The aim of this study is to report an additional case of SFT affecting the parotid gland, and to review the literature on previously reported cases. The patient was a 42-year-old male with a 4-cm, fibro-elastic, movable, painless nodule in the inferior lobe of the parotid gland. The lesion was surgically excised and, following histopathological and immunohistochemical analysis, a diagnosis of SFT was rendered. The patient has been followed-up for ten months, with no signs of recurrence. Clinical, histopathological, immunohistochemical and treatment aspects of the tumor are discussed. Key words:Solitary fibrous tumor, parotid gland, case report.

  3. Remarkable Triple Pleomorphic Adenoma Affecting both Parotid and Submandibular Glands

    PubMed Central

    Pingarrón-Martín, Lorena; Arias-Gallo, L. J.; Demaría-Martínez, G.; Chamorro Pons, M.

    2014-01-01

    The objective of this article is to present the first case reported in the literature of metachronous pleomorphic adenoma of bilateral parotid glands and submaxillary gland. The authors report the case of a 27-year-old female with metachronous mixed tumors in her right parotid and submandibular glands. The patient has no history of previous radiotherapy. All three lesions were diagnosed by fine-needle aspiration. The histopathologic evaluation of all three major salivary gland masses demonstrated pleomorphic adenomas, with no occult malignancy observed on serial sections. The presentation of pleomorphic adenomas in the parotids and submandibular glands probably represents three unrelated primary sites of tumor, yet the possibility of metastasis from one gland to the other cannot be excluded. PMID:26000084

  4. Synchronous benign and malignant tumors in the ipsilateral parotid gland.

    PubMed

    Roh, Jong-Lyel; Kim, Jin-Man; Park, Chan Il

    2007-01-01

    Synchronous benign and malignant tumors in the ipsilateral salivary glands are extremely rare. We report a unique case of synchronous unilateral parotid tumors in a 71-year-old man. The main parotid lesion was preoperatively suggested to be adenocarcinoma by fine needle aspiration cytology. A coexisting Warthin's tumor was also diagnosed on microscopic examination of total parotidectomy specimens. We describe this case of rare synchronous salivary gland tumors exhibiting both benign and malignant components with a review of the literature.

  5. A rare cause of unilateral parotid gland swelling: compensatory hypertrophy due to the aplasia of the contralateral parotid gland.

    PubMed

    Günbey, Hediye Pinar; Günbey, Emre; Tayfun, Fatma; Kaytez, Selda Kargin

    2014-05-01

    In this clinical report, 3 cases, admitted to the ears, nose, throat outpatient clinic with the complaints of unilateral swelling in the parotid region and facial asymmetry, are presented. In the etiology, contralateral parotid gland aplasia with compensatory hypertrophy and sialosis was detected. With this rare condition, clinical and radiological features of this anomaly are discussed. PMID:24799112

  6. Helical Tomotherapy for Parotid Gland Tumors

    SciTech Connect

    Lee, Tae Kyu; Rosen, Isaac I.; Gibbons, John P.; Fields, Robert S.; Hogstrom, Kenneth R.

    2008-03-01

    Purpose: To investigate helical tomotherapy (HT) intensity-modulated radiotherapy (IMRT) as a postoperative treatment for parotid gland tumors. Methods and Materials: Helical tomotherapy plans were developed for 4 patients previously treated with segmental multileaf collimator (SMLC) IMRT. A primary planning target volume (PTV64) and two secondary PTVs (PTV60, PTV54) were defined. The clinical goals from the SMLC plans were applied as closely as possible to the HT planning. The SMLC plans included bolus, whereas HT plans did not. Results: In general, the HT plans showed better target coverage and target dose homogeneity. The minimum doses to the desired coverage volume were greater, on average, in the HT plans for all the targets. Minimum PTV doses were larger, on average, in the HT plans by 4.6 Gy (p = 0.03), 4.8 Gy (p = 0.06), and 4.9 Gy (p = 0.06) for PTV64, PTV60, and PTV54, respectively. Maximum PTV doses were smaller, on average, by 2.9 Gy (p = 0.23), 3.2 Gy (p = 0.02), and 3.6 Gy (p = 0.03) for PTV64, PTV60, and PTV54, respectively. Average dose homogeneity index was statistically smaller in the HT plans, and conformity index was larger for PTV64 in 3 patients. Tumor control probabilities were higher for 3 of the 4 patients. Sparing of normal structures was comparable for the two techniques. There were no significant differences between the normal tissue complication probabilities for the HT and SMLC plans. Conclusions: Helical tomotherapy treatment plans were comparable to or slightly better than SMLC plans. Helical tomotherapy is an effective alternative to SMLC IMRT for treatment of parotid tumors.

  7. Surgical treatment outcomes of patients with bilateral warthin tumors in the parotid gland.

    PubMed

    Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

    2014-01-01

    We describe the treatment outcomes of patients with bilateral Warthin tumors in the parotid gland according to surgical methods. The medical records of ten patients with bilateral Warthin tumors in the parotid gland who underwent surgery between 2004 and 2011 were retrospectively reviewed. Ten patients were included in the study and 13 parotidectomies were performed. Patients with bilateral Warthin tumors in the parotid gland were divided into three groups according to the surgical methods used to treat these individuals. In group 1, the patients were closely observed without undergoing contralateral parotidectomy after unilateral parotidectomy. In group 2, the patients underwent concurrent bilateral parotidectomies. In group 3, the patient underwent contralateral parotidectomy 2 months after unilateral parotidectomy was performed. The overall rate of transient facial nerve dysfunction was 31%. Our findings suggest that concurrent superficial parotidectomy may be an appropriate method for treating bilateral Warthin tumors in the parotid gland, at least for desired patients. The symptoms of this type of tumor and physical examination findings are frequently non-specific and present in the unilateral parotid gland. Therefore, a high degree of discernment is needed and imaging techniques are essential for the determining the correct pre-operative diagnosis.

  8. Giant pleomorphic adenoma of the parotid gland.

    PubMed

    Çetin, Mehmet Ali; Ikincioğulları, Aykut; Saygı, Gökçe; Hatipoğlu, Hatice Gül; Köseoğlu, Sabri; Dere, Hüseyin

    2012-01-01

    Pleomorphic adenomas are the most common benign tumors of the salivary glands. These adenomas generally present without pain and are slowly enlarged. However, they can reach enormous sizes, because they are often neglected by the patient and due to late diagnosis and intervention because of fear of surgery or sociocultural factors. This may lead to functional, aesthetic and social problems. In this article, we present a 55-year-old female patient with a giant pleomorphic adenoma in size of 15x15x20 cm, who presented with the complaint of a mass enlarged and swollen for 20 years in her left neck and face and underwent a successful surgery.

  9. High-frequency ultrasound in parotid gland disease.

    PubMed

    Onkar, Prashant Madhukar; Ratnaparkhi, Chetana; Mitra, Kajal

    2013-12-01

    Parotid gland is involved in many inflammatory and neoplastic conditions. Many a times, it is difficult to ascertain the type of swelling by clinical examination. The anatomy and various abnormalities of the glands are very easily visualized by high-frequency ultrasound. Ultrasound can confirm the presence of the mass with sensitivity up to 100%. It can demonstrate whether a lesion is located in the parotid gland or outside. It can help in differentiating benign from malignant neoplasms and local staging of the mass in malignant lesions. In addition, ultrasound can identify those entities that may not need surgical intervention. The glands appear enlarged and show altered echopattern in acute inflammation and may be normal or reduce in size in chronic inflammation. Other pathologies that involve salivary glands are sialolithiasis and various benign and malignant neoplasms. Ultrasound many times suggests final diagnosis or supplies important differential diagnosis. In this article, the use of high-frequency ultrasound in parotid disease is discussed, and sonographic features of different parotid pathologies are reviewed with examples illustrated. High-frequency ultrasound is the first and many a times the only imaging investigation done for evaluation of parotid glands.

  10. Sonohistology for the computerized differentiation of parotid gland tumors.

    PubMed

    Scheipers, Ulrich; Siebers, Stefan; Gottwald, Frank; Ashfaq, Mohammad; Bozzato, Alessandro; Zenk, Johannes; Iro, Heinrich; Ermert, Helmut

    2005-10-01

    A system for the computerized differentiation of parotid gland tumors is proposed. The parotid gland is the largest of the salivary glands. It is found in the subcutaneous tissue of the face, overlying the mandibular ramus and anterior and inferior to the external ear. The classification system is based on a multifeature tissue characterization approach, using fuzzy inference systems as higher-order classifiers. Baseband ultrasonic echo data were acquired during conventional ultrasound imaging examinations using standard ultrasound equipment. Several tissue-describing parameters were calculated within numerous small regions of interest to evaluate spectral and textural tissue properties. The parameters were processed by an adaptive network-based fuzzy inference system, using the results of conventional histology after parotidectomy as the "gold standard." The results of the classification are presented as a numerical score indicating the probability of a certain tumor or alteration for each parotid gland. The score can be presented to the physician during examination of the patient to improve the differentiation between various types of parotid gland tumors. The system was evaluated on n = 23 cases of patients undergoing radical parotidectomy. The receiver operating characteristic curve area is A(ROC) = 0.95 +/- 0.07 when using fourfold cross-validation over cases and differentiating between various benign parotid gland tumors and monomorphic adenoma.

  11. Canalicular adenoma of the parotid gland: a case report.

    PubMed

    Rossiello, R; Rossiello, L; De Simone, S; Apicella, A; Lanza, A; Colella, G

    2003-01-01

    Canalicular adenoma is an uncommon benign neoplasm that occurs almost exclusively in the upper lip and, very rarely, in other sites. We describe a case arising in the left parotid gland as a firm, painful mass, in order to underline morphological and immunohistochemical findings, particularly in relation to differential diagnosis with low-grade carcinomas of the salivary glands.

  12. Unilateral multiple benign mixed tumors of the parotid gland.

    PubMed

    Behnke, E E

    1982-11-01

    Multiple tumors of a single salivary gland in an unoperated-on patient are rare; only five have previously been reported in the world literature. The author reports the sixth case of multiple, benign mixed tumors of a unilateral parotid gland in a 61-year-old woman, discusses its management, and reviews the literature.

  13. Natural killer cell lymphoma of the parotid gland.

    PubMed

    Furukawa, Masayuki; Suzuki, Hideaki; Tohmiya, Yasuo; Matsuura, Kazuto; Takahashi, Etsu; Ichinohasama, Ryo; Kobayashi, Toshimitsu

    2003-01-01

    The majority of all parotid lymphomas are of the non-Hodgkin type and of B-cell origin. Primary natural killer cell lymphomas of the parotid gland are extremely rare. We present a case of natural killer cell lymphoma in a 34-year-old woman. The disease was refractory to chemotherapy, and the patient eventually succumbed due to lymphoma-associated hemophagocytic syndrome. PMID:14564097

  14. Cavernous hemangioma with large phlebolith of the parotid gland.

    PubMed

    Choi, Hwan Jun; Lee, Joo Chul; Kim, Jun Hyuk; Lee, Young Man; Lee, Hyun Joo

    2013-11-01

    Hemangiomas are vascular anomalies characterized by increased proliferation and turnover of endothelial cells. Hemangiomas of the parotid region are relatively uncommon in adult population, and there are a few reports of hemangioma with large phlebolith within the parotid gland. We herein report a case of it. Sialography may be a useful investigation method in the evaluation of radiopaque lesions localized intraglandularly in the parotid area to rule out the sialolith. Cavernous hemangioma with phleboliths should be included in the differential diagnosis of a swelling in the mandibular area. PMID:24220486

  15. Oncocytoma of the Deep Lobe of the Parotid Gland

    PubMed Central

    Popovski, Vladimir; Benedetti, Alberto; Monevska, Danica Popovik; Grcev, Aleksandar; Serafimovski, Predrag; Pecanovski, Ruse; Stamatoski, Aleksandar

    2016-01-01

    BACKGROUND: Oncocytoma or oxyphilic adenoma is uncommon salivary gland tumour, occurs predominantly in the in patients older than 60 years of age. Clinically oncocytoma resemble other salivary tumours while histology is typically consisting of oncocytes with many hyperplastic mitochondria. It usually occurs in the parotid gland. Because the features of oncocytoma are similar to those of other benign and low-grade malignant salivary tumours, clinical diagnosis is often challenging. CASE PRESENTATION: This report presents the pathologic and imaging findings of an oncocytoma arising in the deep lobe of the right parotid gland in a 74-year-old male. Oncocytoma was diagnosed on the basis of histological, magnetic resonance imaging (MRI), scintigraphic findings and fine needle aspiration cytology (FNAC). CONCLUSION: This case was unique because in the literature there are few articles about the rare presentation and deep lobe location of this type of parotid oncocytoma. PMID:27335603

  16. Two cases of non-Hodgkin's lymphoma in the accessory parotid gland.

    PubMed

    Fujimura, Kazunobu; Yoshida, Masafumi; Sugimoto, Takuya; Kuroda, Yoshiki; Fujiyoshi, Tatsuya

    2004-06-01

    Primary malignant lymphomas in the salivary glands are relatively rare and tumors of the accessory parotid gland comprise only 1% of parotid tumors. We present two cases with a painless swelling of the cheek region. In both cases histological diagnoses of primary non-Hodgkin's lymphoma were made following complete excision of the accessory parotid gland tumor. PMID:15121232

  17. Papillary Cystadenocarcinoma of the Parotid Gland: A Rare Case Report

    PubMed Central

    Job, Anjana Juanita; Manipadam, Marie Therese

    2016-01-01

    Papillary cystadenocarcinoma is a rare malignant neoplasm of the salivary gland, characterized by noticeable cystic and solid areas with papillary endophytic projections. These tumours lack features that characterize cystic variants of several more common salivary gland carcinomas. It was first described in 1991 by World Health Organization as a separate entity and cystadenocarcinoma with or without papillary component in the AFIP classification. Most of these tumours occurred in the major salivary glands followed by minor salivary glands. Cystadenocarcinoma is the malignant counterpart of cystadenoma. We report a case of papillary cystadenocarcinoma of parotid. A 40-year-old lady presented with gradually progressive swelling below the right ear associated with occasional pain. Clinical and radiological features suggested benign neoplasm. Right lobe superficial parotidectomy was performed. The histopathologic diagnosis showed papillary cystadenocarinoma of the parotid gland. Histologic confirmation of stromal invasion is required to differentiate it from the benign lesion. Conservative wide local surgical excision is the treatment of choice. PMID:27504297

  18. Papillary Cystadenocarcinoma of the Parotid Gland: A Rare Case Report.

    PubMed

    Telugu, Ramesh Babu; Job, Anjana Juanita; Manipadam, Marie Therese

    2016-06-01

    Papillary cystadenocarcinoma is a rare malignant neoplasm of the salivary gland, characterized by noticeable cystic and solid areas with papillary endophytic projections. These tumours lack features that characterize cystic variants of several more common salivary gland carcinomas. It was first described in 1991 by World Health Organization as a separate entity and cystadenocarcinoma with or without papillary component in the AFIP classification. Most of these tumours occurred in the major salivary glands followed by minor salivary glands. Cystadenocarcinoma is the malignant counterpart of cystadenoma. We report a case of papillary cystadenocarcinoma of parotid. A 40-year-old lady presented with gradually progressive swelling below the right ear associated with occasional pain. Clinical and radiological features suggested benign neoplasm. Right lobe superficial parotidectomy was performed. The histopathologic diagnosis showed papillary cystadenocarinoma of the parotid gland. Histologic confirmation of stromal invasion is required to differentiate it from the benign lesion. Conservative wide local surgical excision is the treatment of choice.

  19. Lymphadenoma arising in the parotid gland: a case report.

    PubMed

    Kwon, Ghee Young; Kim, Eo-Jin; Go, Jai Hyang

    2002-08-01

    We report a case of lymphadenoma arising in the parotid gland. A 53-year-old female patient presented with a mass in the parotid gland. Grossly, it was a well-demarcated solid mass measuring 3 cm in diameter. Microscopic examination revealed many cysts or duct-like structures in the background of the prominent lymphoid stroma, confirming a diagnosis of lymphadenoma. This particular case was thought to have arisen from an intraparotid lymph node. Lymphadenoma is a rare benign neoplasm of the salivary gland with partial resemblance to other salivary gland tumors, such as Warthin's tumor, cystadenoma, sebaceous lymphadenoma or mucoepidermoid carcinoma. Therefore proper recognition of this rare entity is warranted to avoid confusion in the diagnosis.

  20. Effect of Cisplatin on Parotid Gland Function in Concomitant Radiochemotherapy

    SciTech Connect

    Hey, Jeremias; Setz, Juergen; Gerlach, Reinhard; Vordermark, Dirk; Gernhardt, Christian R.; Kuhnt, Thomas

    2009-12-01

    Purpose: To determine the influence of concomitant radiochemotherapy with cisplatin on parotid gland tissue complication probability. Methods and Materials: Patients treated with either radiotherapy (n = 61) or concomitant radiochemotherapy with cisplatin (n = 36) for head-and-neck cancer were prospectively evaluated. The dose and volume distributions of the parotid glands were noted in dose-volume histograms. Stimulated salivary flow rates were measured before, during the 2nd and 6th weeks and at 4 weeks and 6 months after the treatment. The data were fit using the normal tissue complication probability model of Lyman. Complication was defined as a reduction of the salivary flow rate to less than 25% of the pretreatment flow rate. Results: The normal tissue complication probability model parameter TD{sub 50} (the dose leading to a complication probability of 50%) was found to be 32.2 Gy at 4 weeks and 32.1 Gy at 6 months for concomitant radiochemotherapy and 41.1 Gy at 4 weeks and 39.6 Gy at 6 months for radiotherapy. The tolerated dose for concomitant radiochemotherapy was at least 7 to 8 Gy lower than for radiotherapy alone at TD{sub 50}. Conclusions: In this study, the concomitant radiochemotherapy tended to cause a higher probability of parotid gland tissue damage. Advanced radiotherapy planning approaches such as intensity-modulated radiotherapy may be partiticularly important for parotid sparing in radiochemotherapy because of cisplatin-related increased radiosensitivity of glands.

  1. Necrotizing sialometaplasia of the parotid gland in a dog.

    PubMed

    Kim, Ha-Young; Woo, Gye-Hyeong; Bae, You-Chan; Park, Yeon-Hee; Joo, Yi-Seok

    2010-11-01

    Necrotizing sialometaplasia (NS) is a self-limiting, benign, ischemic, inflammatory disease that is most often described in the submandibular glands of dogs, with clinical and histologic features that resemble malignancy. Unilateral swelling of the parotid salivary gland in a 7-year-old Cocker Spaniel dog was diagnosed as NS. The dog also had otitis externa on the same side as the parotid gland lesions. The main histologic features were included lobular necrosis of salivary tissue; fibrinoid necrosis of some arteries; marked squamous metaplasia of duct and/or acinar epithelium, with intercellular bridge formation; preservation of salivary lobular morphology; and variable inflammation and fibrosis. Etiologic factors for NS in both humans and animals remain obscure.

  2. [Salivary duct cyst of the parotid gland and adenocarcinoma].

    PubMed

    Schwetschke, O; Zimmerer, A; Bosch, F X; Maier, H

    1994-07-01

    The progression of benign cystic lesions of the parotid gland to malignant tumors is an extremely rare event and has been described only for cystadenolymphomas. Here we present a case of malignant transformation to an adenocarcinoma occurring in ductal cells forming the wall of a parotid retention cyst. In addition to clinical and histological findings, we describe the results of immunohistochemical and molecular analyses providing evidence that the cells undergoing neoplastic transformation were latently infected by Epstein-Barr virus (EBV). These results suggest a possible causal relationship between latent EBV infection and malignant progression.

  3. A comparison of mean parotid gland dose with measures of parotid gland function after radiotherapy for head-and-neck cancer: Implications for future trials

    SciTech Connect

    Roesink, Judith M. . E-mail: J.M.Roesink@azu.nl; Schipper, Maria; Busschers, Wim; Raaijmakers, Cornelis P.J.; Terhaard, Chris H.J.

    2005-11-15

    Purpose: To determine the most adequate parameter to measure the consequences of reducing the parotid gland dose. Methods and Materials: One hundred eight patients treated with radiotherapy for various malignancies of the head and neck were prospectively evaluated using three methods. Parotid gland function was objectively determined by measuring stimulated parotid flow using Lashley cups and scintigraphy. To assess xerostomia-related quality of life, the head-and-neck cancer module European Organization for Research and Treatment of Cancer QLQ (Quality of Life Questionnaire) H and N35 was used. Measurements took place before radiotherapy and 6 weeks and 12 months after the completion of radiotherapy. Complication was defined for each method using cutoff values. The correlation between these complications and the mean parotid gland dose was investigated to find the best measure for parotid gland function. Results: For both flow and scintigraphy data, the best definition for objective parotid gland toxicity seemed to be reduction of stimulated parotid flow to {<=}25% of the preradiotherapy flow. Of all the subjective variables, only the single item dry mouth 6 weeks after radiotherapy was found to be significant. The best correlation with the mean parotid gland dose was found for the stimulated flow measurements. The predictive ability was the highest for the time point 1 year after radiotherapy. Subjective findings did not correlate with the mean parotid dose. Conclusions: Stimulated flow measurements using Lashley cups, with a complication defined as flow {<=}25% of the preradiotherapy output, correlated best with the mean parotid gland dose. When reduction of the mean dose to the parotid gland is intended, the stimulated flow measurement is the best method for evaluating parotid gland function.

  4. Polymorphous low-grade adenocarcinoma of the parotid gland.

    PubMed

    Krishnamurthy, Arvind; Vaidhyanathan, Anitha; Majhi, Urmila

    2011-01-01

    Polymorphous low-grade adenocarcinoma (PLGA) has been recently recognized as a distinct entity with a known predilection for minor salivary glands. We present an unusual case of recurrent PLGA arising within the right parotid gland in a 25-year-old lady. The striking histological picture is diverse architecture combined with benign cytological features. Even in the light of multiple recurrences, our tumor displayed a relatively indolent course which is commonly associated with this adenocarcinoma sub-type. Thus, unusual occurrence demonstrates that this tumor should also be considered in differentials of tumors of the major salivary glands. Long-term follow-up is essential to ensure local control.

  5. Function of the parotid gland following radiation therapy for head and neck cancer

    SciTech Connect

    Cheng, V.S.T.; Downs, J.; Herbert, D.; Aramany, M.

    1981-02-01

    The parotid gland was selected for study of its salivary output before and after radiation therapy for head and neck cancer. Before radiation therapy, a sialogram of the parotid gland was performed with the patient's head positioned for radiation therapy; a lateral radiographic view of the parotid gland was used to compare with the radiation treatment portal to determine the portion of the parotid gland to be irradiated. Samples of stimulated saliva were collected from the parotid gland before and at 1 and 6 months post-radiation. Eighteen patients with head and neck cancer who received radiation therapy were studied. The data showed that in the irradiation of nasopharyngeal, advanced oropharyngeal and Waldeyer's ring lesions, 100% of the parotid gland was irradiated; for the early oropharyngeal and hypopharyngeal lesions, from 30 to 90% of the parotid gland was irradiated and for the supraglottic and oral cavity lesions, 25 to 30% of the parotid gland was irradiated. When 100% of the parotid gland was irradiated, no saliva was produced at 1 month post-radiation; this remained the same when re-tested at 4 to 8 months, however, when any portion of the parotid gland was not irradiated, there was residual salivary function.

  6. Simple tool for prediction of parotid gland sparing in intensity-modulated radiation therapy

    SciTech Connect

    Gensheimer, Michael F.; Hummel-Kramer, Sharon M.; Cain, David; Quang, Tony S.

    2015-10-01

    Sparing one or both parotid glands is a key goal when planning head and neck cancer radiation treatment. If the planning target volume (PTV) overlaps one or both parotid glands substantially, it may not be possible to achieve adequate gland sparing. This finding results in physicians revising their PTV contours after an intensity-modulated radiation therapy (IMRT) plan has been run and reduces workflow efficiency. We devised a simple formula for predicting mean parotid gland dose from the overlap of the parotid gland and isotropically expanded PTV contours. We tested the tool using 44 patients from 2 institutions and found agreement between predicted and actual parotid gland doses (mean absolute error = 5.3 Gy). This simple method could increase treatment planning efficiency by improving the chance that the first plan presented to the physician will have optimal parotid gland sparing.

  7. Parotid gland solitary fibrous tumor with mandibular bone destruction and aggressive behavior

    PubMed Central

    González-Otero, Teresa; Castro-Calvo, Alejandro; Ruiz-Bravo, Elena; Burgueño, Miguel

    2014-01-01

    Introduction: Solitary fibrous tumor is associated with serosal surfaces. Location in the salivary glands is extremely unusual. Extrathoracic tumors have an excellent prognosis associated with their benign clinical behavior. We report an aggressive and recurrent case of this tumor. We review the clinical presentation, inmunohistochemical profiles and therapeutic approaches. Case Report: A 73-years-old woman presented a mass in her right parotid gland. She had a past history of right superficial parotidectomy due to a neurilemoma. FNAB and magnetic resonance were non-specific. After a tumor resection, microscopic findings were spindled tumor cells with reactivity to CD34, bcl-2 and CD99 and the tumor was diagnosed as Solitary Fibrous Tumor. The patient suffered two recurrences and the tumor had a histological aggressive behavior and a destruction of the cortical bone of the mandible adjacent to the mass. A marginal mandibulectomy with an alveolar inferior nerve lateralization was performed. Conclusions: Solitary fibrous tumor is a very rare tumor. Usually, they are benign, but occasionally they can be aggressive. Complete resection is the most important prognostic factor and no evidence supports the efficacy of any therapy different to surgery. Due to the unknown prognosis and to the small number of cases reported, a long-term follow-up is guaranteed. Key words:Solitary fibrous tumor, parotid mass, parotid gland, salivary gland, rare tumors. PMID:25136435

  8. Adenocarcinoma arising in warthin tumor of the parotid gland.

    PubMed

    Sayar, Hamide; Öztarakçi, Hüseyin; Sayar, Çağdaş; Ağirbaş, Şule

    2012-01-01

    Warthin tumor is a well-defined benign salivary gland neoplasm consisting of both epithelial and lymphoid components. The tumor is the second most common benign tumor next to pleomorphic adenoma. We present a case of adenocarcinoma, not otherwise classified, arising in unilateral Warthin tumor of the parotid gland in a 63-year-old male patient. Carcinomas arising in or from the epithelial component of a preexisting parotid Warthin tumor are rare and differential diagnosis of metastasis from an adenocarcinoma in Warthin tumor is important. The patient underwent a complete and thorough work-up, and no other primary malignant lesion was found. No other primary malignant lesion had manifested at the last one year follow-up period.

  9. [X-ray diagnosis of parotid gland tumors (without contrasting)].

    PubMed

    Skotnikov, V I; Khazov, P D

    1977-01-01

    The clinico-roentgenological semiotics of neoplastic lesions of the parotid gland in 82 patients is described. In 51 of them mixed tumors were noted, adenomas, angiomas, lipomas - in 8, cancer, sarcoma, metastases - in 16, chronic parotitis simulating the tumor - in 7. Based on the conducted studies, it was found that this method, taking into account the clinical findings too, largely makes it possible (in 79 of 82 cases) to establish the differential diagnosis between different neoplastic processes and chronic parotitis.

  10. In vivo biocompatibility of the PLGA microparticles in parotid gland

    PubMed Central

    Cantín, Mario; Miranda, Patricio; Suazo Galdames, Iván; Zavando, Daniela; Arenas, Patricia; Velásquez, Luis; Vilos, Cristian

    2013-01-01

    Poly(lactic-co-glycolic acid) (PLGA) microparticles are used in various disorders for the controlled or sustained release of drugs, with the management of salivary gland pathologies possible using this technology. There is no record of the response to such microparticles in the glandular parenchyma. The purpose of this study was to assess the morphological changes in the parotid gland when injected with a single dose of PLGA microparticles. We used 12 adult female Sprague Dawley rats (Rattus norvegicus) that were injected into their right parotid gland with sterile vehicle solution (G1, n=4), 0.5 mg PLGA microparticles (G2, n=4), and 0.75 mg PLGA microparticles (G3, n=4); the microparticles were dissolved in a sterile vehicle solution. The intercalar and striated ducts lumen, the thickness of the acini and the histology aspect in terms of the parenchyma organization, cell morphology of acini and duct system, the presence of polymeric residues, and inflammatory response were determined at 14 days post-injection. The administration of the compound in a single dose modified some of the morphometric parameters of parenchyma (intercalar duct lumen and thickness of the glandular acini) but did not induce tissue inflammatory response, despite the visible presence of polymer waste. This suggests that PLGA microparticles are biocompatible with the parotid tissue, making it possible to use intraglandular controlled drug administration. PMID:24228103

  11. Benign cystic teratoma of the parotid salivary gland: report of the first case in Thailand.

    PubMed

    Ayudhya, N S; Parichatikanond, P; Chinda, K

    1991-10-01

    An extremely rare case of benign cystic teratoma of the parotid salivary gland is presented with a review of the literature. It was found in a 35-year-old Thai woman farmer who had had a history of a movable mass at the left parotid gland region for about 20 years. The microscopic examination revealed benign cystic teratoma of the parotid salivary gland. There is only one reported case in the literature, so, this is the second reported case.

  12. Primary cutaneous mucoepidermoid carcinoma infiltrating the parotid gland.

    PubMed

    Minni, A; Roukos, R; De Carlo, A; Di Tillo, G; Illuminati, G; Gallo, P

    2012-10-01

    Mucoepidermoid carcinoma (MEC) of the skin is an extremely rare neoplasm but is common in the major and minor salivary glands accounting of approximately 30% of all malignant tumors arising from these glands. Cutaneous involvement should be carefully assessed to exclude the possibility of metastases from distant sites. We report an 81 year-old man presenting a primary cutaneous mucoepidermoid carcinoma infiltrating his left parotid gland. Excision of the affected skin and a total parotidectomy with supraomohyoid neck dissection (level I-III) was performed followed by radiotherapy. No relapse after 2 years follow up has been observed. Since the primary cutaneous mucoepidermoid carcinoma is an aggressive neoplasm that frequently develops metastases it is important to distinguish it from primary MEC originating from the salivary glands for better management and suitable therapeutic decisions.

  13. Primary cutaneous mucoepidermoid carcinoma infiltrating the parotid gland.

    PubMed

    Minni, A; Roukos, R; De Carlo, A; Di Tillo, G; Illuminati, G; Gallo, P

    2012-10-01

    Mucoepidermoid carcinoma (MEC) of the skin is an extremely rare neoplasm but is common in the major and minor salivary glands accounting of approximately 30% of all malignant tumors arising from these glands. Cutaneous involvement should be carefully assessed to exclude the possibility of metastases from distant sites. We report an 81 year-old man presenting a primary cutaneous mucoepidermoid carcinoma infiltrating his left parotid gland. Excision of the affected skin and a total parotidectomy with supraomohyoid neck dissection (level I-III) was performed followed by radiotherapy. No relapse after 2 years follow up has been observed. Since the primary cutaneous mucoepidermoid carcinoma is an aggressive neoplasm that frequently develops metastases it is important to distinguish it from primary MEC originating from the salivary glands for better management and suitable therapeutic decisions. PMID:23090800

  14. Parotid gland biopsy and /sup 67/Ga imaging correlation in systemic sarcoidosis

    SciTech Connect

    Brantley, S.D.; Orzel, J.A.; Weiland, F.L.; Bower, J.H.

    1987-03-01

    We correlated the results of parotid gland biopsy, chest roentgenograms, and gallium citrate scintigraphy in 24 patients evaluated for possible systemic sarcoidosis. Of 19 patients ultimately proven to have sarcoidosis, 11 (57.9 percent) had positive parotid gland biopsy. The yield of parotid gland biopsy in patients with abnormal gallium parotid activity was only marginally higher (64.7 percent). Abnormal parotid gland uptake of gallium citrate was seen in 17 of these 19 patients (89.5 percent) and was always associated with abnormal lung or perihilar activity. The parotid gland biopsy is a useful technique for obtaining the tissue diagnosis of sarcoidosis; however, gallium scintigraphy should not be performed to select patients as this will only marginally increase the biopsy yield.

  15. Transglutaminase expression in rat parotid gland after isoproterenol stimulation.

    PubMed

    Cocuzzi, E; Kim, H C; Beninati, S; Hand, A R; Chung, S I

    1989-11-01

    Transglutaminases (E.C. 2.3.2.13) are calcium-dependent enzymes that catalyze the covalent cross-linking of proteins, and occur in multiple molecular forms in a variety of tissues. Distribution of each form of transglutaminase varies with different tissues. Studies were undertaken to characterize the form of transglutaminase expressed in rat parotid gland, and to examine a possible physiological role for the enzyme. It was found that chronic treatment of rats with the beta-adrenergic agonist isoproterenol (IPR) resulted in the induction of parotid transglutaminase activity. The properties of this transglutaminase appeared to be distinct from those of the well-characterized guinea pig liver cytosol transglutaminase (TGase C). The findings that protein polymerization (observed on SDS-PAGE) and incorporation of radioactive putrescine, a polyamine, into protein occur in the presence of exogenous transglutaminase and calcium indicated that certain rat parotid salivary proteins are or could be substrates for this enzyme. Analysis of proteolytic digests of rat parotid salivary proteins on an amino acid analyzer and by high-performance liquid chromatography also indicated that these salivary proteins contain gamma-glutamyl derivatives of primary amines (e.g., polyamines or lysine), post-translational products of transglutaminase catalysis. The possible physiological function of this enzyme in the oral cavity might be stabilization of proteinaceous structures during normal oral homeostasis and/or woundhealing. PMID:2573623

  16. Bilateral acinous cell tumors of the parotid gland.

    PubMed

    Nelson, D W; Nichols, R D; Fine, G

    1978-12-01

    Acinous cell tumors are uncommon neoplasms which arise either from the secretory cells of the salivary gland acini or from pluripotential duct cells and occur almost exclusively in the parotid gland. Nine previous instances of the bilateral occurrence of this tumor in the parotid gland have been reported. We present a tenth case and illustrate several aspects of the clinical behavior of this unique tumor. The histological pattern of this type of tumor was considered universally to be benign until 1953 when attention was called to a malignant variant. It is difficult to find reference to a benign form after that time. It is, in fact, impossible to forecast the clinical behavior of an individual specimen based upon its histopathology. In order to recognize this unpredictability, the World Health Organization Classification of Epithelial Tumors of Salivary Gland Origin proposed a category, "Acinic Cell Tumors," separate from clearly benign or malignant neoplasms. Later, attention was called to the grammatical designation, "acinous cell tumor." Because acinous cell tumors are uncommon, numerically significant series are gathered from several institutions or over several decades during which treatment methods vary widely. This makes it difficult to accept the validity of conclusions based upon the reported data. There is, however, a clearly documented tendency of the tumor to recur after long symptomless intervals so that extended follow-up is necessary before "cure" is established. Treatment of acinous cell tumors is surgical. The value of radiation therapy in the management of recurrent tumors is not firmly established.

  17. Melatonin-induced protein synthesis in the rat parotid gland.

    PubMed

    Cevik-Aras, H; Godoy, T; Ekstrom, J

    2011-02-01

    Melatonin occurs in large amounts in the intestinal mucosa and is released during a meal. Recent studies of ours reveal that exogenous melatonin evokes the in vivo secretion of protein and amylase from the rat parotid gland. The aim of the present study was to investigate the effect of melatonin on the protein synthesis of the parotid gland of pentobarbitone-anaesthetised rats as estimated by the rate of incorporation of [³H]leucine into trichloroacetic acid-insoluble material of the gland. Compared with the parotid protein synthesis (set at 100%) of those rats exposed to an intravenous infusion of melatonin (25 mg/kg during 1 hour), under muscarinic and α- and β-adrenoceptor blockade, the synthesis in the corresponding glands of saline-treated control rats was less (by 25%). The synthesis was also less when the melatonin administration was combined with the melatonin 2-preferring receptor antagonist luzindole (24%), the non-selective nitric oxide synthase inhibitor L-NAME (18%) and the neuronal nitric oxide synthase inhibitor N-PLA (21%). Almost all the melatonin receptor-mediated effect was due to nitric oxide generation via the activity of neuronal type nitric oxide synthase. The present findings lend further weight to the idea that salivary glandular activity associated with food intake is hormonally influenced and they also suggest clinical implications for melatonin in the treatment of xerostomia. Since melatonin is known to exert anti-inflammatory actions in the oral cavity, the stimulatory effect of melatonin may include the synthesis of proteins of importance for the oral defence.

  18. Adenoid cystic carcinoma of the parotid gland associated with salivary calculi: An unusual presentation.

    PubMed

    Shenoy, Vijendra S; Kamath, M Panduranga; Sreedharan, Suja; Suhas, S S

    2015-01-01

    Adenoid cystic carcinomas (ACC) of the head and neck are relatively rare tumors, consisting of approximately 10-15% of all salivary gland neoplasms. ACC, a slow-growing aggressive malignant tumor of salivary gland commonly seen in the submandibular, sublingual, minor salivary glands is seldom found in the parotid. Calculus, the common cause of salivary gland dysfunction is usually identified in submandibular salivary gland because of its duct anatomy and physiochemical characteristic serous secretion. We report an unusual case of co-existent presentation of ACC with salivary calculi in the parotid gland which is never been reported in the literature. Co-existence of ductal calculi and ACC is rare. Presence of parotid calculus could be due to long standing ductal obstruction by the slow-growing ACC of the parotid or other possibility is that the malignancy could have developed because of chronic irritation by parotid calculi. Confirmatory studies are required to understand its mutual pathological association. PMID:26458630

  19. Giant solitary fibrous tumor of the parotid gland.

    PubMed

    Chis, Octavian; Albu, Silviu

    2014-01-01

    Solitary fibrous tumors (SFTs) are rare tumors that are mostly found arising from the pleura. SFT of the parotid gland is a rare tumor; only a few cases have been described in the literature. SFTs are benign in most cases. Clinically, SFTs usually manifest as well circumscribed, slow-growing, smooth, and painless masses. CT-Scan and MRI are the most sensitive imaging procedures used. The treatment of choice is complete surgical excision of the lesion. Since recurrence and metastasis can take place after several years, a lifelong clinical and imaging regular follow-up is compulsory. In this paper, we describe the diagnostic and therapeutic challenges of the up-to-now biggest parotid SFT. The clinical presentation, surgical management, and pathological and immunohistochemistry findings are described.

  20. Sclerosing Mucoepidermoid Carcinoma of the Parotid Gland

    PubMed Central

    Bidari-Zerehpoosh, Farahnaz; Naghibzadeh, Bijan; Jamali, Elena; Jamali, Moein; Mafi, Amirali; Bahrami-Motlagh, Hooman

    2016-01-01

    Introduction: Mucoepidermoid carcinoma represents one of the most common malignant salivary gland tumors. However, the sclerosing morphologic variant is extremely rare with only 23 reported cases in the English-language literature since it was discovered in 1987. Case Report: Herein, we describe another case that was diagnosed in a 25-year-old woman presenting with a posterior auricular mass, as well as a review of the literature, which demonstrates that this is an extremely rare malignancy with no strict protocol for treatment. Conclusion: Pathologists must be aware of recognizing low grade sclerosing mucoepidermoid carcinoma which has metastatic potential and is frequently misdiagnosed as a benign lesion.

  1. Sclerosing Mucoepidermoid Carcinoma of the Parotid Gland

    PubMed Central

    Bidari-Zerehpoosh, Farahnaz; Naghibzadeh, Bijan; Jamali, Elena; Jamali, Moein; Mafi, Amirali; Bahrami-Motlagh, Hooman

    2016-01-01

    Introduction: Mucoepidermoid carcinoma represents one of the most common malignant salivary gland tumors. However, the sclerosing morphologic variant is extremely rare with only 23 reported cases in the English-language literature since it was discovered in 1987. Case Report: Herein, we describe another case that was diagnosed in a 25-year-old woman presenting with a posterior auricular mass, as well as a review of the literature, which demonstrates that this is an extremely rare malignancy with no strict protocol for treatment. Conclusion: Pathologists must be aware of recognizing low grade sclerosing mucoepidermoid carcinoma which has metastatic potential and is frequently misdiagnosed as a benign lesion. PMID:27602340

  2. A rare cytological diagnosis of primary non-Hodgkin lymphoma of the parotid gland

    PubMed Central

    Dey, Biswajit; Goyal, Vasudha; Bharti, Jyotsna Naresh; Mahajan, Nidhi; Jain, Shyama

    2016-01-01

    Primary lymphoma of the parotid gland is relatively rare and constitutes about 4-5% of extranodal lymphomas. The majority of them is non-Hodgkin lymphoma (NHL) and is B cell in nature. We report a case of primary diffuse large B-cell lymphoma (DLBCL) of the parotid gland in an elderly male. The case was diagnosed on fine needle aspiration cytology (FNAC) of the right parotid gland as high grade B-cell NHL and confirmed on histopathology as DLBCL. In correlation with the clinicoradiological findings, the case was diagnosed as primary parotid DLBCL. The case highlights the role of FNAC as a timely and useful diagnostic tool. PMID:27279690

  3. Adenocarcinoma of the parotid salivary gland in a cow.

    PubMed

    Salgado, Breno S; Monteiro, Lidianne N; Grandi, Fabrizio; Nonogaki, Suely; Rocha, Rafael M; Rocha, Noeme S

    2012-09-01

    A 6-year-old Girolando dairy cow was presented for evaluation of a large subcutaneous facial mass. Fine-needle aspirates of the mass contained many neoplastic cells with high nuclear:cytoplasmic ratios arranged in sheets and loosely cohesive clusters with streaming erythrocytes and neutrophils in the background. Neoplastic cells were 13-25 μm in diameter and were round to cuboidal with variably distinct borders. Based on the signalment, anatomic location, and cytologic findings, differential diagnoses included salivary adenocarcinoma, squamous cell carcinoma, and mucoepidermoid carcinoma. The cow was euthanized and a necropsy was performed. The primary neoplasm arose from the left parotid salivary gland and meastatic tumor was found in the regional lymph nodes and lung. Histologically, the tumor was composed of anastomosing and irregular solid islets surrounded by scant stroma. Cells were negative for periodic acid-Schiff (PAS), PAS-diastase, and Alcian blue pH 2.5 stains, used to detect mucin. On immunohistochemical analysis, neoplastic luminal salivary gland cells expressed cytokeratin, but not S100, α-smooth muscle actin, or vimentin. Peripheral cells of neoplastic islets were immunoreactive for p63. The final diagnosis was nonsecretory adenocarcinoma of the parotid salivary gland. PMID:22954300

  4. Composite lymphoma arising in the parotid gland: a case report.

    PubMed

    Urano, Makoto; Mizoguchi, Yoshikazu; Nishio, Tomoko; Abe, Masato; Kuroda, Makoto; Saito, Shoji; Sakurai, Kazuo

    2004-03-01

    A case of composite lymphoma (CL) arisen in the parotid gland in a 58-year-old male is reported. Histologically, most of the tumor region was follicular lymphoma (FL), grade 2. However complicating classical Hodgkin lymphoma (CHL) was noted inside the lesion. There have been a few reports of composite lymphoma, complicated by multiple histologic types in the same organ. Extra-nodal cases are particularly rare. This is a very significant case with regard to differences between B cell-derived non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) and its histological origin. PMID:15041061

  5. Large cell neuroendocrine carcinoma of the parotid gland: case report and literature review.

    PubMed

    Casas, Pablo; Bernáldez, Ricardo; Patrón, Mercedes; López-Ferrer, Pilar; García-Cabezas, Miguel A

    2005-03-01

    A 74-year-old male presented with a large polinodular mass in the neck. Fine needle aspiration cytology (FNAC) showed an undifferentiated large cell carcinoma. Computed tomography (CT) showed a large parotid mass with multiple satelite nodules. The remaining radiological studies were normal. Radical parotidectomy was performed. The tumor was a large cell carcinoma with neuroendocrine features and positive immunostain for neuroendocrine markers. The patient received postoperative radiotherapy and was free of tumor eight months later. Only four cases of large cell neuroendocrine carcinoma (LCNEC) of the salivary gland have been communicated. All of them have involved the parotid gland. This tumor presents in elderly patients as a large infiltrating parotid mass. Fine needle aspiration cytology serves to recognize the carcinoma, but it fails in recognizing the neuroendocrine features of the tumor. The histopathological features of this tumor are the same as in other organs. Chromogranin and synaptophysin are useful immunohistochemical markers. A primary location of the tumor in another organ, specially the lung, should be ruled out. Surgery is the main treatment modality and can be complemented with postoperative radiotherapy. The prognosis seems to be poor. More studies are needed to better define the therapeutical alternatives and prognostic factors of these rare tumors.

  6. Warthin's tumor of the parotid salivary gland. A case report.

    PubMed

    Patel, B; Mandel, L

    1999-10-01

    Neoplasms of the salivary glands are not uncommon. The dentist is in the unique position to make an early diagnosis and refer the patient for definitive treatment. This article will review the clinical appearance, pathology, treatment and potential complications of Warthin's tumor, a benign salivary gland tumor. It describes a case presented at the Salivary Gland Center. Columbia University School of Dental and Oral Surgery, New York Presbyterian Hospital-Columbia Campus.

  7. Preservation of Facial Nerve With Adjuvant Radiotherapy for Recurrent Mammary Analogue Secretory Carcinoma of Parotid Gland.

    PubMed

    Jin, Shufang; Ma, Hailong; He, Yue

    2016-06-01

    Mammary analogue secretory carcinoma of salivary glands harbors the recurrent ETV6-NTRK3 gene fusion because of the translocation t (12; 15) (p13; q25) and resembles breast secretory carcinoma. This tumor composed of papillary, cystic, solid, and cribriform patterns. Immunohistochemically, the tumors are positive for mammaglobin, CK7, CK8, STAT5a, vimentin, and S100. In this report, the authors presented a patient of recurrent parotid gland mammary analogue secretory carcinoma in a 22-year-old woman. The patient received extended parotidectomy with partial adhesive masseter surgery. The facial nerve was preserved during the surgery and adjuvant radiotherapy was performed postoperation. The patient did not suffer local recurrence and facial paralysis in the 18 months follow-up period. PMID:27192652

  8. Sialolipoma of the parotid gland: Case report with literature review comparing major and minor salivary gland sialolipomas.

    PubMed

    Qayyum, Sohail; Meacham, Ryan; Sebelik, Merry; Zafar, Nadeem

    2013-01-01

    Sialolipoma is a rare tumor found within both major and minor salivary glands. Here we discuss sialolipoma of the parotid gland and briefly review the English literature. Including our case, a total of 35 sialolipomas have been reported, 18 within major salivary glands and 17 within minor salivary glands. Major gland sialolipomas most often are presented in the parotid gland (77%) and those from minor glands were most often seen in the palate (41%). All lesions were well circumscribed and contained mature adipose tissue intimately admixed with benign salivary gland components. Ductal dilatation was found in 100% of minor salivary gland sialolipomas but in only 28% of major salivary gland tumors. Nerve entrapment has also rarely been noted in major salivary glands (14%) whereas myxoid degeneration has been identified in rare minor salivary glands tumors (13%). Treatment is surgical excision and is curative with no reports of recurrence.

  9. Rosai Dorfman disease of the parotid and submandibular glands: salivary gland scintigraphy and oral findings in two siblings.

    PubMed

    Güven, G; Ilgan, S; Altun, C; Gerek, M; Gunhan, O

    2007-10-01

    Rosai-Dorfman disease (RDD) is an unusual clinical entity characterized by benign pseudolymphomatous proliferation with significant histiocytic infiltration. In the present paper, extranodal RDD of the major salivary glands causing salivary hypofunction and the results of salivary gland scintigraphy and ultrasound are presented in two siblings. Case 1: a 10-year-old boy with bilateral painless masses around the parotid and submandibular glands was referred. Ultrasound examination showed bilateral, well-defined, hypoechoic solid mass lesions within both parotid glands with minimal normal parenchyma in the upper poles. Both submandibular glands were markedly hypoechoic and heterogeneous. Mass lesions within the parotid glands appeared as cold lesions with regular contours on scintigraphy. Dynamic images showed normal uptake and normal response to secretion in the upper poles of the parotid glands, corresponding with ultrasonographically normal parenchyma. Both submandibular glands showed markedly diminished uptake and secretion. Case 2: a 9-year-old boy presented with mass lesions around the submandibular glands. Ultrasound examination showed normal parotid glands and markedly hypoechoic and heterogeneous submandibular glands. Salivary gland scintigraphy showed normal uptake and secretion of parotid glands with markedly diminished uptake and secretion in both submandibular glands. There were severe carious lesions in both patients due to salivary hypofunction. Treatments of the two patients' teeth were performed. Major salivary gland involvement of RDD is important for dentists as it may cause xerostomia and can mimic dental abscess. Functional evaluation of salivary glands with scintigraphy, besides radiological and pathological techniques, will help to explain whether salivary glands are affected or not and improve the diagnostic effectiveness.

  10. Rat parotid gland cell differentiation in three-dimensional culture.

    PubMed

    Baker, Olga J; Schulz, David J; Camden, Jean M; Liao, Zhongji; Peterson, Troy S; Seye, Cheikh I; Petris, Michael J; Weisman, Gary A

    2010-10-01

    The use of polarized salivary gland cell monolayers has contributed to our understanding of salivary gland physiology. However, these cell models are not representative of glandular epithelium in vivo, and, therefore, are not ideal for investigating salivary epithelial functions. The current study has developed a three-dimensional (3D) cell culture model for rat Par-C10 parotid gland cells that forms differentiated acinar-like spheres on Matrigel. These 3D Par-C10 acinar-like spheres display characteristics similar to differentiated acini in salivary glands, including cell polarization, tight junction (TJ) formation required to maintain transepithelial potential difference, basolateral expression of aquaporin-3 and Na+/K+/2Cl- cotransporter-1, and responsiveness to the muscarinic receptor agonist carbachol that is decreased by the anion channel blocker diphenylamine-2-carboxylic acid or chloride replacement with gluconate. Incubation of the spheres in the hypertonic medium increased the expression level of the water channel aquaporin-5. Further, the proinflammatory cytokines tumor necrosis factor-alpha and interferon-gamma induced alterations in TJ integrity in the acinar-like spheres without affecting individual cell viability, suggesting that cytokines may affect salivary gland function by altering TJ integrity. Thus, 3D Par-C10 acinar-like spheres represent a novel in vitro model to study physiological and pathophysiological functions of differentiated acini.

  11. [Treatment of giant tumors of the parotid gland].

    PubMed

    Vyrupaev, S V

    2005-01-01

    Since large () benign mixed tumors of the parotid gland are rare, there is insufficient evidence on the modalities of the facial nerve management. General practice is excision which, however, leads, as a rule, to disfigurement. Eight patients, aged 29-65, with tumors of more than 15 cm in diameter were operated on. Tumors were located externally of the gland (5), parapharyngeally (2), or both (1). The regularities between the facial nerve location and site of tumor were investigated, and it is suggested that, in difficult cases, search should start from the temporal area since it offers most access. When tumor of parapharyngeal localization is excised, it is desirable to perform double osteotomy in the mental part of the mandible as well as at the point of entry of the lower of the alveolar nerve, to avoid the latter's being traumatized. To avoid L. Frey syndrome and restore the facial contour, Alloplant volumetric allotransplant was used.

  12. Bath and Shower Effects in the Rat Parotid Gland Explain Increased Relative Risk of Parotid Gland Dysfunction After Intensity-Modulated Radiotherapy

    SciTech Connect

    Luijk, Peter van Faber, Hette; Schippers, Jacobus M.; Brandenburg, Sytze; Langendijk, Johannes A.; Meertens, Harm; Coppes, Robert P.

    2009-07-15

    Purpose: To assess in a rat model whether adding a subtolerance dose in a region adjacent to a high-dose irradiated subvolume of the parotid gland influences its response (bath-and-shower effect). Methods and Materials: Irradiation of the whole, cranial 50%, and/or the caudal 50% of the parotid glands of Wistar rats was performed using 150-MeV protons. To determine suitable (i.e., subtolerance) dose levels for a bath-dose, both whole parotid glands were irradiated with 5 to 25 Gy. Subsequently groups of Wistar rats received 30 Gy to the caudal 50% (shower) and 0 to 10 Gy to the cranial 50% (bath) of both parotid glands. Stimulated saliva flow rate (function) was measured before and up to 240 days after irradiation. Results: Irradiation of both glands up to a dose of 10 Gy did not result in late loss of function and is thus regarded subtolerance. Addition of a dose bath of 1 to 10 Gy to a high-dose in the caudal 50% of the glands resulted in enhanced function loss. Conclusion: Similar to the spinal cord, the parotid gland demonstrates a bath and shower effect, which may explain the less-than-expected sparing of function after IMRT.

  13. Surgical excision of the parotid salivary gland for treatment of a traumatic mucocele in a dog.

    PubMed

    Guthrie, Kathleen M; Hardie, Robert J

    2014-01-01

    A 3 yr old spayed female mixed-breed German shepherd dog was presented with a right facial swelling that developed after fighting with another dog. A parotid salivary mucocele was diagnosed via physical examination, fine-needle aspirate, and sialography of the parotid and mandibular salivary glands. Surgical excision of the right parotid salivary gland and duct was performed along with drainage of the mucocele. Neither intraoperative nor postoperative complications occurred, and follow-up examination 4 mo later revealed no evidence of recurrence. Case outcome was considered excellent. Sialography was useful for confirming the parotid gland as the source of the mucocele. Surgical excision of the parotid salivary gland is technically challenging, but an effective treatment option for traumatic mucoceles in the dog.

  14. Step-by-step protocol to perfuse and dissect the mouse parotid gland and isolation of high-quality RNA from murine and human parotid tissue.

    PubMed

    Watermann, Christoph; Valerius, Klaus Peter; Wagner, Steffen; Wittekindt, Claus; Klussmann, Jens Peter; Baumgart-Vogt, Eveline; Karnati, Srikanth

    2016-04-01

    Macroscopic identification and surgical removal of the mouse parotid gland is demanding because of its anatomic location and size. Moreover, the mouse parotid gland contains high concentrations of RNases, making it difficult to isolate high-quality RNA. So far, appropriate methods for optimal perfusion-fixation and dissection of mouse parotid glands, as well as the isolation of high quality RNA from this tissue, are not available. Here we present a simple, optimized, step-by-step surgical method to perfuse and isolate murine parotid glands. We also compared two common RNA extraction methods (RNeasy Mini Kit versus TRIzol) for their yields of high-quality, intact RNA from human and murine parotid gland tissues that were either snap-frozen or immersed in RNAlater stabilization solution. Mouse parotid tissue that was perfused and immersed in RNAlater and human samples immersed in RNAlater exhibited the best RNA quality, independent of the isolation method. PMID:27071609

  15. Cystic sebaceous lymphadenoma of the parotid gland: case report and review of the literature.

    PubMed

    Squillaci, S; Marchione, R; Piccolomini, M

    2011-04-01

    Sebaceous lymphadenoma (SL) of the salivary glands is a very rare, benign tumour with distinct histopathologic characteristics and uncertain histogenesis. It is almost exclusively confined to the parotid gland where it occurs generally as a slowly growing mass in elderly patients. Several imaging techniques and fine-needle aspiration cytology (FNAC) can be used for diagnosis, but definitive diagnosis is usually established only by histopathological examination. Such lesions are composed of a varying admixture of islands, duct-like structures and cysts covered with squamous or cuboid and columnar epithelium intermingled with a background of lymphoid stroma, sometimes with lymph follicles. Accurate diagnosis of SL is important since many salivary masses in adults are malignant. We report a case of cystic sebaceous lymphadenoma of the left parotid gland surgically resected in a 70-year-old woman. Fifteen months after surgery, the patient is well, with no evidence of recurrence. Differential diagnostic problems and histogenetic considerations are provided; a comprehensive review of the literature has also been performed.

  16. The role of postoperative radiation therapy in carcinoma ex pleomorphic adenoma of the parotid gland

    SciTech Connect

    Chen, Allen M. . E-mail: allenmchen@yahoo.com; Garcia, Joaquin; Bucci, M. Kara; Quivey, Jeanne M.; Eisele, David W.

    2007-01-01

    Purpose: To evaluate the impact of postoperative radiation therapy on the clinical course of patients with carcinoma ex pleomorphic adenoma of the parotid gland. Methods and Materials: Between 1960 and 2004, 63 patients were treated with definitive surgery for carcinoma ex pleomorphic adenoma of the parotid gland. Forty patients (63%) received postoperative radiation therapy to a median dose of 60 Gy (range, 45-71 Gy). Adenocarcinoma (29 patients), salivary duct carcinoma (16 patients), and adenoid cystic carcinoma (9 patients) were the most common malignant subtypes. Pathologic T -stage was: 16% T1, 33% T2, 32% T3, and 19% T4. Twenty-one patients (33%) had microscopically positive margins and 39 (62%) had perineural invasion. Median follow-up was 50 months (range, 2-96 months). Results: The use of postoperative therapy significantly improved 5-year local control from 49% to 75% (p = 0.005) and was associated with an improvement in survival among patients without evidence of cervical lymph node metastasis (p = 0.01). A Cox proportional hazard model identified pathologic involvement of cervical lymph nodes as an independent predictor of overall survival. Overall survival was 16% for patients with pathologic N-positive disease compared with 67% for those whose lymph node status was negative or unknown (p = 0.001). Conclusion: Surgery followed by postoperative radiation should be considered the standard of care for patients with carcinoma ex pleomorphic adenoma.

  17. Solitary fibrous tumor of the parotid gland extending to the parapharyngeal space.

    PubMed

    Sato, J; Asakura, K; Yokoyama, Y; Satoh, M

    1998-01-01

    Solitary fibrous tumors (SFT) arise in the pleura and less commonly in extrapleural sites. Head and neck regions have included the nose and paranasal sinuses, soft palate, epiglottis, thyroid, parotid and submandibular glands, as well as the infratemporal fossa and parapharyngeal space. We report a case of SFT arising from the parotid gland and extending to the parapharyngeal space. To our knowledge, this is the fourth case of SFT originating from the parotid gland and is the largest of its kind among the extrapleural lesions described. The characteristics revealed by computed tomography and magnetic resonance imaging are presented.

  18. [Surgical treatment of tumors of the parotid gland (author's transl)].

    PubMed

    El Hafed, A; Ballaux, J M; Dor, P

    1979-01-01

    One hundred and thirty-one cases of patients operated for a parotidal tumor were reviewed. We report on 85 cases that had no previous treatment, including 68 benign and 17 malignant tumors. The surgical treatment applied is analysed according to the benign or malignant nature of the tumor and to the results. For benign mixed tumors (43 cases) there were 29 total resections, 12 superficial lobectomies and 2 simple enucleations (intraparotidal location unforseen). For tumors of Warthin (19 cases) the treatment was a superficial lobectomy in all cases. For malignant tumors (17 cases) 5 superficial lobectomies and 12 total resections of the gland were performed. In the latter, the facial nerve was severed in 6 patients and left intact in the other 6. The minimal operation realizing the resection of a parotidal tumor, is the superficial lobectomy realized in once, the deep lobe only being resected if invaded. Preservation of the facial nerve should always be tried, sacrificing it only in cases of infiltrating malignant tumor. PMID:224631

  19. Effects of colchicine on parotid gland: structural and biochemical studies.

    PubMed

    Malberti, A I; González de Crosa, M

    1998-01-01

    The present study involves the analysis of structural, ultrastructural and biochemical modifications induced by colchicine (Col) in Guinea Pig parotid gland. The biochemical studies showed that the highest concentration of soluble proteins occurred 4 hs after colchicine injection. The curve of a-amylase activity in the gland showed an increase in enzyme activity over control at approximately 4 hs post-injection. At 8 hours the rise was even greater. The structural and ultrastructural analyses of the gland revealed that 4 hs post-injection colchicine exerts its maximum inhibitory effect on secretion. At this treatment time, the cytoplasm contained granules of various sizes and sharp outlines. Large areas of the cytoplasm exhibited material which resembled the granular content and seemed to result from the fusion of granules. No secretion was found in the lumen of the ducts. The inhibitory effect on secretion would be due to the disassembly of microtubules which would in turn impair transport of the granules to the apical surface of the membrane and eventual exocytosis. We herein propose that the effects of colchicine in the experimental conditions of this study would be largely reversible at 24 hours. At this time, structural, ultrastructural and biochemical features were similar to those of controls. PMID:11885456

  20. Oncocytic lipoadenoma of the parotid gland: Immunohistochemical and cytogenetic analysis.

    PubMed

    Ilie, Marius; Hofman, Véronique; Pedeutour, Florence; Attias, Rita; Santini, Joseph; Hofman, Paul

    2010-01-15

    Salivary gland oncocytic lipoadenoma is an exceptional benign tumor composed of mature adipose tissue associated with a mixture of oncocytes. We report a case of oncocytic lipoadenoma showing sebaceous differentiation, and provide a cytogenetic analysis, which has not yet been described. A 64-year-old male developed a left parotid gland, well-encapsulated tumor measuring 3.5 x 3 cm(2), showing mature fat cells associated with oncocytic changes of epithelial components. Immunohistochemistry showed a dual epithelial population with ductal (positivity for AE1/AE3, CK19, CK7 antibodies) and basal-cell (positivity for p63, CK14, CK5,6 antibodies) differentiation in oncocytic areas. Moreover, oncocytic cells were stained with anti-alpha-1 antichymotrypsin antibody and phosphotungstic acid-hematoxylin staining. Molecular cytogenetic analysis showed a translocation t(12;14), resulting in structural rearrangement of the region framing the HMGA2 gene at 12q14.3. Such alterations in HMGA2 have been described in both lipomas and pleomorphic adenomas of the salivary glands.

  1. Parotid gland: US findings in Sjögren syndrome. Work in progress.

    PubMed

    Bradus, R J; Hybarger, P; Gooding, G A

    1988-12-01

    To determine the value of sonography of the parotid gland in patients with Sjögren syndrome, six consecutive cases were retrospectively reviewed in which clinical findings indicated Sjögren syndrome. All patients were women. Two patients were found at sonography to have normal parotid glands. Four patients had multiple cystic changes in the parotid glands bilaterally. Each of these four patients had a clinical diagnosis of Sjögren syndrome. One of the four underwent sialography, which demonstrated characteristic sialectasia. Pathologic examination of an excised gland in one of the patients with Sjögren syndrome demonstrated typical benign lymphoepithelial aggregates, which cause obstruction and progressive ductal dilatation. While parotid enlargement in these patients may be due to salivary tumor, lymphoma, or sarcoidosis--all of which appear as solid lesions at sonography--this study suggests that bilateral cystic changes may be the rule in uncomplicated cases of Sjögren syndrome.

  2. Fine-needle aspiration cytology of lymphangioma of the parotid gland in an adult.

    PubMed

    Henke, A C; Cooley, M L; Hughes, J H; Timmerman, T G

    2001-02-01

    Lymphangioma or cystic hygroma is an uncommon benign congenital tumor of lymphatics that is seen in children and, rarely, adults. Lymphangioma primarily involving the parotid gland is an extremely uncommon occurrence in adults. We report on the cytologic findings of a parotid lymphangioma in a 34-yr-old man which showed 13 cc of yellow fluid with red blood cells, lymphocytes, and rare fragments of benign-appearing salivary gland epithelium. The differential diagnosis of cystic parotid gland lesions in adults may include Warthin's tumor, lymphoma, benign lymphoepithelial lesions, branchial cleft cysts, chronic sialadenitis, cystic low-grade mucoepidermoid carcinoma, and cystic pleomorphic adenoma. In this case, the fine-needle aspiration findings along with the magnetic resonance imaging (MRI) findings of a multiloculated cystic mass in the parotid gland allowed the diagnosis of lymphangioma.

  3. Congenital sialolipoma of the parotid gland first reported case and review of the literature.

    PubMed

    Hornigold, R; Morgan, P R; Pearce, A; Gleeson, M J

    2005-03-01

    Tumours of the parotid gland in children are uncommon, and represent only 1.3% of all benign salivary tumours. Lipomas of the parotid are also rare, and account for 0.5% of all parotid gland tumours. Sialolipoma is a new variant of salivary gland lipoma, consisting of adipose and glandular tissue that was first proposed by Nagao et al. in 2001. Ten cases of parotid gland lipoma associated with glandular elements have been previously reported in the literature. All have been in adults and none in children. We present the first reported case of congenital sialolipoma that had developed in a female infant. It was managed successfully by superficial parotidectomy undertaken at ten weeks of age.

  4. Malignant transformation in concurrent benign mixed tumors of the parotid and submaxillary glands.

    PubMed

    McGrath, M H

    1980-05-01

    This patient is the only reported case of concomitant mixed tumors of the parotid and contralateral submaxillary gland. Each lesion had histologic changes consistent with different stages in the transformation of a benign to a malignant mixed tumor. Identifying premalignant disease in the parotid tumor and early preinvasive carcinoma in the submaxillary tumor lends support to the concept of malignant progression in salivary gland mixed tumors.

  5. Infiltrative angiolipoma of the parotid salivary gland in a dog.

    PubMed

    Kitshoff, A M; Millward, I R; Williams, J H; Clift, S J; Kirberger, R M

    2010-12-01

    Solitary benign angiolipoma and infiltrative angiolipoma are rare tumours in dogs. Angiolipomata can be distinguished histologically from lipomata by the large number of tightly packed blood vessels seen between the adipocytes with multiple fibrin thrombi occupying some of the vessels' lumens. The dog presented with a solitary slow-growing mass in the cervical region. Histopathology revealed multifocal to coalescing single or clusters of blood-filled vessels lined by flattened endothelial cells with narrow, elongated, basophilic nuclei. These regions were embedded in adipose tissue with multifocal areas of intervascular remnants of differentiated serous salivary glandular tissue with multifocal small ducts. Fibrin thrombi occupied a few of the vessel lumens. A histological diagnosis of infiltrative angiolipoma was made. On computed tomography, the mass was bilobed with a suspected primary component involving the right parotid gland which was grossly enlarged. The mass had a slightly hypoattenuating mottled to lobulated appearance with a few hyperattenuating mineralised specks throughout. Hounsfield units of the mass ranged between 40 and 45, which was less than the 60-65 of the contralateral salivary glands and cranial musculature. Post contrast images showed no contrast enhancement of 90% of the mass with only a band of peripheral contrast uptake of the affected lateral lobe.

  6. Parotid glands tumours: overview of a 10-year experience with 282 patients, focusing on 231 benign epithelial neoplasms.

    PubMed

    Ungari, C; Paparo, F; Colangeli, W; Iannetti, G

    2008-01-01

    Salivary gland tumours are uncommon, representing less than 6% of head and neck neoplasm. Pleomorphic adenoma is the most common benign epithelial salivary gland neoplasm, comprising 50%-74% of all parotid tumours. It is followed by Warthin's tumour (4-14%). The authors retrospectively reviewed 282 eligible patients surgically treated for parotid gland tumours in the last 10 years, focusing on 231 benign epithelial neoplasms. Clinical and diagnostic findings, surgical treatment and surgical outcome were discussed. The diagnosis of a parotid gland neoplasm must be considered in any patient presenting with a lump near the mandible. Smoking habit is important in Warthin's tumour pathogenesis. Fine needle aspiration citology (FNAC) can't lead alone to histological diagnosis. Only surgery can give histological certainty of benignity, thus preventing malignant degeneration, lump infection or risk of size-dependent surgical complications. Conservative formal parotidectomy appears to be the treatment of choice. Tumour pseudopodia and capsule ruptures are recognised factors involved in pleomorphic adenoma recurrences but also tumour multicentricity might play an important role.

  7. Scintigraphic analysis of the parotid glands in patients with sialorrhea and Parkinson's disease.

    PubMed

    Nicaretta, Denise Hack; de Rosso, Ana Lucia Zuma; Maliska, Carmelindo; Costa, Milton Melciades Barbosa

    2008-01-01

    Since sialorrhea was initially described, it has been associated with Parkinson's disease (PD) but until now little is known about its pathophysiology. The authors studied parotid gland activity using scintigraphic analysis on 14 PD patients with sialorrhea and in eight healthy persons with matching ages. There was no difference between uptake and intra-glandular distribution by the parotid gland in the two groups but the parotid excretion speed in the PD patients was greater than that observed in healthy individuals. Our results reject the hypothesis of PD productive sialorrhea and point to retention sialorrhea due to the increase of saliva excretion velocity.

  8. Pathologic and imaging findings of an oncocytoma in the deep lobe of the left parotid gland.

    PubMed

    Sakai, E; Yoda, T; Shimamoto, H; Hirano, Y; Kusama, M; Enomoto, S

    2003-10-01

    Oncocytoma is a rare salivary gland tumour consisting of oncocytes with many hyperplastic mitochondria. It usually occurs in the parotid gland. Because the features of oncocytoma resemble those of other benign and low-grade-malignant salivary gland tumours, clinical diagnosis is often challenging. This report presents the pathologic and imaging findings of an oncocytoma arising in the deep lobe of the left parotid gland in a 66-year-old man. Oncocytoma was diagnosed on the basis of histological, magnetic resonance imaging, and scintigraphic findings. The tumour showed accumulation of technetium-99m pertechnetate and decreased signal intensity on both T1- and T2-weighted magnetic resonance images.

  9. Sialadenoma papilliferum of the parotid gland: case report and review of literature.

    PubMed

    Loehn, Bridget; Sutton, Collin; Jastram-Belcher, Jennifer; Harton, Anthony; Anderson, Dwayne; Walvekar, Rohan R

    2013-03-01

    Sialadenoma papilliferum is a rare benign salivary gland tumor. We present an unusual case of sialadenoma papilliferum of the parotid gland, discuss clinical presentation, diagnostic challenges, and review of the literature. A 65-year-old male smoker presented with a large, exophytic, fungating, painless mass in the tail parotid for 8 years. The tumor developed an exophytic component 2 years before presentation. The patient subsequently underwent superficial parotidectomy with facial nerve preservation. Initial pathological analysis suggested a variant of Warthin's tumor. The pathology underwent extensive internal and external review. Final diagnosis was consistent with sialadenoma papilliferum. We present the fourth reported case of sialadenoma papilliferum within the parotid gland and only the second that has presented with breach of the overlying skin. The clinical presentation may mimic an advanced parotid malignancy. However, facial nerve preservation and good surgical outcomes can be obtained.

  10. Effect of Irradiation on Microvascular Endothelial Cells of Parotid Glands in the Miniature Pig

    SciTech Connect

    Xu Junji; Yan Xing; Gao Runtao; Mao Lisha; Cotrim, Ana P.; Zheng Changyu; Zhang Chunmei; Baum, Bruce J.; Wang Songlin

    2010-11-01

    Purpose: To evaluate the effect of irradiation on microvascular endothelial cells in miniature pig parotid glands. Methods and Materials: A single 25-Gy dose of irradiation (IR) was delivered to parotid glands of 6 miniature pigs. Three other animals served as non-IR controls. Local blood flow rate in glands was measured pre- and post-IR with an ultrasonic Doppler analyzer. Samples of parotid gland tissue were taken at 4 h, 24 h, 1 week, and 2 weeks after IR for microvascular density (MVD) analysis and sphingomyelinase (SMase) assay. Histopathology and immunohistochemical staining (anti-CD31 and anti-AQP1) were used to assess morphological changes. MVD was determined by calculating the number of CD31- or AQP1-stained cells per field. A terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) apoptosis assay was used to detect apoptotic cells. The activity of acid and neutral Mg{sup 2+}-dependent SMase (ASMase and NSMase, respectively) was also assayed. Results: Local parotid gland blood flow rate decreased rapidly at 4 h post-IR and remained below control levels throughout the 14-day observation period. Parotid MVD also declined from 4 to 24 hours and remained below control levels thereafter. The activity levels of ASMase and NSMase in parotid glands increased rapidly from 4 to 24 h post-IR and then declined gradually. The frequency of detecting apoptotic nuclei in the glands followed similar kinetics. Conclusions: Single-dose IR led to a significant reduction of MVD and local blood flow rate, indicating marked damage to microvascular endothelial cells in miniature pig parotid glands. The significant and rapid increases of ASMase and NSMase activity levels may be important in this IR-induced damage.

  11. Minimal surgery for parotid stones: a 7-year endoscopic experience.

    PubMed

    Karavidas, K; Nahlieli, O; Fritsch, M; McGurk, M

    2010-01-01

    The results of endoscope-assisted parotid surgery are presented as a minimally invasive alternative to parotidectomy for large parotid stones. From 1999 to 2007, 70 patients with parotid sialoliths were treated by minimally invasive surgical techniques in three specialist centres. At surgery a combination of sialoendoscopic and ultrasound examination was used to locate the stone within the duct. The calculus was released by incising the duct through a pre-auricular approach (40 patients) or by direct transcutaneous incision over the stone (27 patients). Four patients were treated using other minimally invasive procedures. Local anesthesia was used in 22 patients and general anesthesia in 48. The average follow-up was 25.5 months with two patients lost to review. In 3 patients treatment had long-term complications (persistent stone fragment; obstructive symptoms due to a fibrous stricture; a visible scar on the cheek). In one patient, endoscopy was abandoned due to stricture. 85 stones were retrieved successfully from 69 patients. The average size of the stones was 7.2 mm. There were no cases of facial nerve weakness or salivary fistula. The data suggest that endoscopic-assisted surgery is a viable alternate to adenectomy for the treatment of large or recalcitrant parotid stones. PMID:19897340

  12. Arterial Spin Labeling Imaging for the Parotid Glands of Patients with Sjögren's Syndrome.

    PubMed

    Kami, Yukiko N; Sumi, Misa; Takagi, Yukinori; Sasaki, Miho; Uetani, Masataka; Nakamura, Takashi

    2016-01-01

    Sjögren's syndrome (SS) is characterized by hypofunction of the salivary and lacrimal glands. The salivary function is largely dependent upon the blood supply in the glands. However, the diseased states of the gland perfusion are not well understood. The arterial spin labeling (ASL) technique allows noninvasive quantitative assessment of tissue perfusion without the need for contrast agent. Here, we prospectively compared the perfusion properties of the parotid glands between patients with SS and those with healthy glands using ASL MR imaging. We analyzed salivary blood flow (SBF) kinetics of 22 healthy parotid glands from 11 volunteers and 28 parotid glands from 14 SS patients using 3T pseudo-continuous ASL imaging. SBF was determined in resting state (base SBF) and at 3 sequential segments after gustatory stimulation. SBF kinetic profiles were characterized by base SBF level, increment ratio at the SBF peak, and the differences in segments where the peak appeared (SBF types). Base SBFs of the SS glands were significantly higher than those of healthy glands (59.2 ± 22.8 vs. 46.3 ± 9.0 mL/min/100 g, p = 0.01). SBF kinetic profiles of the SS glands also exhibited significantly later SBF peaks (p < 0.001) and higher SBF increment ratios (74 ± 49% vs. 47 ± 39%, p = 0.04) than the healthy glands. The best SBF criterion (= 51.2 mL/min/100 mg) differentiated between control subjects and SS patients with 71% sensitivity and 82% specificity. Taken together, these results showed that the SS parotid glands were mostly hyperemic and the SS gland responses to gustatory stimulation were stronger and more prolonged than those of the healthy glands. The ASL may be a promising technique for assessing the diseased salivary gland vascularization of SS patients. PMID:26959680

  13. Keratocystoma of the parotid gland: a case report and review of previous publications.

    PubMed

    Wang, Weiya; Li, Yi; Tang, Ying

    2015-09-01

    Keratocystoma is a rare benign tumour of the salivary glands. We report a patient who presented with a mass in the left parotid gland that was treated by subtotal parotidectomy and he was free of recurrence seven years later. After histological and immunohistochemical examinations we identified a keratocystoma.

  14. Basal cell adenoma in the parotid gland: CT and MR findings.

    PubMed

    Jang, Mijung; Park, Dongwoo; Lee, Seung Ro; Hahm, Chang Kok; Kim, Youngsun; Kim, Yongsoo; Park, Choong Ki; Tae, Kyung; Park, Moon Hyang; Park, Yong Wook

    2004-04-01

    Basal cell adenoma is a rare benign salivary gland epithelial tumor, usually involving the parotid gland. We report CT and MR findings of three cases with basal cell adenoma occurring in the parotid gland. The three cases presented here demonstrate a well-circumscribed tumor, which showed a cystic and solid, or the pure solid mass. They were well enhanced after contrast matter injection. The solid portion of the mass was isoattenuated at CT, with intermediate signal intensity on T1- and T2-weighted MR images. Its cystic portion was hyperintense on both T1- and T2-weighted MR images. It had a hypointense rim on T2-weighted image.

  15. Primary angiosarcoma of the parotid gland arising from benign congenital hemangioma.

    PubMed

    Damiani, Stefania; Corti, Barbara; Neri, Fabrizio; Collina, Guido; Bertoni, Franco

    2003-07-01

    A case of malignant transformation of a benign congenital hemangioma of the parotid gland is presented. The malignant tumor occurred in a woman with a history of congenital hemangioma surgically removed 8 years previously. No radiotherapy had been administered at the time of primary excision. The recurrent tumor consisted of a large lesion occupying nearly all the parotid gland and infiltrating the surrounding soft tissues and overlying skin. Its histopathologic features were typical of epithelioid angiosarcoma. The vast majority of vascular lesions of major salivary glands are benign. However, pathologists should be aware of the remote possibility of malignant transformation in these lesions.

  16. Hybrid tumor of the parotid gland: a case report and review of the literature.

    PubMed

    Sabri, Alain; Bawab, Ibrahim; Khalifeh, Ibrahim; Alam, Elie

    2015-01-01

    The parotid gland is the most common location of benign neoplasms affecting major salivary glands. Hybrid tumors are very rare tumor entities which are composed of two different tumor types, each of which conforms to an exactly defined tumor category. The tumor entities of a hybrid tumor are not separated but have an identical origin within the same topographical area. This report describes a 51-year-old male with three neoplasms occurring within a single parotid gland tumor. The clinical, radiological, and histologic features are described in addition to a review of the literature.

  17. Function of parotid gland following irradiation and its relation to biological parameters

    SciTech Connect

    Sasaki, T.; Yamamoto, M.; Takeda, M.

    1980-09-01

    The function of the parotid gland in the mouse (synthesis and secretion of ..cap alpha..-amylase) following X irradiation was analyzed in relation to the parameters of surviving acinar cell fraction, DNA or protein content, and wet weight of the gland. Both synthesis and secretion of amylase in parotid were essentially unchanged when mice were irradiated with a dose of up to 3000 rad. When mice were irradiated and then given a proliferative stimulus of isoproterenol, latent lethal damage in the acinar cell population was expressed and resulted in cell degeneration in a dose-dependent manner. The mean value of amylase activity per gland in similarly treated parotids was, however, totally unaffected. The relationship between amylase activity per gland and the other biological parameters was analyzed by regression analysis. The results indicate that amylase activity per surviving acinar cell increased proportionately to compensate for the loss of acinar cells.

  18. Effect of tympanic neurectomy on human parotid salivary gland. Histopathologic, Histochemical, and Clinical Study.

    PubMed

    Mandour, M A; Helmi, A M; El-Sheikh, M M; El-Garem, F; El-Ghazzawi, E

    1977-06-01

    Five patients with bilateral chronic recurrent parotiditis and ten patients with unilateral persistent paratoid gland fistulas underwent tympanic neurectomies. Two biopsy specimens from the diseased gland were examined. The first biopsy specimen was taken at the time of operation, while the second one was taken six months later. All specimens were subjected to both histopathologic and histochemical investigations. Definite degenerative and atrophic changes occured in all parotid gland specimens taken six months after selective tympanic neurectomy. All patients were completely cured at about that time. This supported the practical indication of the selective tympanic neurectomy for treating certain benign disorders or diseases of the parotid gland that require persistent arrest of the function of its secretory units.

  19. Volume effects and region-dependent radiosensitivity of the parotid gland

    SciTech Connect

    Konings, Antonius W.T. . E-mail: a.w.t.konings@med.rug.nl; Cotteleer, Femmy; Faber, Hette; Luijk, Peter van; Meertens, Harm; Coppes, Rob P.

    2005-07-15

    Purpose: To detect volume effects and possible regional differences in radiosensitivity of the rat parotid gland. Methods and Materials: Parotid glands of male albino Wistar rats were locally X-irradiated, with collimators with conformal radiation portals used to supply 100% volume and 50% cranial/caudal partial volumes. High-resolution magnetic resonance imaging was used to provide the outlines of the parotid glands. Single doses of up to 40 Gy were applied, and the effects on saliva secretion, measured with the aid of miniaturized Lashley cups, were followed up to 365 days after the irradiation. Results: Under conditions of equal mean absorbed doses and small variations in dose distribution, a pertinent volume effect was observed for late but not for early radiation damage. The late effects were different for the cranial part as compared with the caudal part of the parotid gland. The reduction in flow rate was much more severe after irradiation in the cranial part. After a single dose of 30 Gy, the reductions in flow rates were approximately 65% and 25% for the cranial and caudal parts, respectively. At that dose, no saliva flow was observed after irradiation of 100% of the gland. Conclusion: From the rat model studies presented, it is concluded that late radiation damage after partial irradiation of parotid glands shows region-dependent volume effects. This finding is expected to be relevant to the radiosensitivity of human salivary glands, and it implies that the predictive power of the mean dose concept in radiotherapeutic practice is limited. The finding of region-dependent late radiation damage also challenges the basic assumptions of most current normal tissue complication probability models for parotid gland function.

  20. Mucoepidermoid carcinoma arising in Warthin’s tumor of the parotid gland: Clinicopathological characteristics and immunophenotypes

    PubMed Central

    Yu, Chunkai; Song, Zhigang; Xiao, Zhibo; Lin, Qiushi; Dong, Xiaoqun

    2016-01-01

    Mucoepidermoid carcinoma (MEC), an extremely rare tumor, arises from the epithelial component of preexisting parotid Warthin tumors (WT). Among the 309 cases of surgically resected WTs in Chinese PLA General Hospital and Beijing Shijitan Hospital of Capital Medical University, 5 cases (1.6%) fulfilled the criteria for MECs transformed from WTs. Clinicopathological characteristics of MECs was demonstrated in order to avoid misdiagnosis of this rare type of tumor. All the 5 patients, 3 males and 2 females, presented painless masses in the parotid gland. MECs were located inside or at the edge of WTs, with an obvious transitional zone between WT and MEC. Basal cells of WTs and epidermoid cells of MECs were strongly positive for cytokeratin CK5/6, CK34βE12, and P63; whereas negative for CK7, CK20, and CEA. Mucous cells of MECs were positive for CK7, CEA, as well as periodic acid-Schiff (PAS), whereas negative for CK5/6, CK34βE12, CK20, and P63. MECs patients were followed up for 25–69 months after surgery, presenting no evidence of recurrence or metastasis. Collectively, MECs arising from WT is very rare. The pathological diagnosis was based on histological morphology, especially the transitional zone between WT and MEC. PMID:27417276

  1. Venolymphatic vascular malformation of the parotid gland extending into the parapharyngeal space: A rare presentation.

    PubMed

    Khatib, Yasmeen; Dande, Madhura; Patel, Richa D; Gite, Vinod

    2016-01-01

    Vascular malformations (VMs) are structural malformations of vascular development causing soft tissue abnormality with functional and esthetic impairment. They are named by their predominant vessel type as arterial, venous, lymphatic or mixed types. VMs of the parotid gland are extremely rare and constitute a distinct entity of parotid pathology that requires specific diagnostic tools and management. Till 2013, only fifty cases of VMs of the parotid have been described in the literature. We present a case of a venolymphatic malformation of the parotid gland extending into the parapharyngeal space in a 21-year-old male who presented with a swelling on the left side of the face extending into the neck. Diagnosis was suggested by ultrasonography and computed tomography scan and was confirmed by magnetic resonance imaging examination. Complete surgical excision of the lesion was done with a favorable outcome. Diagnosis was confirmed based on histopathology and immunohistochemical studies. PMID:27601828

  2. Venolymphatic vascular malformation of the parotid gland extending into the parapharyngeal space: A rare presentation

    PubMed Central

    Khatib, Yasmeen; Dande, Madhura; Patel, Richa D; Gite, Vinod

    2016-01-01

    Vascular malformations (VMs) are structural malformations of vascular development causing soft tissue abnormality with functional and esthetic impairment. They are named by their predominant vessel type as arterial, venous, lymphatic or mixed types. VMs of the parotid gland are extremely rare and constitute a distinct entity of parotid pathology that requires specific diagnostic tools and management. Till 2013, only fifty cases of VMs of the parotid have been described in the literature. We present a case of a venolymphatic malformation of the parotid gland extending into the parapharyngeal space in a 21-year-old male who presented with a swelling on the left side of the face extending into the neck. Diagnosis was suggested by ultrasonography and computed tomography scan and was confirmed by magnetic resonance imaging examination. Complete surgical excision of the lesion was done with a favorable outcome. Diagnosis was confirmed based on histopathology and immunohistochemical studies. PMID:27601828

  3. CT features of parotid gland oncocytomas: a study of 10 cases and literature review.

    PubMed

    Tan, T J; Tan, T Y

    2010-09-01

    Oncocytomas of the salivary glands are rare benign epithelial tumors which occur most commonly in the parotid gland. The aim of our study was to characterize the clinical-radiologic-pathologic spectrum of parotid oncocytomas in a series of 10 cases seen in our institution between January 2003 and November 2008. The CT features of parotid oncocytomas in the largest imaging series of this rare but important benign lesion include a well-defined enhancing tumor with a "deformable" appearance when large, and a non-enhancing curvilinear cleft or cystic component. These CT findings are potentially helpful in distinguishing these benign lesions from other parotid tumors in clinical scenarios that preclude surgical resection or when biopsy results are non-diagnostic. Further studies are advocated to validate the specificity and positive predictive value of these imaging features.

  4. Actual Dose Variation of Parotid Glands and Spinal Cord for Nasopharyngeal Cancer Patients During Radiotherapy

    SciTech Connect

    Han Chunhui Chen Yijen; Liu An; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.

    2008-03-15

    Purpose: For intensity-modulated radiotherapy of nasopharyngeal cancer, accurate dose delivery is crucial to the success of treatment. This study aimed to evaluate the significance of daily image-guided patient setup corrections and to quantify the parotid gland volume and dose variations for nasopharyngeal cancer patients using helical tomotherapy megavoltage computed tomography (CT). Methods and Materials: Five nasopharyngeal cancer patients who underwent helical tomotherapy were selected retrospectively. Each patient had received 70 Gy in 35 fractions. Daily megavoltage CT scans were registered with the planning CT images to correct the patient setup errors. Contours of the spinal cord and parotid glands were drawn on the megavoltage CT images at fixed treatment intervals. The actual doses delivered to the critical structures were calculated using the helical tomotherapy Planned Adaptive application. Results: The maximal dose to the spinal cord showed a significant increase and greater variation without daily setup corrections. The significant decrease in the parotid gland volume led to a greater median dose in the later phase of treatment. The average parotid gland volume had decreased from 20.5 to 13.2 cm{sup 3} by the end of treatment. On average, the median dose to the parotid glands was 83 cGy and 145 cGy for the first and the last treatment fractions, respectively. Conclusions: Daily image-guided setup corrections can eliminate significant dose variations to critical structures. Constant monitoring of patient anatomic changes and selective replanning should be used during radiotherapy to avoid critical structure complications.

  5. Role of the Accessory Parotid Gland in the Etiology of Parotitis: Statistical Analysis of Sialographic Features

    PubMed Central

    Zhu, Wangyong; Hu, Fengchun; Liu, Xingguang; Guo, Songcan; Tao, Qian

    2016-01-01

    This retrospective study aimed to identify if the existence of the accessory parotid gland correlated with the etiology of parotitis. This may aid the development of better treatment strategies in the future. Sialographic features of cases with parotitis and healthy subjects were reviewed. The chi-square test was used to compare the incidence of accessory parotid gland between the groups. The Student’s t test was used to compare the length of Stensen’s duct, the length from the orifice to the confluence of the accessory duct, and the angle between the accessory duct and Stensen’s duct between the groups. The incidence of accessory parotid gland in patients with parotitis was 71.8% (28/39), which was significantly higher than that in healthy subjects (P = 0.005). Patients with parotitis had a longer Stensen’s duct than healthy subjects (P = 0.003). There was no significant difference in the length from the orifice to the confluence of the accessory duct or the angle between the accessory duct and Stensen’s duct (P = 0.136 and 0.511, respectively) between the groups. The accessory parotid gland might play a role in the pathogenesis of parotitis. The existence of an accessory parotid gland is likely to interfere with salivary flow. Computational fluid dynamics analysis of salivary flow in the ductal system would be useful in future etiologic studies on parotitis. PMID:26913509

  6. Role of the Accessory Parotid Gland in the Etiology of Parotitis: Statistical Analysis of Sialographic Features.

    PubMed

    Zhu, Wangyong; Hu, Fengchun; Liu, Xingguang; Guo, Songcan; Tao, Qian

    2016-01-01

    This retrospective study aimed to identify if the existence of the accessory parotid gland correlated with the etiology of parotitis. This may aid the development of better treatment strategies in the future. Sialographic features of cases with parotitis and healthy subjects were reviewed. The chi-square test was used to compare the incidence of accessory parotid gland between the groups. The Student's t test was used to compare the length of Stensen's duct, the length from the orifice to the confluence of the accessory duct, and the angle between the accessory duct and Stensen's duct between the groups. The incidence of accessory parotid gland in patients with parotitis was 71.8% (28/39), which was significantly higher than that in healthy subjects (P = 0.005). Patients with parotitis had a longer Stensen's duct than healthy subjects (P = 0.003). There was no significant difference in the length from the orifice to the confluence of the accessory duct or the angle between the accessory duct and Stensen's duct (P = 0.136 and 0.511, respectively) between the groups. The accessory parotid gland might play a role in the pathogenesis of parotitis. The existence of an accessory parotid gland is likely to interfere with salivary flow. Computational fluid dynamics analysis of salivary flow in the ductal system would be useful in future etiologic studies on parotitis. PMID:26913509

  7. Lymphoepithelial carcinoma of the parotid glands and its relationship with benign lymphoepithelial lesions.

    PubMed

    Schneider, Manuela; Rizzardi, Clara

    2008-02-01

    The salivary glands, despite their relatively simple morphology, give rise to more than 30 histologically distinct benign and malignant tumors. Salivary gland neoplasms comprise less than 2% of all tumors in humans and 3% of all head and neck tumors. They arise in the parotid gland in 80% of cases, and approximately 80% are benign and 20% are malignant. Among them are lymphoepithelial lesions, rare lesions of the salivary glands and especially of the parotid gland that are characterized by lymphocytic infiltration associated with an epithelial proliferation. They are divided into benign, which is considered as a tumorlike condition, and malignant, which is a rare carcinoma of the salivary glands. This article provides a review of the current knowledge on lymphoepithelial carcinoma with a look at its association with benign lesions and on the importance of making the correct diagnosis for the appropriate treatment.

  8. Cysts of the parotid gland. Review and report of two unusual cases.

    PubMed

    Shaheen, N A; Harboyan, G T; Nassif, R I

    1975-04-01

    Cysts of the major salivary glands are most frequent in the parotid where they form a small percentage of its benign tumours. They can be congenital or acquired and of parotid or extraparotid origin. Two unusual cysts are reported: a cholesteatoma arising from the ipsilateral mastoid, twenty years after successful radical mastoidectomy, and a deeply located cysts of probably congenital origin. The literature is reviewed and the management discussed. Parotidectomy, often with extensive dissection, remains in general the treatment of choice.

  9. [Salivary stone in parotid gland with a cutaneous fistula].

    PubMed

    Abadi, Peymaneh; Larsen, Stine Rosenkilde; Godballe, Christian

    2013-01-01

    Parotid fistulas are very rare and arise from various causes such as trauma, operative complications, infection, malignancy and stone. They may also be congenital. A rare case of cutaneous salivary fistula is presented. A 59-year-old man had a recurrent inflammatory parotid disease which disappeared after the expulsion of the calculus. PMID:23305643

  10. Parotid gland metastasis in Merkel cell carcinoma of the head and neck: A series of 14 cases.

    PubMed

    Day, Kristine E; Carroll, William R; Rosenthal, Eben L

    2016-09-01

    Merkel cell carcinoma (MCC) is a rare cutaneous cancer of neuroendocrine cell origin that occurs frequently on the head and neck. With a high incidence of local recurrence and regional and distant metastasis, it carries a poor prognosis. We performed a retrospective study to determine the prognostic implications of parotid gland metastasis in MCC of the head and neck. Our study population was made up of 14 patients-13 men and 1 woman, aged 62 to 87 years (mean: 75.9)-who underwent a parotidectomy for the diagnosis of MCC over a period of 10 years and 9 months. Ten patients had a primary skin lesion of the head and neck and 4 presented with a parotid mass and an unknown primary. In all, 13 of the 14 patients were found to have parotid involvement-either a direct extension of MCC into the gland or a positive intraparotid lymph node; some patients had both. All patients underwent tumor excision, and 10 underwent neck dissection. Eleven patients received adjuvant radiotherapy; none received adjuvant chemotherapy. Of the 10 patients who underwent a neck dissection, 6 were found to have a cervical lymph node metastasis on pathologic examination. Follow-up ranged from 1.3 to 39.2 months (mean: 12.4). Three patients were lost to follow-up shortly after surgery, although some information was available on 2 of them. At the final follow-up, mortality data were available on 12 patients; of these, 11 had died. The lone survivor was the patient without a parotid metastasis. Among those known to have died, survival ranged from 1.6 to 49.2 months (mean: 16.0). We conclude that parotid metastasis in patients with MCC of the head and neck is associated with a dismal survival rate that is even worse than the poor survival associated with cervical node involvement. PMID:27657318

  11. Oncocytoma of the parotid gland complicated by hypercalcemia: a case report.

    PubMed

    Evren, Cenk; Demirbilek, Nevzat; Yiğit, Volkan Bilge; Kaur, Ahmet Cemil

    2015-01-01

    Salivary gland tumors are rare head and neck tumors. The majority of these tumors are benign and include pleomorphic adenoma, monomorphic adenoma, oncocytoma, and papillary cystadenoma lymphomatosum. Oncocytoma is a rare benign salivary gland tumor. In this article, we report a 69-year-old female case of oncocytoma of the right parotid gland in whom fine needle aspiration cytology result was reported as a Warthin's tumor.

  12. Polymorphous low-grade adenocarcinoma of parotid gland: a rare occurrence.

    PubMed

    Arathi, N; Bage, Atul M

    2009-01-01

    Polymorphous low-grade adenocarcinoma (PLGA) is a rare salivary gland malignant tumor of low aggressiveness, commonly occurring in minor salivary glands. Its occurrence in major salivary gland has been documented albeit rarely. The striking histological feature is architectural diversity combined with benign cytologic features. We report a case of PLGA arising from left parotid in a 25-year-old male patient. On light microscopy, varied patterns were seen .The cells were uniform with bland nuclei. Neural invasion was noted.

  13. Contrast-enhanced ultrasound in the evaluation of parotid gland lesions: an update of the literature.

    PubMed

    David, E; Cantisani, V; De Vincentiis, M; Sidhu, P S; Greco, A; Tombolini, M; Drudi, F M; Messineo, D; Gigli, S; Rubini, A; Fresilli, D; Ferrari, D; Flammia, F; D'Ambrosio, F

    2016-05-01

    High-resolution ultrasound is the first line examination for parotid gland diffuse disease and focal lesions, normally using grey-scale and colour-Doppler ultrasound. Unfortunately, grey-scale and colour-Doppler ultrasound features of benign and malignant salivary gland lesions may overlap, particularly with benign tumors, where pleomorphic adenomas are often indistinguishable from malignant lesions. With atypical lesions, contrast-enhanced magnetic resonance imaging is usually the second level imaging modality requested. The introduction of ultrasound contrast agents has opened further possible perspectives to improve the interpretation of parotid diseases, particularly the differentiation between benign and malignant lesions. We present a review of the current literature on contrast-enhanced ultrasound for the assessment of parotid gland lesions, considering all characteristics of the technique, evidence of usefulness, future perspectives and limitations.

  14. Benign lymphoepithelial lesion of the parotid gland in intravenous drug users.

    PubMed

    Smith, F B; Rajdeo, H; Panesar, N; Bhuta, K; Stahl, R

    1988-07-01

    Fifteen partial parotid salivary gland resection specimens interpreted as benign lymphoepithelial lesion (BLL) were accessioned by our surgical pathology service between January 1983 and December 1986. Twelve of the specimens were removed from 11 prison inmates referred to our hospital, a patient subgroup constituting the source of only 2% of surgical pathology specimens in general. All prison inmates with BLL had a history of intravenous drug use, had developed unexplained lymphadenopathy concurrently with the parotid gland enlargement, and had suspected human immunodeficiency virus (HIV) infection (serologically confirmed in two). Histopathologic features of the parotid gland specimens included atypical follicular hyperplasia and follicular involution, resembling lymph node changes of HIV infection. The clinical and pathologic findings in these cases suggest an association between HIV infection and BLL, and support a previously proposed mechanism for the development of BLL through progressive enlargement of intraparotid lymph nodes.

  15. Spontaneous infarction of a pleomorphic adenoma in parotid gland: diagnostic problems and review.

    PubMed

    Behzatoglu, Kemal; Bahadir, Burak; Huq, Gulben Erdem; Kaplan, Hasan H

    2005-06-01

    Although infarction of parotid gland pleomorphic adenoma (PA) following fine-needle aspiration (FNA) has been well-documented, spontaneous infarction of PA has remained as an uncommon entity in the literature. To our knowledge, we report the second case of spontaneous infarction occurring in a parotid gland PA. A 44-yr-old man presented with a 2-yr history of slowly enlarging right parotid mass, which had become painful 1 mo before performing FNA biopsy. Smears revealed abundant necrotic debris, atypical squamous cells, and small cells with dark nuclei suggestive of a carcinoma. Histologic examination of the tissue fragments demonstrated degenerated clusters of cells and chondromyxoid matrix. The parotidectomy specimen had features consistent with those of an infarcted PA. Although appears to be rare, spontaneous infarction of PA should be considered in the differential diagnosis, since necrosis may mimic carcinoma and cause misinterpretation of necrosis as an indication of malignancy, in an otherwise benign salivary gland neoplasm.

  16. Effects of methotrexate on rat parotid and submandibular glands and their secretions

    SciTech Connect

    McBride, R.K.

    1986-01-01

    Experimental animals were injected intraperitoneally with methotrexate for 3 days. Parotid and submandibular main ducts were cannulated and saliva flow was evoked by either intravenous infusion of acetylcholine or an intravenous injection of benthanechol. Methotrexate was found to reduce significantly mean food consumption, body weight, and parotid gland wet weights. Experimental animal salivary total gland DNA levels were not different, but total parotid gland RNA, protein, amylase and water content, and submandibular gland RNA were significantly lower compared to control. Acetylcholine, but not bethanechol, evoked parotid protein and amylase outputs and submandibular protein output from experimental animals were significantly higher than the control groups'. The increased outputs were apparently linked to ..beta..-adrenergic receptor activation, since hexamethonium or propranolol eliminated the significant increases while phenoxybenzamine did not. Plasma catecholamine levels were significantly higher in the methotrexate treated animals and probably played a role in the salivary gland ..beta..-adrenergic activation. Methotrexate treatment significantly increased the submandibular gland ..beta..-adrenergic receptor concentration as determined by (/sup 3/H)-dihydroalprenolol receptor binding assays. Muscarinic receptor concentrations determined with (/sup 3/H)-quinuclidninyl benzilate were not changed.

  17. Quality of Life after Salivary Gland Surgery.

    PubMed

    Wax, Mark K; Talmi, Yoav P

    2016-01-01

    Quality of life (QoL) has been recognized as an important endpoint in addition to disease-related and global survival. It is particularly important for patients with salivary gland neoplastic disease. For patients who are undergoing benign salivary gland tumor surgery, cosmetic and functional outcomes are extremely important, as these patients' psychological well-being and ability to function in society can be severely impacted. The following issues related to surgical treatment are discussed: incision, loss of local tissue sensation, development of Frey's syndrome, facial nerve function, and cosmesis. Improvements in the placement of the incision combined with additional minimally invasive procedures have improved QoL. The ultimate goal of benign parotid neoplastic surgery is complete tumor excision while avoiding cosmetic and functional damage, which includes preservation of the function of the facial nerve and its branches; this is the key to maintaining preoperative levels of QoL. There are many measures available to improve cosmesis that have minimal morbidity and that, when used, can provide significant improvements in patient outcomes. The treatment of malignant salivary gland neoplasms is primarily directed at treating the malignancy. When surgical treatment affects important neighboring structures, such as the lingual or hypoglossal nerves, as in submandibular/sublingual cancer, there is a tremendous effect on QoL if postoperative dysfunction of these structures results. Often, this treatment involves using ancillary surgical procedures, such as neck dissection, or nonsurgical treatment, such as radiation therapy. The effect of such multi-modality treatment on QoL is significant. The treatment of underlying salivary disease is often overshadowed by these adjunctive treatments. PMID:27092786

  18. Effect of low-level laser therapy on irradiated parotid glands--study in mice.

    PubMed

    Acauan, Monique Dossena; Gomes, Ana Paula Neutziling; Braga-Filho, Aroldo; de Figueiredo, Maria Antonia Zancanaro; Cherubini, Karen; Salum, Fernanda Gonçalves

    2015-10-01

    The objective of this study was to evaluate the effect of low-level laser therapy (LLLT) on radiotherapy-induced morphological changes and caspase-3 immunodetection in parotids of mice. Forty-one Swiss mice were divided into control, radiotherapy, 2- and 4-J laser groups. The experimental groups were exposed to ionizing radiation in a single session of 10 Gy. In the laser groups, a GaAlAs laser (830 nm, 100 mW, 0.028  cm2, 3.57  W/cm2) was used on the region corresponding to the parotid glands, with 2-J energy (20 s, 71  J/cm2) or 4 J (40 s, 135  J/cm2) per point. LLLT was performed immediately before and 24 h after radiotherapy. One point was applied in each parotid gland. The animals were euthanized 48 h or 7 days after radiotherapy and parotid glands were dissected for morphological analysis and immunodetection of caspase-3. There was no significant difference between groups in the immunodetection of caspase-3, but the laser groups had a lower percentage compared to the radiotherapy group. LLLT promoted the preservation of acinar structure, reduced the occurrence of vacuolation, and stimulated parotid gland vascularization. Of the two LLLT protocols, the one using 4 J of energy showed better results. PMID:26502234

  19. Functional studies of the parotid and pancreas glands in amyotrophic lateral sclerosis

    PubMed Central

    Charchaflie, R. J.; Fernandez, L. Bustos; Perec, C. J.; Gonzalez, E.; Marzi, A.

    1974-01-01

    Functional studies of the pancreas and parotid glands are reported in 17 patients with amyotrophic lateral sclerosis (ALS). The exocrine function of the pancreas was studied by measuring amylase concentration after stimulation with the endogenous secretin-pancreozymine test (ESP). Under these conditions, the pancreatic amylase concentration in ALS patients was found to be markedly decreased by about 45% when compared with those of healthy control subjects. Different conclusions in the literature about a possible impairment of the exocrine pancreas in ALS patients induced us to study the function of the parotid gland, which has close structural, functional, and physiopathological relationship with the pancreas. Flow rate and bicarbonate concentration of parotid saliva were measured after indirect stimulation (intraoral citric acid) and direct stimulation (pilocarpine). After indirect stimulation, both parotid flow rate and bicarbonate concentration from ALS patients were found to be decreased by about 66% and 70% respectively, when compared with controls. On the other hand, direct stimulation with pilocarpine in ALS patients elicited normal responses in both flow rate and bicarbonate concentration of saliva. It is concluded that the pancreatic and parotid deficiencies observed in ALS patients do not indicate primary disease of these exocrine glands. This interpretation is further emphasized by the results obtained by a sweat test, plasma osmolarity, and sialographic studies. The possibility that the gland impairments observed might be due to modifications of the neuroendocrine mechanisms regulating their secretory activity is suggested. PMID:4852110

  20. Basal cell adenocarcinoma of the parotid gland with rare scalp metastasis: a case report.

    PubMed

    Eroglu, Ahmet; Cuce, Ferhat; Simsek, Hakan; Topuz, Ali Kıvanc; Duz, Bulent

    2015-01-01

    Salivary gland tumors constitute 3% of tumors in the body. Salivary gland tumors constitute 4% to 10.80% of all tumors in the head and neck tumors and most of them originate from the parotid gland. Most salivary gland tumors are benign. Basal cell adenocarcinoma is a rare salivary gland tumour. Most appear to be benign clinically. Metastases have occurred in less than 10% of patients. A 58-year-old female patient was admitted with the complaint of a growing mass at the top of her head. She was operated for parotid adenocarcinoma two years ago. Computed Tomography (CT) was performed to clarify the relationship between the mass with the calvarium and intracranial region. There is a risk of malignancy in scalp and calvarium lesions. Patients must be subjected to preoperative radiological evaluations.

  1. Sebaceous lymphadenoma of the parotid gland: report of two cases and review of the literature.

    PubMed

    Hayashi, D; Tysome, J R; Boyei, E; Gluckman, P; Barbaccia, C

    2007-06-01

    Sebaceous lymphadenoma is an unusual salivary gland neoplasm which is rarely correctly diagnosed pre-operatively in the parotid gland. Two cases of sebaceous lymphadenoma are presented in which, in common with most cases reported in the literature, the correct pre-operative diagnosis was not made. Sebaceous lymphadenoma rarely transforms into a malignant tumour. Fine needle aspiration cytology identifies a benign process in the majority of patients who receive appropriate treatment on this basis. Although an uncommon tumour, it should be taken into consideration in the differential diagnosis of a solitary parotid mass.

  2. Parotid Gland Function After Radiotherapy: The Combined Michigan and Utrecht Experience

    SciTech Connect

    Dijkema, Tim; Raaijmakers, Cornelis P.J.; Ten Haken, Randall K.; Roesink, Judith M.; Braam, Petra M.; Houweling, Anette C.; Moerland, Marinus A.; Eisbruch, Avraham; Terhaard, Chris H.J.

    2010-10-01

    Purpose: To analyze the combined and updated results from the University of Michigan and University Medical Center Utrecht on normal tissue complication probability (NTCP) of the parotid gland 1 year after radiotherapy (RT) for head-and-neck (HN) cancer. Patients and Methods: A total of 222 prospectively analyzed patients with various HN malignancies were treated with conventional and intensity-modulated RT. Stimulated individual parotid gland flow rates were measured before RT and 1 year after RT using Lashley cups at both centers. A flow ratio <25% of pretreatment was defined as a complication. The data were fitted to the Lyman-Kutcher-Burman model. Results: A total of 384 parotid glands (Michigan: 157; Utrecht: 227 glands) was available for analysis 1 year after RT. Combined NTCP analysis based on mean dose resulted in a TD{sub 50} (uniform dose leading to 50% complication probability) of 39.9 Gy and m (steepness of the curve) of 0.40. The resulting NTCP curve had good qualitative agreement with the combined clinical data. Mean doses of 25-30 Gy were associated with 17-26% NTCP. Conclusions: A definite NTCP curve for parotid gland function 1 year after RT is presented, based on mean dose. No threshold dose was observed, and TD{sub 50} was equal to 40 Gy.

  3. Fine needle aspiration cytology of lymphoepitheliomalike carcinoma of the parotid gland. A case report.

    PubMed

    Thompson, M B; Nestok, B R; Gluckman, J L

    1994-01-01

    Lymphoepitheliomalike carcinoma is a rare primary neoplasm of the salivary gland that has also been reported to occur in other primary sites. In this report we document the clinical, cytomorphologic and histologic findings of a case affecting the parotid gland. The patient was a 48-year-old, white woman with a two-month history of a swelling on the left side of the face and associated pain. Physical examination and computed tomography revealed a left parotid mass with spread to the superior cervical lymph nodes. Fine needle aspiration (FNA) of the parotid and upper cervical nodes revealed multiple, irregular aggregates of epithelial cells with a high nuclear/cytoplasmic ratio and finely granular chromatin. Prominent, single, round nucleoli were present. Multiple chromocenters were also noted. These aggregates were found in a background of abundant, benign, small and large lymphocytes. The patient underwent parotidectomy with radical neck dissection. Histopathologic examination of the parotid showed a poorly differentiated carcinoma in a benign lymphoid background consistent with lymphoepitheliomalike carcinoma, with metastatic tumor involving two lymph nodes of the parotid compartment. To our knowledge, this is the first reported case of FNA biopsy of this unusual entity. The cytomorphologic features of these neoplasms when aspirated from the salivary gland are sufficiently distinctive to allow a specific diagnosis of lymphoepitheliomalike carcinoma.

  4. [The "stimulatory proteodyschylia" in the amitriptylin (Laroxyl) treated rat parotid gland. Experiments on the effect of antidepressive pharmacotherapy on the parotid glands of the rat (author's transl)].

    PubMed

    Chilla, R; Hoffmann, G; Arglebe, C

    1977-06-30

    The activity of total amylase and isoamylases in the rat parotid gland is reduced by treatment with Amitriptylin (Laroxyl) for 3 and 7 days while the protein content of the glands remains constant. These changes are no longer visible after treatment for 21 days and following a period without drug application. To differentiate the disturbances of protein secretion (proteodyschylia) prominent in the clinical picture of sialadenosis, the following classification is proposed. We suggest the term "stimulatory proteodyschylia" for a decrease of acinar amylolytic activity, here caused by Amitriptylin application, as opposed to the "inhibitory proteodyschylia" characterized by an acinar amylase congestion.

  5. Basal Cell Adenoma of Parotid Gland: Case Report and Review of Literature.

    PubMed

    Kanaujia, S K; Singh, Ashutosh; Nautiyal, Shivani; Ashutosh, Kumar

    2015-12-01

    Basal cell adenoma (BCA) of the salivary gland is a rare neoplasm consists of a monomorphic population of basaloid epithelial cells, and it accounts for approximately 1-2 % of all salivary gland tumors. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass. Histologically, isomorphic cells in nests and interlaced trabecules with a prominent basal membrane are observed. In contrast to pleomorphic adenoma, it tends to be multiple and its recurrence rate after surgical excision is high. Due to prognostic implications, differential diagnosis with basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma is mandatory. We report a case of BCA of the parotid gland. We also review the literature and discuss the diagnosis and management of this rare entity. PMID:26693465

  6. Histological analysis of parotid and submandibular glands in chronic alcohol abuse: a necropsy study.

    PubMed Central

    Scott, J; Burns, J; Flower, E A

    1988-01-01

    A quantitative histological analysis of the major salivary glands was carried out at necropsy in 28 alcoholics and in a series of age and sex matched controls. The findings were related to the different types of histologically diagnosed liver disease present. Significant quantitative changes of salivary gland structure were noted in cirrhosis but not in other forms of alcoholic liver disease. In cirrhotic subjects the parotid contained proportionally more adipose but less acinar tissues than in controls. The submandibular gland showed a proportional increase in adiposity and reduction in fibrovascular tissues but no noticeable reduction in its acinar proportional volume. Neither grossly detectable parotid enlargement nor acinar hypertrophy, a feature which has previously been noted as characteristic of alcoholic sialadenosis, were evident in this series. These findings provide little structural support for the reportedly increased secretory capacity of salivary glands in chronic alcohol abuse. PMID:3170770

  7. Oncocytic lipoadenoma of the parotid gland: cytological findings and differential diagnosis on fine-needle aspiration.

    PubMed

    Ashraf, Mohammad Javad; Azarpira, Negar; Anbardar, Mohammad Hossein; Hashemi, Seyed Basir

    2015-01-01

    Oncocytic lipoadenoma is a rare benign neoplastic lesion of salivary gland. To the best of our knowledge, the detailed cytomorphological findings were described only in two cases. We are reporting a 56-year-old woman who presented with 1-year history of right parotid gland mass. Cytologic examination revealed tight clusters of bland looking oncocytic ductal cells with few aggregates of mature adipose tissue in a lipoid background and a benign oncocytic tumor of parotid gland was rendered. Histologically, a tumor with islands of oncocytic epithelial cells admixed with abundant mature adipose tissue was identified. Oncocytic lipoadenoma despite its rarity should be considered in the differential diagnosis of salivary gland fine-needle aspirations containing oncocytes especially those which are accompanied by mature adipose tissue and lipoid background.

  8. Bilateral mucosa-associated lymphoid tissue lymphomas of parotid glands: a 13-year interval.

    PubMed

    Dunphy, C H; Grosso, L E; Rodriquez, J J; Dunphy, F R

    1996-05-01

    Benign lymphoepithelial lesions of salivary gland may have a population of monoclonal B cells. There is controversy regarding the clinical significance of monoclonality in these lesions. Morphologically and clinically, benign lymphoepithelial lesions of the salivary gland with monoclonal B cells falls within the spectrum of low-grade B-cell lymphomas of mucosa-associated lymphoid tissue. We report a case of bilateral parotid lymphomas of mucosa-associated lymphoid tissue, separated diagnostically by a 13-year interval. Polymerase chain reaction analysis detected similar clones in the bilateral parotid glands. This finding supports the natural history of mucosa-associated lymphoid tissue lymphomas. In addition, because mucosa-associated lymphoid tissue lymphomas have an unpredictable period of localized disease, recognition of monoclonality in benign lymphoepithelial lesions of salivary glands is important for local cure and can be aided by combining histologic with immunohistochemical, flow cytometric immunophenotyping, and Southern blot and/or polymerase chain reaction analysis.

  9. Parotid Gland Sparing With Helical Tomotherapy in Head-and-Neck Cancer

    SciTech Connect

    Voordeckers, Mia; Farrag, Ashraf; Everaert, Hendrik; Tournel, Koen; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2012-10-01

    Purpose: This study evaluated the ability of helical tomotherapy to spare the function of the parotid glands in patients with head-and-neck cancer by analyzing dose-volume histograms, salivary gland scintigraphy, and quality of life assessment. Methods and Materials: Data from 76 consecutive patients treated with helical tomotherapy (Hi-Art Tomotherapy) at University Hospital Brussel were analyzed. During planning, priority was given to planning target volume (PTV) coverage: {>=}95% of the dose must be delivered to {>=}95% of the PTV. Elective nodal regions received 54 Gy (1.8 Gy/fraction). A dose of 70.5 Gy (2.35 Gy/fraction) was prescribed to the primary tumor and pathologic lymph nodes (simultaneous integrated boost scheme). Objective scoring of salivary excretion was performed by salivary gland scintigraphy. Subjective scoring of salivary gland function was evaluated by the European Organization for Research and Treatment of Cancer quality of life questionnaires Quality of Life Questionnaire-C30 (QLQ-C30) and Quality of Life Questionnaire-Head and Neck 35 (H and N35). Results: Analysis of dose-volume histograms (DVHs) showed excellent coverage of the PTV. The volume of PTV receiving 95% of the prescribed dose (V95%) was 99.4 (range, 96.3-99.9). DVH analysis of parotid gland showed a median value of the mean parotid dose of 32.1 Gy (range, 17.5-70.3 Gy). The median parotid volume receiving a dose <26 Gy was 51.2%. Quality of life evaluation demonstrated an initial deterioration of almost all scales and items in QLQ-C30 and QLQ-H and N35. Most items improved in time, and some reached baseline values 18 months after treatment. Conclusion: DVH analysis, scintigraphic evaluation of parotid function, and quality of life assessment of our patient group showed that helical tomotherapy makes it possible to preserve parotid gland function without compromising disease control. We recommend mean parotid doses of <34 Gy and doses <26 Gy to a maximum 47% of the parotid

  10. Texture-based and diffusion-weighted discrimination of parotid gland lesions on MR images at 3.0 Tesla.

    PubMed

    Fruehwald-Pallamar, Julia; Czerny, Christian; Holzer-Fruehwald, Laura; Nemec, Stefan F; Mueller-Mang, Christina; Weber, Michael; Mayerhoefer, Marius E

    2013-11-01

    The purpose of this study was to evaluate whether texture-based analysis of standard MRI sequences and diffusion-weighted imaging can help in the discrimination of parotid gland masses. The MR images of 38 patients with a biopsy- or surgery-proven parotid gland mass were retrospectively analyzed. All patients were examined on the same 3.0 Tesla MR unit, with one standard protocol. The ADC (apparent diffusion coefficient) values of the tumors were measured with three regions of interest (ROIs) covering the entire tumor. Texture-based analysis was performed with the texture analysis software MaZda (version 4.7), with ROI measurements covering the entire tumor in three slices. COC (co-occurrence matrix), RUN (run-length matrix), GRA (gradient), ARM (auto-regressive model), and WAV (wavelet transform) features were calculated for all ROIs. Three subsets of 10 texture features each were used for a linear discriminant analysis (LDA) in combination with k nearest neighbor classification (k-NN). Using histology as a standard of reference, benign tumors, including subtypes, and malignant tumors were compared with regard to ADC and texture-based values, with a one-way analysis of variance with post-hoc t-tests. Significant differences were found in the mean ADC values between Warthin tumors and pleomorphic adenomas, as well as between Warthin tumors and benign lesions. Contrast-enhanced T1-weighted images contained the most relevant textural information for the discrimination between benign and malignant parotid masses, and also for the discrimination between pleomorphic adenomas and Warthin tumors. STIR images contained the least relevant texture features, particularly for the discrimination between pleomorphic adenomas and Warthin tumors. Texture analysis proved to differentiate benign from malignant lesions, as well as pleomorphic adenomas from Warthin tumors, based on standard T(1w) sequences (without and with contrast). Of all benign parotid masses, Warthin tumors had

  11. Parotid Gland Biopsy, the Alternative Way to Diagnose Sjögren Syndrome.

    PubMed

    Spijkervet, Fred K L; Haacke, Erlin; Kroese, Frans G M; Bootsma, Hendrika; Vissink, Arjan

    2016-08-01

    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjögren syndrome (SS), lymphoma in SS, and connective tissue disorders (sarcoidosis, amyloidosis). In SS characteristic histology findings are found, including lymphocytic infiltration surrounding the excretory ducts in combination with destruction of acinar tissue. In this article the main techniques are described for taking labial and parotid salivary gland biopsies with respect to their advantages, postoperative complications, and usefulness for diagnostic procedures, monitoring disease progression, and evaluation of treatment.

  12. Sclerosing polycystic adenosis of the parotid gland presenting with a Warthin tumor.

    PubMed

    Tokyol, Ciğdem; Aktepe, Fatma; Hastürk, Güler Senyıldız; Yıldız, Hüseyin; Miman, Murat Cem

    2012-01-01

    Sclerosing polycystic adenosis (SPA) frequently presents as an isolated process, however it may involve adjacent benign salivary gland neoplasia. In this article, we present a 77-year-old female case with a 10-year history of a slow-growing mass of the left parotid gland of SPA presenting with a Warthin tumor. The patient underwent left superficial parotidectomy. The histopathological examination revealed SPA and multifocal Warthin tumor.

  13. Synchronous ipsilateral sebaceous lymphadenoma and acinic cell adenocarcinoma of the parotid gland.

    PubMed

    Mayorga, M; Fernández, N; Val-Bernal, J F

    1999-11-01

    The synchronous or metachronous occurrence of 2 tumors of the salivary glands in a patient is rare. These tumors are usually benign and of the same histologic type. Here we report a 78-year-old woman who developed a sebaceous lymphadenoma and an acinic cell adenocarcinoma simultaneously in the left parotid gland. To our knowledge, this combination of neoplasms has not been reported before.

  14. Large carcinoma ex pleomorphic adenoma of the parotid gland: a case report and review of literature.

    PubMed

    Yoshida, Naohiro; Hara, Mariko; Kanazawa, Hiromi; Iino, Yukiko

    2013-12-01

    Pleomorphic adenoma (PA) is one of the most common benign tumors of the parotid gland. PA usually grows slowly and is painless. Surgery is necessary for treating PA. Facial palsy, salivary fistula, and Frey syndrome have been reported as complications of tumor resection. PA can transform into a carcinoma ex pleomorphic adenoma (CXPA) over time and as it enlarges. This report describes a case of a large CXPA that transformed from a PA that had developed over 17 years and caused withdrawal from social contact because fear of surgery made the patient refuse treatment. The tumor gradually enlarged without any pain for a decade, but rapid growth and bleeding began a year before admission. Postoperative facial function and local control of the tumor were excellent, but the patient required adjuvant chemotherapy for lung and mediastinum lymph node metastasis leading to dyspnea from tracheal stenosis. This case indicates the importance of adequate explanation and advice when choosing therapy for PA, especially given the risk of a PA transforming to a CXPA.

  15. Branchial Cleft-Like Cysts Involving 3 Different Organs: Thyroid Gland, Thymus, and Parotid Gland.

    PubMed

    Nakazawa, Tadao; Kondo, Tetsuo; Oishi, Naoki; Tahara, Ippei; Kasai, Kazunari; Inoue, Tomohiro; Mochizuki, Kunio; Katoh, Ryohei

    2015-10-01

    Branchial cleft cysts (BCCs) are also named lateral cervical cysts and widely acknowledged as being derived from embryonic remnants. Lymphoepithelial cysts (LECs) generally show microscopic features that are identical to those of BCCs, and rarely occur at unusual sites or organs.A case of multiple cysts arising in both lobes of the thyroid gland, thymus, and right parotid gland in a 41-year-old man is reported. Clinically, the patient presented with Hashimoto's thyroiditis for about 20 years and had past histories of idiopathic thrombocytopenic purpura and severe respiratory infection.This case is unusual in that multiple cysts arose synchronously and/or heterochronously and grew, increasing their sizes in these different organs. Microscopic examinations revealed that all of the cysts were composed of squamous epithelium, dense lymphoid tissue with germinal centers, and a fibrous capsule. These findings corresponded to those of BCCs or LECs. It is notable that the histopathological features were nearly the same in the individual organs. A review of the literature disclosed no previous such reported cases.The etiology is unknown. However, based upon the similar histopathological features of all the excised specimens, common immune and/or hematopoietic disorders may have contributed to their occurrence and development in association with putative genetic abnormalities.

  16. Branchial Cleft-Like Cysts Involving 3 Different Organs: Thyroid Gland, Thymus, and Parotid Gland.

    PubMed

    Nakazawa, Tadao; Kondo, Tetsuo; Oishi, Naoki; Tahara, Ippei; Kasai, Kazunari; Inoue, Tomohiro; Mochizuki, Kunio; Katoh, Ryohei

    2015-10-01

    Branchial cleft cysts (BCCs) are also named lateral cervical cysts and widely acknowledged as being derived from embryonic remnants. Lymphoepithelial cysts (LECs) generally show microscopic features that are identical to those of BCCs, and rarely occur at unusual sites or organs.A case of multiple cysts arising in both lobes of the thyroid gland, thymus, and right parotid gland in a 41-year-old man is reported. Clinically, the patient presented with Hashimoto's thyroiditis for about 20 years and had past histories of idiopathic thrombocytopenic purpura and severe respiratory infection.This case is unusual in that multiple cysts arose synchronously and/or heterochronously and grew, increasing their sizes in these different organs. Microscopic examinations revealed that all of the cysts were composed of squamous epithelium, dense lymphoid tissue with germinal centers, and a fibrous capsule. These findings corresponded to those of BCCs or LECs. It is notable that the histopathological features were nearly the same in the individual organs. A review of the literature disclosed no previous such reported cases.The etiology is unknown. However, based upon the similar histopathological features of all the excised specimens, common immune and/or hematopoietic disorders may have contributed to their occurrence and development in association with putative genetic abnormalities. PMID:26496296

  17. Basal cell adenoma of the parotid gland. Case report and review of the literature.

    PubMed

    González-García, Raúl; Nam-Cha, Syong H; Muñoz-Guerra, Mario F; Gamallo-Amat, C

    2006-03-01

    Basal cell adenoma of the salivary glands is an uncommon type of monomorphous adenoma. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass. Histologically, isomorphic cells in nests and interlaced trabecules with a prominent basal membrane are observed. It is also characterized by the presence of a slack and hyaline stroma and the absence of myxoid or condroid stroma. In contrast to pleomorphic adenoma, it tends to be multiple and its recurrence rate after surgical excision is high. Due to prognostic implications, differential diagnosis with basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma is mandatory. We describe a case of basal cell adenoma of the parotid gland. We also review the literature and discuss the diagnosis and management of this rare entity.

  18. Multiple oncocytic cystadenoma with intraluminal crystalloids in parotid gland: case report.

    PubMed

    Başak, Kayhan; Kiroğlu, Kumru

    2014-12-01

    Oncocytic cystadenoma is a benign tumor of salivary glands, histologically characterized by multicystic growth of the oncocytic epithelial lining. Crystals in different shapes and nature associate oncocytic type of salivary gland neoplasms. An 82 year-old woman with right parotideal mass had an operation of superficial parotidectomy. Histological examination revealed multiple unilocular or multilocular cystic lesions with incomplete fibrous capsule, papillary foldings, and 1 or 2 layers of oncocytic epithelium lines. The epithelium lining the cysts were positive for CK8, CK14, CK18, CK19, and negative for SMA, S-100, and p63 immunohistochemically. Cystadenomas were described as mostly multilocular and we presented a multifocal cystic neoplastic lesion lined by oncocytic type epithelial cells with intraluminal crystalloids. Multiple cysts forming morphology, incomplete fibrous capsule of most cysts and immunohistocemical findings were considered as multiple oncocytic cystadenoma with intraluminal crystalloids in the parotid gland.

  19. Synovial sarcoma of the parotid gland: a case report and review of the literature.

    PubMed

    Rigante, M; Visocchi, M; Petrone, G; Mulè, A; Bussu, F

    2011-02-01

    Parotid gland tumours are very heterogeneous, being benign in 80% of cases, and generally arising from epithelial cells. Nevertheless, a small group of non-epithelial tumours representing just 5% of all salivary gland neoplasms has also been reported, the most common of these being haemangioma, especially in children. However, lymphomas, neuromas, neurofibromas, lipomas and sarcomas can also be found. Synovial cell sarcoma is a high grade histological variety of sarcoma and is generally located near large joints and bursae of the lower extremities, such as knee, tendon sheaths and bursal structures. It is rarely found in the head and neck region due to its lack of synovioblastic tissue. Herewith, the case of a young female, affected by a synovial sarcoma of the left parotid gland, is presented and a review is made of the literature on this rare specific localization focusing on management and outcome.

  20. Benign cystic lymphoepithelial lesion of the parotid gland an unusual presentation of the acquired immunodeficiency syndrome.

    PubMed

    Galindo, L M; Franceschini, A; Soltero, E; Dávila, R

    1991-08-01

    This article presents a case of a young, otherwise asymptomatic male patient with a parotid gland enlargement. The initial clinical history did not reveal any risk factors related with HIV infection. A fine needle aspiration biopsy of the lesion showed a benign cystic lymphoepithelial lesion of the parotid gland. This once unusual lesion of the salivary gland has been recently associated with infection by the human immunodeficiency virus (HIV) and is presently encountered with increased frequency in the clinical practice. The knowledge of the association between these two entities led, in this case, to the diagnosis of HIV infection in an otherwise asymptomatic patient. Early detection of HIV infection is of vital importance since it has been demonstrated that prompt treatment of these patients with AZT slows down the progression of the disease.

  1. Nonsebaceous lymphadenoma of the parotid gland: cytopathologic findings and differential diagnosis.

    PubMed

    Castelino-Prabhu, Shobha; Li, Qing Kay; Ali, Syed Z

    2010-02-01

    Lymphadenomas (sebaceous and nonsebaceous types) of the salivary glands are extremely uncommon benign neoplasms. There are rare published reports of cytopathologic characteristics of "nonsebaceous lymphadenomas" of the parotid gland. We report herein, the case of an 80-year-old female who was evaluated at The Johns Hopkins Hospital for a 4.0 cm, nontender, mobile asymptomatic left parotid mass present for 3 months. An ultrasound-guided fine-needle aspiration revealed a uniform population of cohesive basaloid-type cells associated with scant myxoid stroma and was interpreted as "epithelioid neoplasm with basaloid features." Subsequently, a superficial parotidectomy was performed, which revealed a nonsebaceous type lymphadenoma. The rarity of this neoplasm and its superficial resemblance to more common salivary gland neoplasms may present diagnostic issues on FNA.

  2. Parotid gland non-Hodgkin lymphoma in primary Sjögren syndrome.

    PubMed

    Zenone, Thierry

    2012-05-01

    The risk of malignant non-Hodgkin lymphoma is increased in primary Sjögren syndrome. In the literature, most studies evaluating this risk were conducted in tertiary reference university hospital. So, selection bias in series exists, in particular selection of the most severe cases in tertiary reference university care centers. Some studies had also a selection bias because patients were hospitalized (data were obtained from hospital discharge registries) and therefore the more severe cases were considered. Between October 1999 and November 2009, 109 adult patients were admitted to our department of internal medicine (non-university hospital, secondary level of the healthcare system, hospitalized patients and outpatient) with diagnosis of primary Sjögren syndrome. Two cases of parotid gland lymphoma occurred during the period of follow-up. No other lymphoma was detected. In this study, clinically identifiable parotid gland non-Hodgkin lymphoma occurs in 1.8% of patients with primary Sjögren syndrome. Because most non-Hodgkin lymphoma initially involves the neck organs, meticulous imaging studies mainly focused on the cervical regions are recommended in the follow-up of patients with primary Sjögren syndrome. Patients whose main complaint is persistent parotid gland swelling may have a parotid biopsy in order to diagnose non-Hodgkin lymphoma.

  3. An unusual case of epithelial-myoepithelial carcinoma of the parotid gland radiologically simulating a benign lesion.

    PubMed

    Sharma, Shubhra; Patankar, Sangeeta

    2014-01-01

    Epithelialmyoepithelial carcinoma (EMEC) is a rare low-grade malignant salivary gland neoplasm that most commonly occurs in the parotid gland but can also arise in minor salivary glands. Here, we present a case of EMEC in a 60-year-old male patient with a huge swelling in the left parotid gland region. Clinically and radiologically, it simulated a benign salivary gland neoplasm. However, fine-needle aspiration cytology and histologic examination revealed atypical myoepithelial cells in solid sheets or nests suggestive of epithelial-myoepithelial carcinoma. Diagnosis was further confirmed by positive immunohistochemical staining with calponin (CALP) and periodic acid-Schiff (PAS) for glycogen.

  4. [Congenital parotid gland fistula in the children: diagnostics and surgical treatment].

    PubMed

    Bogomil'sky, M R; Ivanenko, A M; Mazur, E M; Bulynko, S A; Soldatsky, Yu L

    2016-01-01

    The objective of the present study was to improve diagnostics and surgical treatment of congenital parotid gland fistulae. It involved 86 children presenting with this defect at the age varying from 4 months to 17 years who were admitted to the Department of Otorhinolaryngology of the Morozovskaya City Children's Clinical Hospital during the period from 2010 till 2014. It was shown that parotid fistula suppuration is an absolute indication for the surgical treatment of such children regardless of their age. The proposed diaphanoscopic technique was shown to produce good results and can be recommended for both diagnostics an intraoperative visualization of the fistulous passage. PMID:26977568

  5. Sebaceous lymphadenoma of the parotid gland in a 13-year-old girl: a case report.

    PubMed

    Rawlinson, Neil J; Almarzooqi, Saeeda; Nicol, Kathleen

    2010-06-01

    Sebaceous lymphadenoma is a benign rare tumor of the salivary gland. It typically presents in the 6th decade of life as a slowly growing parotid mass. Pathologic examination reveals a well circumscribed mass composed of epithelial islands set in a lymphoid background. The epithelial nests are composed of sebaceous cells and ductal structures. Surgical excision is curative. Prognosis is good with rare recurrence or malignant transformation. Currently, there are less than 50 reported cases in the English literature. We report the second case of sebaceous lymphadenoma in the pediatric population and the youngest reported so far that presented in a 13 year old girl with a parotid mass.

  6. Cytomegalovirus in the parotid gland of a slow loris, Nyctecibus coucang.

    PubMed

    Tandler, B

    1997-07-01

    Sporadic enlarged cells with both nuclear and cytoplasmic viruses were found in the intralobular ducts of the parotid salivary gland of an adult female slow loris; these ducts are homologous to striated ducts in the salivary glands of other primates. The duct cell nuclei contained reticular inclusions and virions in all stages of development. Cytoplasmic virions were, in almost every case, confined to vacuoles; only a very few were free in the cytosol. The viruses conformed in ultrastructure to that of cytomegaloviruses described in other species. This may be the first observation by electron microscopy of in situ cytomegaloviruses in the salivary glands of a nonhuman primate.

  7. Benign lymphoepithelial lesion of the parotid gland with sebaceous differentiation.

    PubMed

    Ide, F; Shimoyama, T; Horie, N; Kaneko, T; Matsumoto, M

    1999-06-01

    The salivary duct system in the setting of chronic sialadenitis is predisposed to undergo a variety of cellular modifications. This report documents a rare type of metaplasia of a parotid benign lymphoepithelial lesion. Epimyoepithelial islands showing focal sebaceous differentiation and pure sebaceous cell nests in addition to their usual histologic appearance were noted throughout the lesion. The possible pathogenesis is discussed through a review of the literature.

  8. Epithelioid myoepithelioma of the accessory parotid gland: pathological and magnetic resonance imaging findings.

    PubMed

    Iguchi, Hiroyoshi; Yamada, Kei; Yamane, Hideo; Hashimoto, Shigeo

    2014-05-01

    Tumors of the accessory parotid gland (APG) are rare, and pleomorphic adenoma (PA) is the most common benign APG tumor subtype. Myoepithelioma of the APG is much rarer than PA, and to date, only 5 cases have been sporadically reported in the English literature. We describe the clinicopathological and MRI findings of an epithelioid myoepithelioma of the APG that was treated in our hospital. The patient's only clinical symptom was a slow-growing and painless mid-cheek mass. The tumor was suspected to be PA before surgery based on the following MRI findings: (1) a well-circumscribed and lobulated contour, (2) isointensity and hyperintensity relative to the muscle on T1- and T2-weighted images (WIs), respectively, (3) good enhancement on contrast-enhanced T1-WIs, (4) peripheral hypointensity on T2-WIs, and (5) a gradual time-signal intensity curve enhancement pattern on gadolinium-enhanced dynamic MRI. The tumor was completely resected via a standard parotidectomy approach, and the postoperative pathological examination of the tumor, including immunohistochemistry, confirmed the diagnosis of epithelioid myoepithelioma. As it is hardly possible to distinguish myoepithelioma from PA and low-grade malignant tumors preoperatively, a pathological examination using frozen sections is helpful for surgical strategy-related decisions.

  9. Parotid gland atrophy induced by occlusion of the ductal system with a protein solution.

    PubMed

    Rettinger, G; Stolte, M; Sidiras, T

    1984-01-01

    Nonneoplastic disorders of the parotid gland, such as chronic recurrent parotitis, asymptomatic gland enlargement, or salivary fistulae, are therapeutic problems. Surgical removal of the gland is often difficult, since scar tissue may be present in these benign diseases. Therefore, alternative treatment methods, such as ligation of Stensen's duct, irradiation, or tympanic neurectomy, have been used to induce atrophy of gland parenchyma. This goal can also be attained by intraluminal duct occlusion, which involves instillation of a resorbable protein solution into the duct system, a procedure similar to sialographic injection. Intraluminal duct occlusion is a simple technique with rapid onset of atrophy and low morbidity, and with its use options remain open for other treatment modalities. The authors have used this method in the treatment of various diseases in 26 parotid glands and one submandibular gland. Their experience, which includes three-year patient follow-up data, suggests that this technique may be a useful alternative to salivary gland resection in certain nonneoplastic diseases.

  10. Tumor-associated lymphoid proliferation in the parotid gland. A potential diagnostic pitfall.

    PubMed

    Auclair, P L

    1994-01-01

    A substantial proportion of neoplastic and nonneoplastic parotid diseases have a prominent lymphoid component. The lymphoid element in lesions such as papillary cystadenoma lymphomatosum, sebaceous lymphadenoma, and lymphoepithelial carcinoma are readily recognized as a required diagnostic element. However, when other types of benign and malignant salivary gland neoplasms demonstrate tumor-associated lymphoid proliferation, the tumor may be either misclassified or misinterpreted as metastatic disease. Examples of primary benign and malignant parotid neoplasms exhibiting tumor-associated lymphoid proliferation are documented and illustrated. Other parotid lesions that may have a lymphoid element include sialadenitis, cysts with associated lymphoid tissue, parenchymal neoplasms with an expected lymphoid component or those that arise within an intraparotid lymph node, autoimmune disease, malignant lymphoma, and metastatic disease. An approach to recognition and separation of these entities is discussed.

  11. Recurrent pleomorphic adenoma of the parotid gland: Long-term outcome of patients treated with radiation therapy

    SciTech Connect

    Chen, Allen M. . E-mail: achen@radonc17.ucsf.edu; Garcia, Joaquin; Bucci, M. Kara; Quivey, Jeanne M.; Eisele, David W.

    2006-11-15

    Purpose: To evaluate the role of radiation therapy in the management of recurrent pleomorphic adenoma of the parotid gland. Methods and Materials: Between 1960 and 2004, 34 patients were treated with postoperative radiation therapy for recurrent pleomorphic adenoma of the parotid gland to a median dose of 5000 cGy (range, 4,500-6,000 cGy). Median age was 48 years (range, 24-72 years). Gross total resection at the time of surgery before radiation was achieved in 30 patients (88%), and histologic analysis demonstrated multifocal disease in 16 patients (47%). Radiation was delivered for a first, second, third, fourth, fifth, and sixth local recurrence in 24%, 21%, 24%, 24%, 6%, and 3% of patients, respectively. Results: With a median follow-up of 17.4 years (range, 2.3-28.9 years), 2 patients had local recurrences at a median of 3.4 years after completion of radiation. The 20-year actuarial local control rate was 94%. One patient developed a second malignancy at approximately 14 years after completion of therapy. Conclusion: The use of postoperative radiation therapy leads to excellent long-term local control for the treatment of recurrent pleomorphic adenoma with acceptable late toxicity. Although the incidence of second malignancy was low in this population, continued follow-up is warranted.

  12. Radioprotective effect of amifostine on parotid gland functioning is region dependent

    SciTech Connect

    Konings, Antonius W.T. . E-mail: a.w.t.konings@med.umcg.nl; Faber, Hette; Vissink, Arjan; Coppes, Rob P.

    2005-12-01

    Purpose: To investigation the protective ability of amifostine during partial irradiation of the rat parotid gland. Methods and Materials: Single-dose X-ray irradiation was performed by use of collimators with conformal radiation portals for either the 100% volume (15 Gy) or the 50% cranial/caudal partial parotid gland volumes (30 Gy). Amifostine was administered intraperitoneally at a dose of 250 mg per kg body weight, 25 minutes before irradiation. Saliva flow rates, gland weights, and the tissues of the individual lobes were investigated up to 1 year after treatment. Results: A clear protective effect of amifostine was found against loss of saliva flow, the altered appearance of gross morphology, loss of gland weight, and histopathologic changes for the 100% volume gland irradiations and for the 50% volume cranial irradiations but not for the 50% volume caudal irradiations. Conclusions: The protective ability of amifostine is strongly dependent on the irradiated glandular region and observed for later damage only. The major effect of the drug seems to be the prevention of volume effects caused by secondary damage that occurs in shielded parts of the gland. The results of the present study show that understanding of the anatomy and physiology of organs that are to be spared is necessary to ensure optimal preservation of function.

  13. Fine structure of the parotid gland in tree shrew (Tupaia glis).

    PubMed

    Suzuki, S; Mifune, H; Nishida, T; Obara, T; Kamimura, R; Sakamoto, H; Mohammad Abdul, A; Nishinakagawa, H

    1995-10-01

    The parotid glands of Tupaia glis were examined by light and transmission electron microscopy. The acinar cells were seromucous in nature, and contained many acidophilic granules with strong affinity for periodic acid-Schiff (PAS) and weak affinity for alcian blue (AB). These granules consisted of a fine granular matrix of moderate density in which a denser corpuscles or semilunar materials were present. Intercalated duct cells had a few fine vesicles, vacuoles and very few dense granules in the apical region. In occasional epithelial cells, acidophilic, PAS-positive and AB-negative bodies with moderate density were observed in the supranuclear region. The striated ducts consisted of columnar light and dark cells containing round or small ovoid granules of moderate density and did not show the granular duct as seen in the parotid glands of kobe mole and tenrec which are placed in the order insectivora.

  14. Function of the parotid gland in juvenile recurrent parotitis: a case series.

    PubMed

    Xie, Li-song; Pu, Yi-ping; Zheng, Ling-yan; Yu, Chuang-qi; Wang, Zhi-jun; Shi, Huan

    2016-04-01

    Our aim was to find out how the parotid gland functions in 44 patients with juvenile recurrent parotitis, and to assess the value of measuring the serum amylase activity. Clinical and personal details were recorded, and all patients had their serum amylase activity measured together with sialography during the chronic phase. The function of the gland was classified by sialographic images. The chi square test and Spearman's rank correlation coefficient were used in the statistical analyses. There was a significant association between the degree of glandular function and serum amylase activity (p=0.014). The patients with unilateral and bilateral disease differed significantly in their degree of glandular function (p=0.020), those with bilateral disease having poorer function. There were no significant correlations between other clinical variables and glandular function. Serum amylase activity is an important diagnostic variable in juvenile recurrent parotitis, and poor parotid function reflects the severity of the disease. PMID:26852271

  15. La tuberculose primaire de la glande parotide: à propos de deux cas

    PubMed Central

    Touiheme, Nabil; Kettani, Mounir; Messary, Abdelhamid

    2014-01-01

    La localisation isolée de la tuberculose au niveau de la glande parotide est extrêmement rare. Aucun élément clinique, radiologique et biologique ne permet d'affirmer le diagnostic. Nous rapportons deux cas survenus chez un patient âgé de 40 ans, et une femme de 35 ans immunocompétent, opérés pour une tuméfaction parotidienne et le diagnostic de tuberculose reposait sur l'examen histologique. La symptomatologie de la tuberculose de la glande parotide est polymorphe ce qui pose un problème diagnostic, Le diagnostic est surtout anatomopathologique et le traitement repose sur les antibacillaires. PMID:25426195

  16. Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor

    PubMed Central

    Aynali, Giray; Ceyhan, Ali Murat; Çiriş, Metin

    2016-01-01

    Malignant melanoma of the parotid gland is often metastatic and mainly originates from malignant melanomas in the head and neck. Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously. The investigation of a patient's old photographs may help in the detection of preexisting and regressed pigmented lesions in the facial and neck regions. PMID:27478668

  17. Castleman Disease of the Parotid Gland: A Report of a Case.

    PubMed

    Abo-Alhassan, Fawaz; Faras, Fatemah; Bastaki, Jassem; Al-Sihan, Mutlaq K

    2015-01-01

    Castleman disease is an extremely rare benign lymphoproliferative disorder of unknown etiology. It affects the lymphatic chain in anybody region, although the commonest site is the mediastinum. The head and neck region is the second most common site; however, the salivary glands are rarely affected. We report a case of a 29-year-old Asian lady who presented with a 2-year history of an enlarging left parotid mass. Histopathology of the excisional biopsy confirmed the diagnosis of Castleman disease.

  18. Minimally invasive endoscopic resection of benign tumours of the accessory parotid gland: an updated approach.

    PubMed

    Li, Biao; Zhang, Lei; Zhao, Zeliang; Shen, Guofang; Wang, Xudong

    2013-06-01

    The most common conventional approaches for the resection of benign tumours in the accessory parotid gland are a standard parotidectomy incision, a modified standard parotidectomy incision, or a face-lift incision. The resulting scars may severely affect the patient's postoperative appearance. The previously reported endoscopically assisted approach offers a less aesthetically invasive technique, but it may still leave a visible preauricular scar 4-5 cm long. We have used a modified endoscopic approach with minimal, and concealed, incisions for the resection of benign tumours in the accessory parotid gland. Five patients were diagnosed by physical examination, imaging, and preoperative fine-needle aspiration biopsy. They had endoscopically assisted resections using our modified approach, and we evaluated its feasibility. All the resections were successful. The mean operating time was 108 min (range 90-130). The postoperative scars were concealed and aesthetically satisfactory. There were no facial paralyses, salivary fistulas, or recurrences in the short term. Using endoscopically assisted resection we completely removed benign tumours from the accessory parotid gland and obtained good aesthetic results. Our updated endoscopic approach for these resections is successful with shorter, concealed incisions. It is a viable alternative to conventional approaches.

  19. Effects of 5-fluorouracil on the secretory process of the rat parotid gland

    SciTech Connect

    Sandborg, R.R.

    1986-01-01

    Experimental animals were injected intraperitoneally with 100 mg/kg 5-fluorouracil for three days. The total volume, amylase and protein content of cannulated parotid saliva were determined following stimulation with either 5 mg/kg pilocarpine or 5 mg/kg isoproterenol in experimental, pair-fed , and control animals. Saliva from experimental animals was significantly lower in volume, amylase and protein content than both control groups. 5-fluorouracil treatment reduced the total glandular amylase per unit DNA in both unstimulated and isoproterenol-stimulated parotid glands. Decreased protein synthesis may be the mechanism underlying depleted secretory protein stores since the contents of isolated secretory granules from experimental parotid glands contained less radiolabelled protein than either control group and whole gland homogenates showed marked reductions in the activities of three lysosomal enzymes and total RNA content. Experimental animals contained less labelled protein in their secretory granules than controls, but secreted a greater proportion of their total glandular radiolabelled secretory protein into saliva relative to amylase suggesting that newly synthesized secretory proteins are preferentially secreted.

  20. Parotid Gland Biopsy, the Alternative Way to Diagnose Sjögren Syndrome.

    PubMed

    Spijkervet, Fred K L; Haacke, Erlin; Kroese, Frans G M; Bootsma, Hendrika; Vissink, Arjan

    2016-08-01

    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjögren syndrome (SS), lymphoma in SS, and connective tissue disorders (sarcoidosis, amyloidosis). In SS characteristic histology findings are found, including lymphocytic infiltration surrounding the excretory ducts in combination with destruction of acinar tissue. In this article the main techniques are described for taking labial and parotid salivary gland biopsies with respect to their advantages, postoperative complications, and usefulness for diagnostic procedures, monitoring disease progression, and evaluation of treatment. PMID:27431350

  1. Non-sebaceous lymphadenoma of the parotid gland: immunohistochemical study and DNA ploidy analysis.

    PubMed

    Gallego, Lorena; Junquera, Luis; Fresno, Manuel F

    2009-04-01

    Nonsebaceous lymphadenoma (NSL) is an unusual benign salivary gland tumor characterized by a predominant lymphoid background, dense lymphoid infiltrate, and absence of sebaceous differentiation. To our knowledge, only 10 previous cases have been reported in the literature. We report an additional case of NSL arising in the parotid gland in 58-year-old female patient. The extensive immunohistochemical investigation of the tumor revealed the presence of both luminal and myoepithelial cells. DNA analysis for flow cytometry was performed. The histogram presented a single peak in the G0-G1 area. The tumor was considered as being DNA diploid.

  2. Malignancy-simulating change in parotid gland oncocytoma following fine needle aspiration. Report of 3 cases.

    PubMed

    Skálová, A; Stárek, I; Michal, M; Leivo, I

    1999-01-01

    We report here there cases of benign parotid gland oncocytoma with pseudomalignant change that mimic acinic cell carcinoma. All patients underwent fine-needle aspiration biopsy of the tumor 62, 725 and 33 days before surgical excision. In histologic sections, there were clusters of pigmented cells with PAS-positive foamy to finely granular cytoplasm similar to those seen in salivary gland acinic cell carcinomas. This report provides another, previously undescribed, example of a diagnostic pitfall that may be observed in histologic tissue specimens removed after FNA of oncocytic tumors.

  3. Hyalinizing clear cell carcinoma of the oral cavity and of the parotid gland.

    PubMed

    Rinaldo, A; McLaren, K M; Boccato, P; Maran, A G

    1999-01-01

    Hyalinizing clear cell carcinoma (HCCC) is a rare, recently described tumor of salivary gland origin. Differential diagnosis includes benign lesions as clear cell change in a pleomorphic adenoma or in oncocytoma and malignant tumors - i.e. epithelial-myoepithelial carcinoma, polymorphous low-grade adenocarcinoma, mucoepidermoid carcinoma, clear cell acinic carcinoma, clear cell squamous carcinoma, clear cell malignant melanoma, clear cell odontogenic carcinoma, clear cell rhabdomyosarcoma, sebaceous carcinoma and metastasis of renal carcinoma. A favorable prognosis after wide local excision has been evidenced. Three new cases of HCCC (2 in the oral cavity and 1 in the parotid gland) are presented.

  4. Correct diagnosis of Warthin tumor in the parotid gland with dynamic MRI.

    PubMed

    Ogawa, Takenori; Suzuki, Takahiro; Sakamoto, Maya; Watanabe, Mika; Tateda, Yutaka; Oshima, Takeshi; Kato, Kengo; Sagai, Shun; Kobayashi, Toshimitsu; Shiga, Kiyoto

    2012-01-01

    Warthin tumor (WT) is a benign tumor of the salivary gland primarily affecting middle-aged men. WT is almost exclusively located in the parotid gland and tend to grow slowly without symptoms. Although fine needle aspiration cytology (FNAC) often correctly diagnoses these tumors, they are occasionally misdiagnosed as malignant. Our study sought to distinguish between WT and non-WT using dynamic MRI. In dynamic MRI, a series of images are taken over time measuring the intensity of gadolinium uptake by the parotid. We examined two patients for this study. The first was a 53-year old male, heavy smoker, experiencing manic-depressive episodes. He received a brain MRI at which time his parotid tumor was discovered. Parotid FNAC indicated a squamous cell carcinoma. The second patient was a 76-year old male, moderate smoker and drinker, who had been complaining about swelling in the neck. FNAC of the parotid indicated acinic cell carcinoma and gadolinium-enhanced MRI suggested the tumor was malignant. Prior to surgically extracting of these masses, we performed dynamic MRI on each patient. Both tumors exhibited a pattern consisting of rapid enhancement and rapid attenuation, the pattern of which is characteristic of WT. The surgical specimens confirmed that both were WTs without malignant transformation. Our findings indicate that dynamic MRI is a useful tool for preoperative diagnosis of WT, where other examinations indicate malignancy. Early and correct diagnosis of WT can minimize the use of invasive procedures, and eliminate the stress placed on the patient from a diagnosis of cancer.

  5. Parotid gland is the main source of human salivary epidermal growth factor

    SciTech Connect

    Thesleff, I.; Viinikka, L.; Saxen, L.; Lehtonen, E.; Perheentupa, J.

    1988-01-01

    To clarify the production of human epidermal growth factor (EGF) by different salivary glands, the authors measured its concentration by radioimmunoassay separately in whole saliva, in parotid gland (PG) saliva and in mixed submandibular (SMG) and sublingual gland (SLG) saliva. Also, they studied the presence of EGF in PG and SMG by immunohistochemistry. The mean concentrations of EDG in PG saliva was higher than in whole saliva, which in turn was higher than in mixed SMG + SLG saliva. No sex difference existed in any salivary gland EGF. Immunohistochemistry revealed EGF in the acinar cells of both PG and SMG, buy only in PG there were prominent EDG deposits in luminal spaces. Their data suggest that EDG is produced by both PG and SMG, but that more of it is secreted from the PG. This result is new and challenges the general view that human salivary EDG is mainly from SMG.

  6. Arterial Spin Labeling Imaging for the Parotid Glands of Patients with Sjögren’s Syndrome

    PubMed Central

    Kami, Yukiko N.; Sumi, Misa; Takagi, Yukinori; Sasaki, Miho; Uetani, Masataka; Nakamura, Takashi

    2016-01-01

    Sjögren’s syndrome (SS) is characterized by hypofunction of the salivary and lacrimal glands. The salivary function is largely dependent upon the blood supply in the glands. However, the diseased states of the gland perfusion are not well understood. The arterial spin labeling (ASL) technique allows noninvasive quantitative assessment of tissue perfusion without the need for contrast agent. Here, we prospectively compared the perfusion properties of the parotid glands between patients with SS and those with healthy glands using ASL MR imaging. We analyzed salivary blood flow (SBF) kinetics of 22 healthy parotid glands from 11 volunteers and 28 parotid glands from 14 SS patients using 3T pseudo-continuous ASL imaging. SBF was determined in resting state (base SBF) and at 3 sequential segments after gustatory stimulation. SBF kinetic profiles were characterized by base SBF level, increment ratio at the SBF peak, and the differences in segments where the peak appeared (SBF types). Base SBFs of the SS glands were significantly higher than those of healthy glands (59.2 ± 22.8 vs. 46.3 ± 9.0 mL/min/100 g, p = 0.01). SBF kinetic profiles of the SS glands also exhibited significantly later SBF peaks (p < 0.001) and higher SBF increment ratios (74 ± 49% vs. 47 ± 39%, p = 0.04) than the healthy glands. The best SBF criterion (= 51.2 mL/min/100 mg) differentiated between control subjects and SS patients with 71% sensitivity and 82% specificity. Taken together, these results showed that the SS parotid glands were mostly hyperemic and the SS gland responses to gustatory stimulation were stronger and more prolonged than those of the healthy glands. The ASL may be a promising technique for assessing the diseased salivary gland vascularization of SS patients. PMID:26959680

  7. Surgical management of parotid disease.

    PubMed

    Jones, R

    2000-10-01

    Surgery of the salivary glands is complex because of their anatomical relations, their differing pathologies and the difficulty in diagnosis. All of the salivary glands can be, and are, subject to these pathologies and are of interest to the Oral and Maxillofacial Surgeon. The greatest number of salivary gland neoplasms occur in the parotid glands and are mainly benign. It is the purpose of this paper to review the surgery and pathology relating to the parotid salivary glands presenting to the Department of Oral and Maxillofacial Surgery at the University of Adelaide. Although this cohort of patients is relatively small it gives some idea of the range of pathology which presents in this area and the complications which can be expected from this surgery.

  8. Visualizing form and function in organotypic slices of the adult mouse parotid gland

    PubMed Central

    Warner, Jennifer D.; Peters, Christian G.; Saunders, Rudel; Won, Jong Hak; Betzenhauser, Matthew J.; Gunning, William T.; Yule, David I.; Giovannucci, David R.

    2008-01-01

    An organotypic slice preparation of the adult mouse parotid salivary gland amenable to a variety of optical assessments of fluid and protein secretion dynamics is described. The semi-intact preparation rendered without the use of enzymatic treatment permitted live-cell imaging and multiphoton analysis of cellular and supracellular signals. Toward this end we demonstrated that the parotid slice is a significant addition to the repertoire of tools available to investigators to probe exocrine structure and function since there is currently no cell culture system that fully recapitulates parotid acinar cell biology. Importantly, we show that a subpopulation of the acinar cells of parotid slices can be maintained in short-term culture and retain their morphology and function for up to 2 days. This in vitro model system is a significant step forward compared with enzymatically dispersed acini that rapidly lose their morphological and functional characteristics over several hours, and it was shown to be long enough for the expression and trafficking of exogenous protein following adenoviral infection. This system is compatible with a variety of genetic and physiological approaches used to study secretory function. PMID:18669626

  9. A functional and chemical study of radiation effects on rat parotid and submandibular/sublingual glands

    SciTech Connect

    Vissink, A.; S-Gravenmade, E.J.; Ligeon, E.E.; Konings, W.T. )

    1990-12-01

    The aim of this study was to monitor composition and rate of secretion of rat parotid and submandibular/sublingual saliva following local single doses of X-rays ranging from 5 to 20 Gy. Pilocarpine-stimulated samples of parotid and submandibular/sublingual saliva were simultaneously collected with miniaturized Lashley cups before and 1-30 days after irradiation. The lag phase (period between injection of pilocarpine and start of the secretion) and flow rate were recorded and the concentrations of sodium, potassium, calcium, phosphate, and amylase were measured. With increasing dose and time, the salivary flow rate as well as sodium concentration decreased, while potassium concentrations increased throughout the follow-up period. The lag phase and the concentration of amylase reached their maximum at 3 and 10 days after irradiation, respectively. The changes in lag phase and flow rate were most obvious after doses of 15 or 20 Gy and showed a great similarity for parotid and submandibular/sublingual saliva. No dose-response relationship was observed for the changes in concentrations of calcium and phosphate. It is concluded that for radiation doses of 10 Gy and above, irreversible changes (lag phase, flow rate, potassium, sodium) were observed. A saturation of the irradiation effects (lag phase, flow rate) seems to exist at doses larger than 15 Gy. No significant differences were observed between the radiation-induced functional changes in parotid and submandibular/sublingual salivary gland tissue.

  10. Localization and secretion of epidermal growth factor in the parotid gland and its intragastric kinetics in sheep.

    PubMed

    Onaga, Takenori; Shimizu, Yasuhito; Hayashi, Hideaki; Tsuji, Masayoshi; Endoh, Daiji; Okada, Hiroyuki

    2006-09-20

    Ruminants secrete a large quantity of saliva that is rich in electrolytes; however, it remains unclear whether their parotid saliva contains epidermal growth factor (EGF). The present study was set up to examine the distribution of EGF and transforming growth factor-alpha (TGF-alpha) in the ovine parotid and submandibular glands and the salivary secretion of EGF-like binding activity (EGF-LBA) as the sum of EGF and TGF-alpha in conscious sheep. We also measured changes in the intragastric concentration of EGF-LBA in the ovine rumen and abomasum, and examined the effect of bilateral diversion of parotid saliva on intragastric EGF-LBA concentration in sheep. Both the ovine parotid and, to a lesser extent, the submandibular glands contained EGF-LBA. Immunohistochemical study showed that EGF and TGF-alpha-immunoreactivities were localized in the ductal epithelium in both glands. Transcriptional expression of EGF and TGF-alpha mRNA was demonstrated in both glands by reverse transcription-polymerase chain reaction (RT-PCR). In conscious sheep, the parotid gland continuously secreted EGF-LBA in the saliva before feeding, and the secretion of parotid EGF-LBA was markedly increased during feeding. After diversion of the parotid saliva for 1 week, EGF-LBA concentration in the ruminal fluid, but not in the abomasal fluid, decreased in the postprandial period, indicating that parotid EGF-LBA is a primary source of EGF-LBA for the rumen fluid during the postprandial period in sheep. Moreover, RT-PCR detected the expression of TGF-alpha mRNA in the rumen and abomasum and that of EGF in the abomasum, implying that these stomachs possibly supply, in part, EGF-LBA to the luminal fluid.

  11. Multi-atlas-based segmentation of the parotid glands of MR images in patients following head-and-neck cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Cheng, Guanghui; Yang, Xiaofeng; Wu, Ning; Xu, Zhijian; Zhao, Hongfu; Wang, Yuefeng; Liu, Tian

    2013-02-01

    Xerostomia (dry mouth), resulting from radiation damage to the parotid glands, is one of the most common and distressing side effects of head-and-neck cancer radiotherapy. Recent MRI studies have demonstrated that the volume reduction of parotid glands is an important indicator for radiation damage and xerostomia. In the clinic, parotid-volume evaluation is exclusively based on physicians' manual contours. However, manual contouring is time-consuming and prone to inter-observer and intra-observer variability. Here, we report a fully automated multi-atlas-based registration method for parotid-gland delineation in 3D head-and-neck MR images. The multi-atlas segmentation utilizes a hybrid deformable image registration to map the target subject to multiple patients' images, applies the transformation to the corresponding segmented parotid glands, and subsequently uses the multiple patient-specific pairs (head-and-neck MR image and transformed parotid-gland mask) to train support vector machine (SVM) to reach consensus to segment the parotid gland of the target subject. This segmentation algorithm was tested with head-and-neck MRIs of 5 patients following radiotherapy for the nasopharyngeal cancer. The average parotid-gland volume overlapped 85% between the automatic segmentations and the physicians' manual contours. In conclusion, we have demonstrated the feasibility of an automatic multi-atlas based segmentation algorithm to segment parotid glands in head-and-neck MR images.

  12. [Pleomorphic adenoma of the parotid gland, rules for resection].

    PubMed

    de Ridder, Mischa; Smeele, Ludi E; Balm, Alfons J M

    2012-01-01

    The importance of complete excision of a benign pleomorphic adenoma is illustrated by two patients' histories. A 28-year-old man underwent a local excision of a nodule under the left ear without histological confirmation. Ten years later he returned to our institute with a large multilocular process and subcutaneous nodules. Cytology showed pleomorphic adenoma. Patient was treated with total facial nerve preserving parotidectomy and radiotherapy. An 81-year-old male underwent a surgical removal of a swelling under his left ear eight years before admission for a large diffusely infiltrating tumor in the neck. Repeated cytology showed carcinoma ex pleomorphic adenoma. This tumor was inoperable and he was treated by palliative irradiation. In case of incomplete resection, pleomorphic adenoma cells are spilled with an increasing chance of local recurrence. Also degeneration into carcinoma ex pleomorphic adenoma is possible after incomplete resection, with impact on survival. These risks of residual disease determine the need of centralization of diagnosis and treatment of this benign parotid tumor.

  13. Acinic Cell Carcinoma of the Parotid Gland with Four Morphological Features

    PubMed Central

    Rosero, David S; Alvarez, Ramiro; Gambó, Paula; Alastuey, María; Valero, Alberto; Torrecilla, Nerea; Roche, A. Belén; Simón, Sara

    2016-01-01

    Acinic cell carcinoma arising in salivary glands is a rare tumor, accounting for 2% to 5% of the primary neoplasms of the parotid gland. When these tumors are well-differentiated, the neoplasia has innocuous aspect, due to the similarity to normal parotid tissue. This makes the diagnosis difficult. Initially the malignancy of this tumor was uncertain; however, recent studies have declared it as malignant. The female / male ratio is 3:2. The nodule usually presents as solitary and well defined shape. Several authors have used different terms to describe histomorphological patterns of these tumors. Four descriptive categories (solid, microcystic, papillary-cystic and follicular) are useful for pathologists. Here we report a case of a 49 yr old man with a left parotid nodule of 5 cm. Parotidectomy was performed at the Hospital Universitario Miguel Servet, in Zaragoza (Spain). The microscopy showed a tumor with acinic semblance, having the four morphologic patterns previously described. The morphological and immunohistochemical study was consistent with the diagnosis of acinic cell carcinoma. PMID:27499783

  14. Giant secretory granules in the ducts of the parotid and submandibular glands of the slow loris.

    PubMed

    Tandler, B; Pinkstaff, C A; Nagato, T; Phillips, C J

    1996-06-01

    The parotid and submandibular glands of a slow loris, a rare Southeast Asian primate, were obtained after the head had been perfused by fixative for a study of the brain. These tissues were processed by conventional means for electron microscopy. Glands also were obtained at autopsy from 2 other lorises, fixed by immersion in formalin, and subjected to a battery of tests for glycoconjugates. In the parotid gland, a short segment of the proximal striated duct lacks both basal striations and any sign of secretory activity. The major portion of the striated duct consists of tall cells that contain a spectrum of secretory granules, some larger than the nuclei (many granules are > 9 mum in diameter). These granules, which are delimited by a single membrane, are capable of chain exocytosis. Many of the giant granules have bundles of cytofilaments (4.5-6.5 nm) in apparent association with their surface. Occasional cells contain numerous small granules. Duct cells with or without granules lack basal striations. The granules contain neutral glycoconjugates but no acidic glycoconjugates. Some, but not all, interlobular excretory ducts also have secretory granules that run the gamut from tiny to giant. Exactly the same situation occurs in the submandibular gland. Unlike other primates, which may have duct cells that contain only a few tiny granules in their apices, the cells in both the striated and excretory ducts in the slow loris appear to be specialized for secretion rather than for transport. The biofunction of the giant granules is unknown.

  15. Surgical management of pleomorphic adenoma of parotid gland in elderly patients: role of morphological features.

    PubMed

    Guerra, Germano; Testa, Domenico; Montagnani, Stefania; Tafuri, Domenico; Salzano, Francesco Antonio; Rocca, Aldo; Amato, Bruno; Salzano, Giovanni; Dell'Aversana Orabona, Giovanni; Piombino, Pasquale; Motta, Gaetano

    2014-01-01

    The neoplasms of the salivary glands account for 2% of head and neck tumors and the most common form is the Pleomorphic adenoma (PA). Parotid gland is affected from 80% to 90% of cases. In elderly these tumors occur mostly in females. These benign tumors are composed of epithelial and myoepithelial cells that are arranged with various morphological patterns and subtypes. The classification of these tumors is also based on the amount and nature of the stroma. In literature there is an almost complete consensus that, in the major salivary glands, PAs are enclosed by a layer of fibrous tissue often called "capsule" but there is disagreement about the form, extension and thickness of this layer. The treatment is surgical and there are two main different surgical approaches: an enucleation (local dissection) or so-called subtotal superficial parotidectomy and lateral or superficial total parotidectomy. Histopathological characteristics of PAs especially of capsular alterations such as thin capsule areas, capsule-free regions, capsule penetration, satellite nodules and pseudopodia in the different subtypes are important for the choice of surgical treatment and the first explanation for tumor recurrence. In our study we describe a morphological features of 84 cases of pleomorphic adenoma of parotid gland from elderly patients treated by a surgical "enucleation like" method called nucleoresection.

  16. Parotid gland solitary fibrous tumor: a case report and clinicopathologic review of 22 cases from the literature.

    PubMed

    Bauer, Justin L; Miklos, Andrew Z; Thompson, Lester D R

    2012-03-01

    .2, smooth muscle actin, muscle specific actin, desmin, MYOD1, myogenin, CD117, GFAP, CD31, FVIII-RAg, collagen IV, p63, p53, calponin, caldesmon, CD56, NFP, and ALK-1. The principle differential diagnoses include pleomorphic adenoma, myoepithelioma, nodular fasciitis, schwannoma, fibromatosis coli, spindle cell "sarcomatoid" carcinoma, and spindle cell melanoma. All patients were managed with surgery, while two patients also received radiation therapy. Metastatic disease was identified in one patient immediately after excision. All patients with follow-up were alive without evidence of disease (n = 18), but the average follow-up is only 1.9 years. One patient is alive with disease at 12 months. Parotid gland SFT is a rare tumor, usually presenting in middle aged adults as a slowly growing mass. Characteristic histologic appearance with CD34 and bcl-2 immunoreactivity support the diagnosis. Surgery is the treatment of choice to yield a good outcome.

  17. Effects of double ligation of Stensen's duct on the rabbit parotid gland.

    PubMed

    Maria, O M; Maria, S M; Redman, R S; Maria, A M; Saad El-Din, T A; Soussa, E F; Tran, S D

    2014-04-01

    Salivary gland duct ligation is an alternative to gland excision for treating sialorrhea or reducing salivary gland size prior to tumor excision. Duct ligation also is used as an approach to study salivary gland aging, regeneration, radiotherapy, sialolithiasis and sialadenitis. Reports conflict about the contribution of each salivary cell population to gland size reduction after ductal ligation. Certain cell populations, especially acini, reportedly undergo atrophy, apoptosis and proliferation during reduction of gland size. Acini also have been reported to de-differentiate into ducts. These contradictory results have been attributed to different animal or salivary gland models, or to methods of ligation. We report here a bilateral double ligature technique for rabbit parotid glands with histologic observations at 1, 7, 14, 30, 60 days after ligation. A large battery of special stains and immunohistochemical procedures was employed to define the cell populations. Four stages with overlapping features were observed that led to progressive shutdown of gland activities: 1) marked atrophy of the acinar cells occurred by 14 days, 2) response to and removal of the secretory material trapped in the acinar and ductal lumens mainly between 30 and 60 days, 3) reduction in the number of parenchymal (mostly acinar) cells by apoptosis that occurred mainly between 14-30 days, and 4) maintenance of steady-state at 60 days with a low rate of fluid, protein, and glycoprotein secretion, which greatly decreased the number of leukocytes engaged in the removal of the luminal contents. The main post- ligation characteristics were dilation of ductal and acinar lumens, massive transient infiltration of mostly heterophils (rabbit polymorphonuclear leukocytes), acinar atrophy, and apoptosis of both acinar and ductal cells. Proliferation was uncommon except in the larger ducts. By 30 days, the distribution of myoepithelial cells had spread from exclusively investing the intercalated ducts

  18. Keratocystoma of the parotid gland: a report of two cases of an unusual pathologic entity.

    PubMed

    Nagao, Toshitaka; Serizawa, Hiromi; Iwaya, Keiichi; Shimizu, Tohru; Sugano, Isamu; Ishida, Yasuo; Yamazaki, Kazuto; Shimizu, Michio; Itoh, Tomoo; Konno, Akiyoshi; Ebihara, Yoshiro

    2002-09-01

    Benign salivary gland tumors composed of purely squamous cells are quite unusual and are not included in the World Health Organization classification. We have seen two benign parotid gland tumors characterized by multicystic spaces with stratified squamous linings and focal solid epithelial nests. Seifert et al. recently described such a case as a choristoma; we, however, herein propose a new designation, keratocystoma, for this unique tumor group, because of its distinctive histological features. These tumors occurred in men aged 18 and 38 years with enlarging parotid gland tumors. Both had largely similar gross and histological features, with some variations. The epithelium lining of the cysts showed apparent keratinization through a parakeratotic or orthokeratotic pathway without forming a granular cell layer. Stratification of the epithelium was always regularly oriented from the outer basal to the inner keratotic cell layer. Focally, the outer layer had bud-like protrusions. In some areas, solid squamous cell islands surrounded by basement membrane were enclosed within the collagenous stroma. These cystic and solid structures were randomly distributed, showing no definite lobular architecture. All of the tumor cells had uniform, bland nuclei and abundant eosinophilic cytoplasm. Scattered mitotic figures were observed, limited to the outer epithelial layer, and showed no abnormal patterns. Transformation from the parotid ductal epithelium to the tumor cells is evident. Foci of foreign-body reactions against keratin materials were present. Immunoreactivities for cytokeratins reconfirmed the nature of squamous differentiation of the tumor cells. Ki-67-positive cells were confined along the outer basal layer of the tumor epithelium. Tests for alpha-smooth muscle actin and S-100 protein were completely negative. Both patients had no evidence of recurrence 3 and 2 years after subtotal parotidectomy, respectively, without any additional therapy. We believe that this

  19. Keratocystoma of the parotid gland: a report of two cases of an unusual pathologic entity.

    PubMed

    Nagao, Toshitaka; Serizawa, Hiromi; Iwaya, Keiichi; Shimizu, Tohru; Sugano, Isamu; Ishida, Yasuo; Yamazaki, Kazuto; Shimizu, Michio; Itoh, Tomoo; Konno, Akiyoshi; Ebihara, Yoshiro

    2002-09-01

    Benign salivary gland tumors composed of purely squamous cells are quite unusual and are not included in the World Health Organization classification. We have seen two benign parotid gland tumors characterized by multicystic spaces with stratified squamous linings and focal solid epithelial nests. Seifert et al. recently described such a case as a choristoma; we, however, herein propose a new designation, keratocystoma, for this unique tumor group, because of its distinctive histological features. These tumors occurred in men aged 18 and 38 years with enlarging parotid gland tumors. Both had largely similar gross and histological features, with some variations. The epithelium lining of the cysts showed apparent keratinization through a parakeratotic or orthokeratotic pathway without forming a granular cell layer. Stratification of the epithelium was always regularly oriented from the outer basal to the inner keratotic cell layer. Focally, the outer layer had bud-like protrusions. In some areas, solid squamous cell islands surrounded by basement membrane were enclosed within the collagenous stroma. These cystic and solid structures were randomly distributed, showing no definite lobular architecture. All of the tumor cells had uniform, bland nuclei and abundant eosinophilic cytoplasm. Scattered mitotic figures were observed, limited to the outer epithelial layer, and showed no abnormal patterns. Transformation from the parotid ductal epithelium to the tumor cells is evident. Foci of foreign-body reactions against keratin materials were present. Immunoreactivities for cytokeratins reconfirmed the nature of squamous differentiation of the tumor cells. Ki-67-positive cells were confined along the outer basal layer of the tumor epithelium. Tests for alpha-smooth muscle actin and S-100 protein were completely negative. Both patients had no evidence of recurrence 3 and 2 years after subtotal parotidectomy, respectively, without any additional therapy. We believe that this

  20. Long-term dexamethasone treatment alters the histomorphology of acinar cells in rat parotid and submandibular glands.

    PubMed

    Bighetti, Bruna B; d Assis, Gerson F; Vieira, Danilo C; Violato, Natalia M; Cestari, Tania M; Taga, Rumio; Bosqueiro, José R; Rafacho, Alex

    2014-10-01

    Glucocorticoids (GCs) induce insulin resistance (IR), a condition known to alter oral homeostasis. This study investigated the effects of long-term dexamethasone administration on morphofunctional aspects of salivary glands. Male Wistar rats received daily injections of dexamethasone [0.1 mg/kg body weight (b.w.), intraperitoneally] for 10 days (DEX), whereas control rats received saline. Subsequently, glycaemia, insulinaemia, insulin secretion and salivary flow were analysed. The parotid and submandibular glands were collected for histomorphometric evaluation and Western blot experiments. The DEX rats were found to be normoglycaemic, hyperinsulinaemic, insulin resistant and glucose intolerant (P < 0.05). DEX rat islets secreted more insulin in response to glucose (P < 0.05). DEX rats had significant reductions in the masses of the parotid (29%) and submandibular (16%) glands (P < 0.05) that was associated with reduced salivary flux rate. The hypotrophy in both glands observed in the DEX group was associated with marked reduction in the volume of the acinar cells in these glands of 50% and 26% respectively (P < 0.05). The total number of acinar cells was increased in the submandibular glands of the DEX rats (P < 0.05) but not in the parotid glands. The levels of proteins related to insulin and survival signalling in both glands did not differ between the groups. In conclusion, the long-term administration of dexamethasone caused IR, which was associated with significant reductions in both mass and flux rate of the salivary glands. The parotid and submandibular glands exhibited reduced acinar cell volume; however, the submandibular glands displayed acinar hyperplasia, indicating a gland-specific response to GCs. Our data emphasize that GC-based therapies and insulin-resistant states have a negative impact on salivary gland homeostasis.

  1. Long-term dexamethasone treatment alters the histomorphology of acinar cells in rat parotid and submandibular glands

    PubMed Central

    Bighetti, Bruna B; Assis, Gerson F d; Vieira, Danilo C; Violato, Natalia M; Cestari, Tania M; Taga, Rumio; Bosqueiro, José R; Rafacho, Alex

    2014-01-01

    Glucocorticoids (GCs) induce insulin resistance (IR), a condition known to alter oral homeostasis. This study investigated the effects of long-term dexamethasone administration on morphofunctional aspects of salivary glands. Male Wistar rats received daily injections of dexamethasone [0.1 mg/kg body weight (b.w.), intraperitoneally] for 10 days (DEX), whereas control rats received saline. Subsequently, glycaemia, insulinaemia, insulin secretion and salivary flow were analysed. The parotid and submandibular glands were collected for histomorphometric evaluation and Western blot experiments. The DEX rats were found to be normoglycaemic, hyperinsulinaemic, insulin resistant and glucose intolerant (P < 0.05). DEX rat islets secreted more insulin in response to glucose (P < 0.05). DEX rats had significant reductions in the masses of the parotid (29%) and submandibular (16%) glands (P < 0.05) that was associated with reduced salivary flux rate. The hypotrophy in both glands observed in the DEX group was associated with marked reduction in the volume of the acinar cells in these glands of 50% and 26% respectively (P < 0.05). The total number of acinar cells was increased in the submandibular glands of the DEX rats (P < 0.05) but not in the parotid glands. The levels of proteins related to insulin and survival signalling in both glands did not differ between the groups. In conclusion, the long-term administration of dexamethasone caused IR, which was associated with significant reductions in both mass and flux rate of the salivary glands. The parotid and submandibular glands exhibited reduced acinar cell volume; however, the submandibular glands displayed acinar hyperplasia, indicating a gland-specific response to GCs. Our data emphasize that GC-based therapies and insulin-resistant states have a negative impact on salivary gland homeostasis. PMID:25186305

  2. Solitary Fibrous Tumour of the Parotid Gland: A Case Report and Review of the Literature.

    PubMed

    Kwok, Matthew M; Subramaniyan, Muthukumar; Chan, Sor Way

    2015-01-01

    Introduction. Solitary fibrous tumours (SFT) of the parotid gland are a very rare group of spindle-cell tumours with only 28 cases reported in the literature. This review aims to report an additional case of parotid SFT and provide a review of all reported cases of this rare condition. Case Presentation. A 26-year-old male presented a 3 cm well-demarcated, slowly enlarging mass which was completely excised, revealing histological and immunohistochemical features of SFT. Discussion. Reviews of all reported cases suggest that histology and immunohistochemistry are paramount in the diagnosis of SFT. These features, along with clinical presentation and management of this rare condition, will be discussed.

  3. Solitary Fibrous Tumour of the Parotid Gland: A Case Report and Review of the Literature.

    PubMed

    Kwok, Matthew M; Subramaniyan, Muthukumar; Chan, Sor Way

    2015-01-01

    Introduction. Solitary fibrous tumours (SFT) of the parotid gland are a very rare group of spindle-cell tumours with only 28 cases reported in the literature. This review aims to report an additional case of parotid SFT and provide a review of all reported cases of this rare condition. Case Presentation. A 26-year-old male presented a 3 cm well-demarcated, slowly enlarging mass which was completely excised, revealing histological and immunohistochemical features of SFT. Discussion. Reviews of all reported cases suggest that histology and immunohistochemistry are paramount in the diagnosis of SFT. These features, along with clinical presentation and management of this rare condition, will be discussed. PMID:26236526

  4. Recurrence in Region of Spared Parotid Gland After Definitive Intensity-Modulated Radiotherapy for Head and Neck Cancer

    SciTech Connect

    Cannon, Donald M.; Lee, Nancy Y.

    2008-03-01

    Purpose: To discuss the implications of three examples of periparotid recurrence after definitive intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC). Methods and Materials: We present 3 patients with HNC who underwent definitive IMRT with concurrent chemotherapy and later had treatment failure in or near a spared parotid gland. Two patients had bilateral multilevel nodal disease, and all had Level II nodal disease ipsilateral to the site of recurrence. The patients were treated using dose-painting IMRT with a dose of 70 Gy to the gross tumor volume and 59.4 Gy or 54 Gy to the high-risk or low-risk clinical tumor volume, respectively. The parotid glands were spared bilaterally. The patients had not undergone any surgical treatment for HNC before radiotherapy. Results: All patients had treatment failure in the region of a spared parotid gland. Failure in the 2 patients with bilateral multilevel nodal involvement occurred in the periparotid lymph nodes. The third patient developed a dermal metastasis near the tail of a spared parotid gland. On pretreatment imaging, the 2 patients with nodal failure had small nonspecific periparotid nodules that showed no hypermetabolic activity on positron emission tomography. Conclusion: For HNC patients receiving definitive IMRT, nonspecific positron emission tomography-negative periparotid nodules on pretreatment imaging should raise the index of suspicion for subclinical disease in the presence of multilevel or Level II nodal metastases. Additional evaluation of such nodules might be indicated before sparing the ipsilateral parotid gland.

  5. The Shape of Parotid DVH Predicts the Entity of Gland Deformation During IMRT for Head and Neck Cancers.

    PubMed

    Broggi, S; Scalco, E; Fiorino, C; Belli, M L; Sanguineti, G; Ricchetti, F; Dell'Oca, I; Dinapoli, N; Valentini, V; Di Muzio, N; Cattaneo, G M; Rizzo, G

    2015-12-01

    The Jacobian of the deformation field of the registration between images taken during Radiotherapy is a measure of compression/expansion of the voxels within an organ. The Jacobian mean value was applied to investigate possible correlations between parotid deformation and anatomical, clinical and dosimetric parameters. Data of 84 patients were analyzed. Parotid deformation was evaluated through Jacobian maps of images taken at the start and at the end of the treatment. Several clinical, geometrical and dosimetric factors were considered. Correlation between Jacobian mean value and these parameters was assessed through Spearman's test. Univariate and multivariate logistic analyses were performed by considering as the end point the first quartile value of the Jacobian mean value. Parotid dose volume histograms were stratified according to gland deformation, assessing the most predictive dose-volume combination. At multivariate analysis, age (p = 0.02), overlap between tumor volume and parotid gland (p = 0.0006) and the parotid volume receiving more than 10 Gy (p = 0.02) were found as the best independent predictors, by considering Jacobian mean value parotids with Jacobian mean value fist quartile, the parotid volume receiving more than 10 Gy and 40 Gy were found as the most predictive dosimetric parameters. Parotid glands were divided in three different sub-groups (bad-, medium- and good dose volume histogram). The risk to have Jacobian means value lower than first quartile was 39.6% versus 19.6% versus 11.3% in these three groups. By including in the multivariate analysis this "dose volume grouping" parameter, age and bad dose volume histogram were found as the most predictive parameters for large shrinkage. The pattern of parotid deformation may be well predicted by some pre-treatment variables; a bad dose volume histogram seems the most important predictor.

  6. Evaluation of Parotid Gland Function following Intensity Modulated Radiation Therapy for Head and Neck Cancer

    PubMed Central

    Lee, Seok Ho; Kim, Tae Hyun; Kim, Joo Young; Park, Sung Yong; Pyo, Hong Ryull; Shin, Kyung Hwan; Kim, Dae Yong; Kim, Joo Young

    2006-01-01

    Purpose This study was undertaken to determine the parotid gland tolerance dose levels following intensity modulated radiation therapy (IMRT) for treating patients who suffered with head and neck cancer. Materials and Methods From February 2003 through June 2004, 34 head and neck patients with 6 months of follow-up were evaluated for xerostomia after being treated by IMRT. Their median age was 59 years (range: 29~78). Xerostomia was assessed using a 4-question xerostomia questionnaire score (XQS) and a test for the salivary flow rates (unstimulated and stimulated: USFR and SSFR, respectively). The patients were also given a validated LENT SOMA scale (LSS) questionnaire. Evaluations were performed before IMRT and at 1, 3 and 6 months after IMRT. Results All 34 patients showed significant changes in the XQS, LSS and Salivary Flow rates (USFR and SSFR) after IMRT. No significant changes in the XQS or LSS were noted in 12 patients who received a total parotid mean dose of ≤3,100 cGy at 1, 3 and 6 months post-IMRT relative to the baseline values. However, for the 22 patients who received >3,100 cGy, significant increases in the XQS and LSS were observed. The USFR and SSFR from the parotid glands in 7 patients who received ≤2,750 cGy were significantly preserved at up to 6 months after IMRT. However, the USFR and SSFR in 27 patients who were treated with >2,750 cGy were significantly lower than the baseline values at all times after IMRT. Conclusion We suggest that the total parotid mean dose should be limited to ≤2,750 cGy to preserve the USFR and SSFR and so improve the subsequent quality of life. PMID:19771265

  7. Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

    PubMed Central

    van Rij, CM; Oughlane-Heemsbergen, WD; Ackerstaff, AH; Lamers, EA; Balm, AJM; Rasch, CRN

    2008-01-01

    Background and purpose To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Results Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy. Conclusion Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT. PMID:19068126

  8. Time course and significance of acute hyperamylasemia in patients receiving fractionated therapeutic radiation to the parotid gland region

    SciTech Connect

    Borok, T.L.; Cooper, J.S.

    1982-08-01

    To improve our understanding of hyperamylasemia secondary to parotid gland irradiation, serial serum amylase levels were measured from 12 consecutive patients who received incidental parotid irradiation during radiotherapy of their head and neck tumors. Rapid transient increases in enzyme activity, limited to the first days of radiotherapy, were consistently found. Awareness of the frequency and nature of this response may avoid unnecessary investigation and concern for abdominal pathology in this clinical setting.

  9. Benign mixed tumor of the mandible 17 years after the occurrence of a similar lesion in the parotid gland.

    PubMed

    Drinkard, D W; Schow, C E

    1986-10-01

    Presented is a salivary tumor occurring in the posterior mandible. This tumor was preceded by a mixed tumor of the ipsilateral parotid gland, which was removed surgically 17 years earlier. The actual connection between the two lesions is discussed, but the true relationship can only be speculative. The mandibular lesion may represent a recurrence of the parotid tumor, a second primary tumor, or may possibly be metastatic in origin.

  10. Acinic cell carcinoma of the parotid gland in children.

    PubMed

    Levine, S B; Potsic, W P

    1986-09-01

    Acinic cell carcinoma is an infrequent malignancy of salivary gland tissue in adults that is very rare in children. Review of the English literature reveals only 25 reported cases of this neoplasm in pediatric populations. This is a case report of the youngest known child to undergo parotidectomy and facial nerve dissection for an acinic cell carcinoma. The unusual clinical and surgical findings might suggest the need for changes in approach to treatment of a tumor that has been previously described as relatively benign.

  11. Radiotherapy in epithelial tumors of the parotid gland: Case presentation and literature review

    SciTech Connect

    Ravasz, L.A.; Terhaard, C.H.; Hordijk, G.J. )

    1990-07-01

    A group of 113 patients irradiated for parotid tumor was studied retrospectively. Sixty-two patients were irradiated after superficial parotidectomy or enucleation of a pleomorphic adenoma. None of them had a recurrence after 5-15 years. Sixteen patients were irradiated postoperatively after surgery for a recurrence of pleomorphic adenoma. Only one of them had developed a recurrent tumor. Thirty-five patients with a malignant parotid tumor were treated by irradiation, 22 after surgery and 13 after biopsy only. Patients with a low malignancy tumor (10/11) and adenoid cystic carcinoma (6/12) responded better than patients with a high malignancy carcinoma (2/12). A tumor larger than 4 cm, facial nerve palsy, lymph node metastasis, and inoperability indicate a poor prognosis. With high dose radiotherapy it is possible to treat inoperable tumors successfully. Adenoid cystic carcinomas can respond well to irradiation alone.43 references.

  12. Facial Paralysis Secondary to Extensive Perineural Spread of Adenocarcinoma of the Parotid Gland Identified by PET/CT.

    PubMed

    Achong, Dwight M; Zloty, Martin

    2016-06-01

    Brain MRI in an 82-year-old man with presumed Bell's palsy revealed a clinically unsuspected right parotid gland mass but no other acute findings. Biopsy revealed poorly differentiated adenocarcinoma. Staging F-FDG PET/CT revealed an FDG-avid parotid mass, abnormal FDG uptake along the course of the facial nerve from mass to skull base, and multiple FDG-avid right level II neck lymph nodes and hepatic metastases. The PET/CT findings and prolonged clinical course suggest that diffuse perineural spread of tumor from a smoldering parotid neoplasm, and not idiopathic Bell's palsy, was responsible for the patient's facial paralysis. PMID:26825200

  13. Oncocytoma of the Parotid Gland: A Case Report and Review of the Literature

    PubMed Central

    Sepúlveda, Ilson; Platín, Enrique; Spencer, M. Loreto; Mucientes, Pablo; Frelinghuysen, Michael; Ortega, Pablo; Ulloa, David

    2014-01-01

    We report the case of a patient who presented to the ENT service with left facial swelling of 5 months duration. Imaging studies revealed a dense expansive mass confined to the inside of the left deep parotid lobule and moderate enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of an oncocytoma. The patient was treated with total parotidectomy, complete tumor resection and sparing facial nerve surgery. Today, the patient is disease free and has no complications. PMID:24707257

  14. Radiation-Induced Damage to Microstructure of Parotid Gland: Evaluation Using High-Resolution Magnetic Resonance Imaging

    SciTech Connect

    Kan, Tomoko; Kodani, Kazuhiko; Michimoto, Koichi; Fujii, Shinya; Ogawa, Toshihide

    2010-07-15

    Purpose: To elucidate the radiation-induced damage to the microstructure of the parotid gland using high-resolution magnetic resonance imaging. Methods and Materials: High-resolution magnetic resonance imaging of the parotid gland was performed before radiotherapy (RT) and during the RT period or {<=}3 weeks after RT completion for 12 head-and-neck cancer patients using a 1.5-T scanner with a microscopy coil. The maximal cross-sectional area of the gland was evaluated, and changes in the internal architecture of the gland were assessed both visually and quantitatively. Results: Magnetic resonance images were obtained at a median parotid gland dose of 36 Gy (range, 11-64). According to the quantitative analysis, the maximal cross-sectional area of the gland was reduced, the width of the main duct was narrowed, and the intensity ratio of the main duct lumen to background was significantly decreased after RT (p <.0001). According to the visual assessment, the width of the main duct tended to narrow and the contrast of the duct lumen tended to be decreased, but no significant differences were noted. The visibility of the duct branches was unclear in 10 patients (p = .039), and the septum became dense in 11 patients (p = .006) after RT. Conclusion: High-resolution magnetic resonance imaging is a noninvasive method of evaluating radiation-induced changes to the internal architecture of the parotid gland. Morphologic changes in the irradiated parotid gland were demonstrated during the RT course even when a relatively small dose was delivered to the gland.

  15. Pleomorphic adenoma of an unusual size in the deep lobe of the parotid gland.

    PubMed

    Uslu, S S; Inal, E; Ataoglu, O; Sezer, C

    1995-10-01

    Tumors of the salivary glands in children are not as common as in adults and they are mostly benign. The most common benign epithelial neoplasm seen in children is pleomorphic adenoma. As is usually the case in the adult population, it is usually found in the superficial lobe of the parotid gland. Its localization in the deep lobe is rare. Pleomorphic adenomas of the deep lobe present with a neck mass and when it is large, it may have an intraoral extension as well. It may also assume a dumb-bell shape as it enlarges and may be observed on CT or MRI scans as a prestyloid mass. The choice of treatment depends on the localization and the size of the tumor. The method can be transoral, cervical, transmandibular, transparotid, retromandibular fossa or a combination of these. A child with an unusually large pleomorphic adenoma of the deep lobe of the parotid gland is presented in this study. The deep lobe tumor was totally removed using a combination of cervical and transmandibular approaches.

  16. The effects of antidepressants and pilocarpine on rat parotid glands: an immunohistochemical study

    PubMed Central

    Mattioli, Tatiana Maria Folador; da Silva, Silvana; Grégio, Ana Maria Trindade; Machado, Maria Ângela Naval; de Lima, Antônio Adilson Soares; Azevedo-Alanis, Luciana Reis

    2011-01-01

    OBJECTIVES: To evaluate the effects of antidepressants and pilocarpine on the quantity of myoepithelial cells and on the proliferation index of the epithelial cells of rat parotid glands. INTRODUCTION: Hyposalivation, xerostomia, and alterations in saliva composition are important clinical side effects related to the use of antidepressants. METHODS: Ninety male Wistar rats were allocated to nine groups. The control groups received saline for 30 (group C30) or 60 days (group C60) or pilocarpine for 60 days (group Pilo). The experimental groups were administered fluoxetine (group F30) or venlafaxine for 30 days (group V30); fluoxetine (group FS60) or venlafaxine (group VS60) with saline for 60 days; or fluoxetine (group FP60) or venlafaxine (group VP60) with pilocarpine for 60 days. Parotid gland specimens were processed, and the immunohistochemical expression of calponin and proliferating cell nuclear anti-antigen on the myoepithelial and parenchymal cells, respectively, was evaluated. Analysis of variance (ANOVA), Tukey HSD and Games-Howell tests were applied to detect differences among groups (p<0.05). RESULTS: Compared with the controls, chronic exposure to antidepressants was associated with an increase in the number of positively stained cells for calponin. In addition, venlafaxine administration for 30 days was associated with an increase in the number of positively stained cells for proliferating cell nuclear anti-antigen. Fluoxetine and pilocarpine (group FP60) induced a significant decrease in the number of positively stained cells for calponin compared with all other groups. CONCLUSIONS: The number of positively stained cells for calponin increased after chronic administration of antidepressants. The proliferation index of the epithelial cells of rat parotid glands was not altered by the use of antidepressants for 60 days. PMID:22179167

  17. Small cell carcinoma ex-pleomorphic adenoma of the parotid gland.

    PubMed

    Cimino-Mathews, Ashley; Lin, Brian M; Chang, Steven S; Boahene, Kofi D; Bishop, Justin A

    2012-12-01

    Small cell carcinoma (SCC) is a high-grade malignancy usually encountered in the lungs but also seen in almost any site including the salivary glands. SCC is important to recognize because it often metastasizes widely and is treated with systemic chemotherapy. Carcinoma ex pleomorphic adenoma is a malignant epithelial neoplasm arising in a pre-existing benign mixed tumor (i.e., pleomorphic adenoma, PA). While virtually any salivary carcinoma can arise from a PA, to our knowledge SCC ex-PA has not been described. We report a case of a woman presenting with fullness of the right neck and a parotid gland mass. The tumor was resected and evaluated grossly, by light microscopy, and by immunohistochemistry. Grossly, a 1.6 cm well-circumscribed nodule was identified within the parotid. Microscopic examination revealed foci of SCC associated with high-grade adenocarcinoma, in the background of a PA. The SCC was immunoreactive for cytokeratin in a dot-like pattern and neuroendocrine markers synaptophysin and CD56. Despite the focal nature of the SCC in the parotid, a pure SCC metastasis was present in one neck level II lymph node. The patient was free of disease with 8 months of follow-up. Our case illustrates that: (1) although rare, in the salivary glands SCC may arise from lower grade neoplasms including PAs; (2) SCC ex PA may metastasize as pure SCC even if the primary SCC component was focal; (3) adequate sampling of PAs is crucial to prevent missing a rare SCC that must be treated with chemotherapy.

  18. The effect of dietary consistency and water content on the parotid glands of submandibular and sublingual duct-ligated rats.

    PubMed

    Kurahashi, M

    2002-05-01

    The aim here was to estimate the significance of oral sensation and mastication on functional changes in the parotid glands of partially desalivated rats. Submandibular and sublingual duct-ligated and sham-operated control rats were fed three diets of similar chemical composition but different physical presentations. Two were solid, either pellets or powder, and one was liquid. Water and food intakes were similar for both the duct-ligated rats and sham-operated control rats when they ate the pelleted or powdered-diet, though more food was wasted by the duct-ligated rats in the powdered-diet group than in the pelleted-diet group. No food was wasted in the rats fed the liquid-diet. Parotid gland weight and amylase activity were greatest with the submandibular and sublingual duct-ligated rats fed the powdered-diet and smallest with the duct-ligated and sham-operated control rats fed the liquid-diet. The amount of food wasted correlated positively with the parotid gland weight and parotid amylase activity of the rats. These findings support the view that it is the contact of dry food with the oral mucosa rather than the jaw movements involved in mastication that increases parotid gland weight and amylase activity in partial desalivated rats.

  19. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia.

    PubMed

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-07-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  20. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

    PubMed Central

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-01-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy. PMID:23162409

  1. Parotid gland pathophysiology after mixed gamma and neutron irradiation of cancer patients

    SciTech Connect

    Anderson, M.W.; Izutsu, K.T.; Rice, J.C.

    1981-11-01

    Electrolyte and protein concentrations were measured in parotid saliva samples obtained from patients receiving localized, fractionated, neutron and gamma irradiation for the treatment of cancer. Salivary sodium chloride concentration increased transiently but then usually decreased to preirradiation values after 2 weeks of therapy. There were concurrent decreases in salivary flow rate, pH, and bicarbonate concentration. The decreases in sodium chloride concentration and flow rate are inconsistent with a previously suggested, irradiation-induced ductal sodium resorption defect. The findings contribute toward understanding how salivary gland physiology is altered in irradiation injury.

  2. Histopathologic and immunohistochemical study in one case of cystadenoma of parotid gland becoming malignant.

    PubMed

    Simionescu, C; Florescu, M; Margaritescu, C; Marinescu, M

    Cystadenoma and cystadenocarcinoma of the salivary glands are rare tumors, approximately half of cases being diagnosed at the level of parotid. The studied tumor associated both benign and malign zones, with deep infiltrating character in the adjacent structures. In both areas the growing pattern was predominantly cystic and papillary, and the proliferated neoplastic cells were majority cubical or columnar, with low grade of nuclear pleomorphism in the becoming malign areas, discordant with the infiltrative character of the neoplasm. Immunohistochemically, we investigated the tumor with AE1-AE3, CEA, SMA, S-100 and PCNA.

  3. Anesthetic considerations on adrenal gland surgery.

    PubMed

    Domi, Rudin; Sula, Hektor; Kaci, Myzafer; Paparisto, Sokol; Bodeci, Artan; Xhemali, Astrit

    2015-01-01

    Adrenal gland surgery needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, and surgeon. The indications for adrenal gland surgery include hormonal secreting and non-hormonal secreting tumors. Adrenal hormonal secreting tumors present to the anesthesiologist unique challenges requiring good preoperative evaluation, perioperative hemodynamic control, corrections of all electrolytes and metabolic abnormalities, a detailed and careful anesthetic strategy, overall knowledge about the specific diseases, control and maintaining of postoperative adrenal function, and finally a good collaboration with other involved colleagues. This review will focus on the endocrine issues, as well as on the above-mentioned aspects of anesthetic management during hormone secreting adrenal gland tumor resection. PMID:25368694

  4. Anesthetic Considerations on Adrenal Gland Surgery

    PubMed Central

    Domi, Rudin; Sula, Hektor; Kaci, Myzafer; Paparisto, Sokol; Bodeci, Artan; Xhemali, Astrit

    2015-01-01

    Adrenal gland surgery needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, and surgeon. The indications for adrenal gland surgery include hormonal secreting and non-hormonal secreting tumors. Adrenal hormonal secreting tumors present to the anesthesiologist unique challenges requiring good preoperative evaluation, perioperative hemodynamic control, corrections of all electrolytes and metabolic abnormalities, a detailed and careful anesthetic strategy, overall knowledge about the specific diseases, control and maintaining of postoperative adrenal function, and finally a good collaboration with other involved colleagues. This review will focus on the endocrine issues, as well as on the above-mentioned aspects of anesthetic management during hormone secreting adrenal gland tumor resection. PMID:25368694

  5. Genomic alterations in Warthin tumors of the parotid gland.

    PubMed

    Wemmert, Silke; Willnecker, Vivienne; Sauter, Birgit; Schuh, Sebastian; Brunner, Christian; Bohle, Rainer Maria; Urbschat, Steffi; Schick, Bernhard

    2014-04-01

    Despite the fact that Warthin tumors are the second most common type of benign salivary gland tumors, information regarding genetic alterations is extremely limited, and the tumorigenesis of these tumors has not been elucidated. The present results of the largest series of 30 tumors analyzed by comparative genomic hybridization (CGH) to date confirmed previous genetic findings and identified significant new candidate regions. The most commonly observed alterations were deletions of the short arm of chromosome 8, followed by deletions on 9p. Further representative changes were deletions on 16p and 22q with the minimal overlapping region at 16p12p13.1 and 22q12.1q12.3. Moreover, we indicated two different patterns of chromosomal aberrations. One group harbors deletions on 8p partly apparent with deletions on 9q, 11q 15q, 16p and 22. The second group shows gains on 22, partly apparent with gains on 1p and 20q and deletions on 9p. This leads to the assumption that Warthin tumors, in particular those with a high number of alterations, can be divided into two different genetic groups based on the pattern of numerical chromosomal aberrations. Further studies should address whether these subgroups also reflect a different clinical presentation.

  6. Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review

    PubMed Central

    Liu, Jingxuan; Marzouk, Mark

    2016-01-01

    There is only one previously reported incident in the English literature of sarcoma ex pleomorphic adenoma of the parotid and there are only 8 cases of primary parotid leiomyosarcoma. In our case, a 79-year-old female patient presented to our care with left preauricular pain, swelling, and facial weakness. After CT imaging, she underwent left total parotidectomy. A spindle cell lesion was identified intraoperatively and the facial nerve was sacrificed. Subsequent analysis of the lesion yielded a diagnosis of leiomyosarcoma ex pleomorphic adenoma. After 30 fractions of radiation therapy, scans were negative for tumor. However, 18 months after first experiencing symptoms, she was found to have metastases to the brainstem and lung. When diagnosing sarcoma ex pleomorphic adenoma of the parotid gland, it is important to perform thorough immunohistochemical staining and exclude a previous history of sarcoma or other sources of metastases. Complete resection is critical due to the tumor's local aggressiveness and metastatic potential. Although these tumors are not very responsive to chemotherapy or radiation, adjuvant treatment is commonly used when margins are unclear.

  7. Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review

    PubMed Central

    Liu, Jingxuan; Marzouk, Mark

    2016-01-01

    There is only one previously reported incident in the English literature of sarcoma ex pleomorphic adenoma of the parotid and there are only 8 cases of primary parotid leiomyosarcoma. In our case, a 79-year-old female patient presented to our care with left preauricular pain, swelling, and facial weakness. After CT imaging, she underwent left total parotidectomy. A spindle cell lesion was identified intraoperatively and the facial nerve was sacrificed. Subsequent analysis of the lesion yielded a diagnosis of leiomyosarcoma ex pleomorphic adenoma. After 30 fractions of radiation therapy, scans were negative for tumor. However, 18 months after first experiencing symptoms, she was found to have metastases to the brainstem and lung. When diagnosing sarcoma ex pleomorphic adenoma of the parotid gland, it is important to perform thorough immunohistochemical staining and exclude a previous history of sarcoma or other sources of metastases. Complete resection is critical due to the tumor's local aggressiveness and metastatic potential. Although these tumors are not very responsive to chemotherapy or radiation, adjuvant treatment is commonly used when margins are unclear. PMID:27672466

  8. Association between microtubules and Golgi vesicles isolated from rat parotid glands.

    PubMed

    Coffe, G; Raymond, M N

    1990-01-01

    We report an isolation procedure of trans-Golgi vesicles (GVs) from rat parotid glands. Various organelle markers were used, particularly galactosyl transferase as a trans-Golgi marker, to test the purity of the GV fraction. A quantitative in vitro binding assay between microtubules and GVs is described. The vesicles were incubated with taxol-induced microtubules, layered between 50% and 43% sucrose cushions and subjected to centrifugation. Unlike free microtubules which were sedimented, the GV-bound microtubules co-migrated upward with GVs. Quantification of these bound microtubules was carried out by densitometric scanning of Coomassie blue-stained gels. The association between microtubules and GVs followed a saturation curve, with a plateau value of 20 micrograms of microtubule protein bound to 500 micrograms of GV fraction. The half-saturation of the GV sites was obtained with a microtubule concentration of 20 micrograms/ml. Electron microscopy of negatively stained re-floated material showed numerous microtubule-vesicle complexes. Coating of microtubules with an excess of brain microtubule-associated proteins (MAPs) abolished binding. In the absence of exogenous microtubules, we showed that the GV fraction was already interacting with a class of endogenous rat parotid microtubules. This class of colcemid and cold-stable microtubules represents 10-20% of the total tubulin content of the parotid cell. PMID:1983303

  9. Regulated phosphorylation of secretory granule membrane proteins of the rat parotid gland

    SciTech Connect

    Marino, C.R.; Castle, J.D.; Gorelick, F.S. )

    1990-07-01

    An antiserum raised against purified rat parotid secretory granule membrane proteins has been used to identify organelle-specific protein phosphorylation events following stimulation of intact cells from the rat parotid gland. After lobules were prelabeled with ({sup 32}P)orthophosphate and exposed to secretagogues, phosphoproteins were immunoprecipitated with the granule membrane protein antiserum, separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and visualized by autoradiography. Parallel studies of stimulated amylase release were performed. Isoproterenol treatment of parotid lobules resulted in an increase in the phosphate content of immunoprecipitable 60- and 72-kDa proteins that correlated with amylase release in a time-dependent manner. Forskolin addition mimicked these effects, but only the isoproterenol effects were reversed by propranolol treatment. To confirm the specificity of the antiserum to the secretory granule membrane fraction, subcellular isolation techniques were employed following in situ phosphorylation. The 60- and 72-kDa phosphoproteins were immunoprecipitated from both a particulate fraction and a purified secretory granule fraction. Furthermore, the extraction properties of both species suggest that they are integral membrane proteins. These findings support the possibility that stimulus-regulated secretion may involve phosphorylation of integral membrane proteins of the exocrine secretory granule.

  10. Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review.

    PubMed

    Coulter, Michael; Liu, Jingxuan; Marzouk, Mark

    2016-01-01

    There is only one previously reported incident in the English literature of sarcoma ex pleomorphic adenoma of the parotid and there are only 8 cases of primary parotid leiomyosarcoma. In our case, a 79-year-old female patient presented to our care with left preauricular pain, swelling, and facial weakness. After CT imaging, she underwent left total parotidectomy. A spindle cell lesion was identified intraoperatively and the facial nerve was sacrificed. Subsequent analysis of the lesion yielded a diagnosis of leiomyosarcoma ex pleomorphic adenoma. After 30 fractions of radiation therapy, scans were negative for tumor. However, 18 months after first experiencing symptoms, she was found to have metastases to the brainstem and lung. When diagnosing sarcoma ex pleomorphic adenoma of the parotid gland, it is important to perform thorough immunohistochemical staining and exclude a previous history of sarcoma or other sources of metastases. Complete resection is critical due to the tumor's local aggressiveness and metastatic potential. Although these tumors are not very responsive to chemotherapy or radiation, adjuvant treatment is commonly used when margins are unclear. PMID:27672466

  11. Metachronous pleomorphic adenomas occurring in the parotid and a minor salivary gland with genetic changes detected by comparative genomic hybridization.

    PubMed

    Southorn, Bryony; Manor, Esther; Bodner, Lipa; Spedding, Anne V; Brennan, Peter A

    2013-04-01

    A 32-year-old female underwent an extracapsular dissection for a pleomorphic adenoma (PA) of the parotid gland. Six months later, she presented with an increasing lump on the upper lip that, following excision, was confirmed to be a second PA. Formalin-fixed paraffin embedded tissues were analyzed for chromosomal aberrations. Comparative genomic hybridization analysis showed multiple chromosomal aberrations in the parotid PA. In comparison, no chromosomal aberrations were found in the lip PA. To our knowledge, metachronous benign pleomorphic adenomas occurring in both a major and minor salivary gland is unreported, and furthermore, there are no comparative genomic hybridization reports of this rare occurrence. We discuss the clinicopathological implications.

  12. Unique cellular structures in the parotid gland of an Old world fruit bat, Pteropus lylei (Lyle's flying fox).

    PubMed

    Lanlua, Passara; Sricharoenvej, Sirinush; Niyomchan, Apichaya; Chico, Diane E

    2007-01-01

    Pteropus lylei (Lyle's flying fox), an Old World fruit bat, consumes only ripe fruit, which contains low protein and sodium. The carpophagous diet of P. lylei presents an adaptive challenge for salivary glands to conserve sufficient nutrition for living. Therefore, the parotid glands in both sexes were investigated by using light microscopy and transmission electron microscopy. No structural difference was observed in the parotid glands between sexes. The acinar cell contained dense serous secretory granules, prominent luminal microvilli and intercellular canaliculi. The intercalated duct exhibited simple cuboidal epithelium with no secretory granule. Striated duct consisted of simple columnar epithelium with basal striation, numerous elongated mitochondria, and apical vesicles. In the interlobular duct, simple tall columnar epithelium and apocrine secretion were found. The interlobar and excretory ducts surprisingly contained continuous capillaries that intervened in stratified cuboidal epithelium. In addition, there were several blood vessels around the interlobular, interlobar and excretory ducts. The morphological adaptation of the parotid gland observed in P. lylei enables this species to obtain sufficient nutrients from the preferred consumption of ripe fruit. Serous secretory granule was suitable for digestion of ripe fruit. A well-developed striated duct, continuous capillaries among the epithelial cells of interlobar and excretory ducts, and numerous blood vessels around these ducts enhanced the reabsorption of amino acids and ions. Structural variations in the parotid gland can indicate not only a correlation to diet and survival but also a close relationship of the Old World fruit bat to other kinds of bats.

  13. OK-432 injection therapy for cystadenocarcinoma of the parotid gland: A case report.

    PubMed

    Makiyama, Kiyoshi; Hirai, Ryoji; Iikuni, Fusako; Ikeda, Atsuo; Tomomatsu, Hirotaka

    2016-01-01

    OK-432 is an immunomodulator that has been reported to be efficacious as an injection therapy for cervical lymphomas and ranulas. We performed OK-432 injection therapy to treat a cystadenocarcinoma of the parotid gland in a 72-year-old man. The 50 × 46-mm tumor was located in the deep lobe of the gland. The tumor had compressed the glossopharyngeal, vagus, and hypoglossal nerves, causing neurally mediated syncope, hoarseness, dysphagia, and dysarthria. A concentration of 5 KE/2 ml of OK-432 was injected. Within 2 months, the cyst had disappeared; no recurrence was apparent during 59 months of follow-up. To the best of our knowledge, no previous report has described injection of OK-432 for malignant cystic disease. We describe the injection method, injection dose, and postinjection course in the hope that this information will prove useful for future applications against malignant cystic disease.

  14. Malignant oncocytoma of the parotid gland. A light and electron microscopic study.

    PubMed

    Lee, S C; Roth, L M

    1976-03-01

    A case malignant oncocytoma of the parotid gland occurring in a 91-year-old man is reported. The tumor recurred 10-months and 2 1/2 years after the primary excision. Both primary and recurrent tumors exhibited an infiltrative pattern. The histologic appearance of the original tumor and the recurrent lesion were similar, but there were areas of increased mitotic activity and pleomorphism in the latter. Ultrastructural examination of the recurrent tumor revealed that the cytoplasm was packed with mitochondria. The fine structure was, for the most part, similar to the benign variant reported previously. In the present tumor, however, intercellular spaces were more prominent and a basal lamina was not observed. The malignant oncocytoma occurs both in major and minor salivary glands. The tumor mostly affects the older age group, but the biologic behavior cannot be evaluated fully because of the paucity of cases reported and the lack of follow-up information.

  15. Carcinosarcoma of the parotid gland: report of a case with cytohistologic and immunohistochemical findings.

    PubMed

    Latkovich, P; Johnson, R L

    1998-08-01

    True malignant mixed tumors (carcinosarcomas) of salivary gland origin are exceedingly rare and demonstrate malignant epithelial and stromal components. We report a case of parotid gland carcinosarcoma that showed squamous cell carcinoma and malignant fibrous hystiocytoma without clinical or histologic evidence of a preexisting pleomorphic adenoma. This tumor consisted of 2 histologically different populations of cells without evidence of a common origin from the myoepithelial cell, which is the putative precursor cell of pleomorphic adenoma and its derived carcinosarcoma. In addition to supplementing the literature, this case report includes cytohistologic and immunohistochemical analyses that provide further insights into the variable histogenesis of this neoplasm and the distinction between de novo carcinosarcoma and carcinosarcoma originating from pleomorphic adenoma.

  16. Antigen-presenting cells in parotid glands contain cystatin D originating from acinar cells.

    PubMed

    Nashida, Tomoko; Sato, Ritsuko; Haga-Tsujimura, Maiko; Yoshie, Sumio; Yoshimura, Ken; Imai, Akane; Shimomura, Hiromi

    2013-02-01

    Cystatin D encoded by Cst5 is a salivary classified type II cystatin. We investigated the dynamism of cystatin D by examining the distribution of cystatin D protein and mRNA in rats, to identify novel functions. The simultaneous expression of Cst5 and cystatin D was observed in parotid glands, however in situ hybridization showed that only acinar cells produced cystatin D. Synthesized cystatin D was localized in small vesicles and secreted from the apical side to the saliva, and from the basolateral side to the extracellular region, a second secretory pathway for cystatin D. We also identified antigen-presenting cells in the parotid glands that contained cystatin D without the expression of Cst5, indicating the uptake of cystatin D from the extracellular region. Cystatin D was detected in blood serum and renal tubular cells with megalin, indicating the circulation of cystatin D through the body and uptake by renal tubular cells. Thus, the novel dynamism of cystatin D was shown and a function for cystatin D in the regulation of antigen-presenting cell activity was proposed.

  17. Nicotine and methyl methane sulfonate in mini organ cultures of human parotid gland tissue.

    PubMed

    Ginzkey, Christian; Friehs, Gudrun; Koehler, Christian; Hackenberg, Stephan; Voelker, Hans-Ullrich; Richter, Elmar; Kleinsasser, Norbert H

    2010-08-16

    The aim was to demonstrate the applicability of using mini organ cultures (MOC) of the human parotid gland for indicating DNA damage by nicotine. Macroscopically healthy specimens of human parotid glands (1 mm3) were cultured for 7 d. Morphology was examined after HE and immunohistochemical staining of alpha-amylase. MOC were exposed to 2.0 mM nicotine or 100 microM methyl methane sulfonate (MMS) for 1, 2 and 3 h, followed by a regeneration period of 24 h. DNA damage was assessed by the comet assay. Histological findings demonstrated healthy acinar cells up to 8 days of culture and a strong expression pattern of alpha-amylase. Cells in the centre of mini organs showed a granular cytoplasm starting at day 3. 1-3 h nicotine exposure significantly increased DNA damage as determined by DNA in the tail (DT), with no significant differences with increasing exposure time and only a trend towards decreased values of DT after regeneration. MMS demonstrated a time-dependent increase in DNA damage and distinctly reduced DT values after regeneration. MOC may be used to study DNA damage and repair after repetitive exposure to xenobiotics. They provide additional information for in vitro studies of cells growing in an intact tissue structure. PMID:20466043

  18. A case with tumor of left parotid gland and denture stomatitis.

    PubMed

    MercuŢ, Veronica; Iorgulescu, Daniel; Popescu, Sanda Mihaela; Mărgăritescu, Claudiu; MercuŢ, Răzvan; CrăiŢoiu, Monica Mihaela; Scrieciu, Monica

    2015-01-01

    The article discuss the case of an edentulous patient presented to the dental clinic for pain and burning sensation of oral mucosa and diagnosed subsequently with oxyphilic adenoma. A 58-year-old patient, with maxillary edentulism, treated with complete denture, presented to the Clinic of Prosthetic Dentistry of the Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania, for pain of oral mucosa and bad stability of denture. The diagnosis of erythematous denture stomatitis as consequence of salivary flow reduction was establish after patient's clinical examination, and by unstimulated sialometry. Clinical exam suggested hyposalivation could be a consequence of a tumor situated at the level of the left parotid gland. The echography confirmed the diagnosis of left parotid gland tumor. The tumor was surgical removed and histopathological exam confirmed oxyphilic adenoma. Education of patient for wearing new denture while maintaining a strict oral hygiene and dealing with low salivary flow was the treatment for denture stomatitis. General dentist has an important role in finding and diagnosing patients with systemic diseases, especially salivary tumors.

  19. [Tumors of the parapharyngeal space: case report of clear cell myoepithelioma of the parotid gland and review of literature].

    PubMed

    De Stefani, A; Lerda, W; Bussi, M; Valente, G; Cortesina, G

    1999-10-01

    The parapharyngeal space is a deep neck region and can be the site of a wide range of neoplasms, including primary benign or malignant tumors, metastatic tumors, neoplasms invading the parapharyngeal space from the adjacent regions and neoformations stemming from systemic processes. Tumors of the parapharyngeal space are, nevertheless, relatively rare and account for 0.5-0.8% of all head and neck tumors. Most are benign tumors originating in the deep lobe of the parotid gland and the minor salivary glands. The most frequent tumor is pleomorphic adenoma while myoepithelioma accounts for just 1% of all salivary gland tumors. The present case report involves a case of myoepithelioma of the deep parotid gland lobe, arising in the parapharyngeal space. Together with a review of the literature, considerations are presented on the clinical and radiological evaluation, differential diagnosis and treatment of these lesions.

  20. Large Cohort Dose-Volume Response Analysis of Parotid Gland Function After Radiotherapy: Intensity-Modulated Versus Conventional Radiotherapy

    SciTech Connect

    Dijkema, Tim Terhaard, Chris H.J.; Roesink, Judith M.; Braam, Petra M.; Gils, Carla H. van; Moerland, Marinus A.; Raaijmakers, Cornelis P.J.

    2008-11-15

    Purpose: To compare parotid gland dose-volume response relationships in a large cohort of patients treated with intensity-modulated (IMRT) and conventional radiotherapy (CRT). Methods and materials: A total of 221 patients (64 treated with IMRT, 157 with CRT) with various head-and-neck malignancies were prospectively evaluated. The distribution of tumor subsites in both groups was unbalanced. Stimulated parotid flow rates were measured before and 6 weeks, 6 months, and 1 year after radiotherapy. Parotid gland dose-volume histograms were derived from computed tomography-based treatment planning. The normal tissue complication probability (NTCP) model proposed by Lyman was fit to the data. A complication was defined as stimulated parotid flow ratio <25% of the pretreatment flow rate. The relative risk of complications was determined for IMRT vs. CRT and adjusted for the mean parotid gland dose using Poisson regression modeling. Results: One year after radiotherapy, NTCP curves for IMRT and CRT were comparable with a TD{sub 50} (uniform dose leading to a 50% complication probability) of 38 and 40 Gy, respectively. Until 6 months after RT, corrected for mean dose, different complication probabilities existed for IMRT vs. CRT. The relative risk of a complication for IMRT vs. CRT after 6 weeks was 1.42 (95% CI 1.21-1.67), after 6 months 1.41 (95% CI; 1.12-1.77), and at 1 year 1.21 (95% CI 0.87-1.68), after correcting for mean dose. Conclusions: One year after radiotherapy, no difference existed in the mean dose-based NTCP curves for IMRT and CRT. Early after radiotherapy (up to 6 months) mean dose based (Lyman) models failed to fully describe the effects of radiotherapy on the parotid glands.

  1. Malignant dermal cylindroma in a patient with multiple dermal cylindromas, trichoepitheliomas, and bilateral dermal analogue tumors of the parotid gland.

    PubMed

    Rockerbie, N; Solomon, A R; Woo, T Y; Beals, T F; Ellis, C N

    1989-08-01

    A malignant dermal cylindroma of the scalp arose from one of multiple long-standing dermal cylindromas in a 76-year-old man with coexisting trichoepitheliomas and bilateral dermal analogue tumors of the parotid gland. The histologic transition from a benign dermal cylindroma to an anaplastic keratinocytic neoplasm was readily apparent. The malignant dermal cylindroma is a rare neoplasm. To our knowledge, the constellation of benign and malignant dermal cylindromas, multiple trichoepitheliomas, and salivary gland neoplasms has not been previously reported.

  2. Fine-needle aspiration of pigmented villonodular synovitis of the temporomandibular joint masquerading as a primary parotid gland lesion.

    PubMed

    Yu, G H; Staerkel, G A; Kershisnik, M M; Varma, D G

    1997-01-01

    The fine-needle aspiration findings in a case of pigmented villonodular synovitis of the temporomandibular joint are presented. The characteristic cytomorphologic and clinical features of this uncommon, benign fibrohistiocytic lesion are discussed. In addition, due to the initial clinical impression of a primary parotid gland lesion, the differential diagnosis for the cytomorphologic features observed (histiocytoid cells admixed with osteoclast-like giant cells) are discussed within the context of a primary salivary gland mass.

  3. Fine-needle aspiration biopsy findings in sclerosing polycystic adenosis of the parotid gland.

    PubMed

    Etit, Demet; Pilch, Ben Z; Osgood, Rebecca; Faquin, William C

    2007-07-01

    Sclerosing polycystic adenosis (SPA) is a recently described, rare lesion of the salivary gland analogous to fibrocystic disease of the breast. Recognition of this benign entity is important since the differential diagnosis includes other more common benign and malignant salivary gland neoplasms, particularly mucoepidermoid carcinoma and tumors with cystic and oncocytic features. While the histomorphology of SPA is well documented, there is only one other cytologic description of SPA in the English-language literature. Here we describe the fine-needle aspiration biopsy findings in a case of SPA of the parotid gland in an 84-year-old woman. The aspirate was characterized by flat cohesive sheets of epithelial cells with moderate amounts of finely granular oncocytic cytoplasm and enlarged round nuclei with indistinct nucleoli. Some epithelial groups formed glandular structures with lumens, and the background contained small amounts of delicate mucoproteinaceous material. Occasional markedly vacuolated cells were present as well as many cells with apocrine change manifested by well-defined apical snouting. Familiarity with the cytomorphologic features of SPA, including its characteristic apocrine changes, is important for distinguishing it from other more clinically significant salivary gland lesions.

  4. Glycomic profile of the human parotid gland between 18th and 26th week of fetal development.

    PubMed

    Rêgo, Moacyr J B M; Silva Filho, Antônio F; Sobral, Ana P V; Beltrão, Eduardo I C

    2016-01-01

    The formation of new and functional structural components of several organs, such as parotid glands, can be influenced by the glycocode. This study analyzed the glycobiology of parotid salivary gland tissue during fetal development using specific biochemical probes (lectins and antibodies). Eleven parotid gland samples from human fetuses were obtained from spontaneous abortions at 14-28 weeks of gestation, and tissue sections were analyzed for lectin histochemistry and immunohistochemistry. From the 18th to 26th week, Canavalia ensiformis agglutinin, wheat germ agglutinin, Ulex europaeus agglutinin-I, peanut agglutinin, Sambucus nigra agglutinin, and Vicia villosa agglutinin lectin staining were predominantly observed in the apical and/or basement membranes of the ducts and tubulo-acinar units. Moreover, the presence of galectin-1 was found in the membrane, cytoplasm, and nucleus of both structures. Conversely, Gal-3 and mucin-1 were restricted to the glandular ducts. The lectin staining pattern changed during the weeks evaluated. Nevertheless, the carbohydrate subcellular localization represented a key factor in the investigation of structural distribution profiles and possible roles of these glycans in initial parotid gland development. These findings are defined by their high biological value and provide an important base for the development of subsequent studies. (J Oral Sci 58, 353-360, 2016). PMID:27665974

  5. Primary B-Cell Mucosa-Associated Lymphoid Tissue Lymphoma of the Hard Palate and Parotid Gland: Report of One Case and Review of the Literature

    PubMed Central

    Yonal-Hindilerden, Ipek; Hindilerden, Fehmi; Arslan, Serkan; Turan-Guzel, Nalan; Dogan, Ibrahim Oner; Nalcaci, Meliha

    2016-01-01

    A 61-year-old woman was admitted to our hospital with an ulcerated palate mass and swelling of the right parotid gland. Incisional biopsy from the hard palate revealed an extranodal marginal zone B-cell lymphoma, also called mucosa-associated lymphoid tissue (MALT) lymphoma. Final diagnosis was MALT lymphoma of the parotid gland with concomitant involvement of an extremely seldom site of involvement: the hard palate. To our knowledge, this report illustrates the first case of MALT lymphoma of the hard palate and parotid gland without an underlying autoimmune disease. Rituximab-based combination regimen (R-CHOP) provided complete remission with total regression of mass lesions at the hard palate and parotid gland. At 44-month follow-up, there is no disease relapse. We adressed the manifestations and management of MALT lymphoma patients with involvement of salivary gland and oral cavity. PMID:27738485

  6. Differential diagnosis of parotid gland tumours: which magnetic resonance findings should be taken in account?

    PubMed

    Tartaglione, T; Botto, A; Sciandra, M; Gaudino, S; Danieli, L; Parrilla, C; Paludetti, G; Colosimo, C

    2015-10-01

    Our aim was to define typical magnetic resonance (MRI) findings in malignant and benign parotid tumours. This study is based on retrospective evaluation of pre-surgical MRI of 94 patients with parotid gland tumours. Histology results were available for all tumours. There were 69 cases of benign (73%) and 25 cases of malignant (27%) tumours, including 44 pleomorphic adenomas, 18 Warthin's tumours, 7 various benign tumours, 6 squamous cell carcinomas, 3 carcinoma ex pleomorphic adenomas, 2 mucoepidermoid carcinomas, 1 adenoid cystic carcinoma and 13 various malignant tumours. The following MRI parameters were evaluated: shape, site, size, margins, signal intensity (SI) on T1w and T2w images, contrast enhancement, signal of cystic content, presence or absence of a capsule, perineural spread, extraglandular growth pattern and cervical adenopathy. Statistical analysis was performed to identify the MRI findings most suggestive of malignancy, and to define the most typical MRI pattern of the most common histologies. Ill-defined margins (p < 0.001), adenopathies (p < 0.001) and infiltrative grown pattern (p < 0.001) were significantly predictive of malignancy. Typical findings of pleomorphic adenoma included hyperintensity on T2w images (p = 0.02), strong contrast enhancement (p < 0.001) and lobulated shape (p = 0.04). Typical findings of Warthin's tumour included hyperintense components on T1w images (p < 0.001), location in the parotid inferior process (p < 0.001) and mild or incomplete contrast enhancement (p = 0.01). SI on T1w and T2w images and contrast enhancement enables differential diagnosis between pleomorphic adenoma and Warthin's tumour. PMID:26824912

  7. Isolation of the murine ribonuclease gene Rib-1: structure and tissue specific expression in pancreas and parotid gland.

    PubMed Central

    Samuelson, L C; Wiebauer, K; Howard, G; Schmid, R M; Koeplin, D; Meisler, M H

    1991-01-01

    The mouse pancreatic ribonuclease gene Rib-1 was isolated from a library of mouse genomic DNA and sequenced. This small gene contains a nontranslated exon of 52 base pairs, an intron of 791 base pairs, and a coding exon of 741 base pairs. Rib-1 transcripts were detected in parotid gland as well as in pancreas. The abundance of the transcripts were approximately 200-fold greater in pancreatic RNA than in parotid RNA. The sites of transcription initiation were mapped by primer extension and ribonuclease protection assays. One major initiation site and several minor initiation sites were identified in pancreatic RNA. Transcription in parotid appears to be initiated from the same sites. Parotid-specific transcripts were not detected. The data suggest that Rib-1 is transcribed in pancreas and parotid from the same promoter. This is in contrast with the mechanism for production of amylase in pancreas and parotid, which is accomplished by tissue specific expression of different gene copies. Images PMID:1840677

  8. Parotid Gland Dose in Intensity-Modulated Radiotherapy for Head and Neck Cancer: Is What You Plan What You Get?

    SciTech Connect

    O'Daniel, Jennifer C.; Garden, Adam S.; Schwartz, David L.; Wang He; Ang, Kian K.; Ahamad, Anesa; Rosenthal, David I.; Morrison, William H.; Asper, Joshua A.; Zhang Lifei; Tung Shihming; Mohan, Radhe; Dong Lei

    2007-11-15

    Purpose: To quantify the differences between planned and delivered parotid gland and target doses, and to assess the benefits of daily bone alignment for head and neck cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eleven head and neck cancer patients received two CT scans per week with an in-room CT scanner over the course of their radiotherapy. The clinical IMRT plans, designed with 3-mm to 4-mm planning margins, were recalculated on the repeat CT images. The plans were aligned using the actual treatment isocenter marked with radiopaque markers (BB) and bone alignment to the cervical vertebrae to simulate image-guided setup. In-house deformable image registration software was used to map daily dose distributions to the original treatment plan and to calculate a cumulative delivered dose distribution for each patient. Results: Using conventional BB alignment led to increases in the parotid gland mean dose above the planned dose by 5 to 7 Gy in 45% of the patients (median, 3.0 Gy ipsilateral, p = 0.026; median, 1.0 Gy contralateral, p = 0.016). Use of bone alignment led to reductions relative to BB alignment in 91% of patients (median, 2 Gy; range, 0.3-8.3 Gy; 15 of 22 parotids improved). However, the parotid dose from bone alignment was still greater than planned (median, 1.0 Gy, p = 0.007). Neither approach affected tumor dose coverage. Conclusions: With conventional BB alignment, the parotid gland mean dose was significantly increased above the planned mean dose. Using daily bone alignment reduced the parotid dose compared with BB alignment in almost all patients. A 3- to 4-mm planning margin was adequate for tumor dose coverage.

  9. ( sup 3 H)protein secretion in rat parotid gland: Substance P-. beta. -adrenergic synergism

    SciTech Connect

    Dreux, C.; Imhoff, V.; Rossignol, B. )

    1987-12-01

    In parotid fragment ({sup 3}H)protein, secretion induced by substance P was moderate, but strongly Ca dependent. However, secretion induced by isoproterenol was large and Ca independent. Potentiation of protein secretion was observed when substance P (SP) and isoproterenol (ISO) acted together. Addition of 10{sup {minus}8} M SP caused a shift to the left in the secretion dose-response curve caused by ISO, but did not enhance ISO-induced maximal response. The potentiating effect seems to be a postreceptor event, since it can be mimicked by forskolin (FK), known to induce directly cAMP accumulation, thus bypassing the {beta}-adrenergic receptor. The synergism described above was, therefore, investigated at the second messenger production level. Stimulation of parotid gland fragments by simultaneous addition of SP plus ISO or FK did not modify cAMP nor inositol trisphosphate (IP{sub 3}) accumulation induced independently by each secretagogue alone. The ionophore A23187 was also able to potentiate secretion induced by a {beta}-adrenergic agonist, this effect being totally abolished by external calcium omission, thus suggesting a role for external calcium in this potentiation phenomenon. These results suggest that the potentiation phenomenon observed is a postreceptor event that occurs at a step distal from the second messenger production.

  10. Molecular cloning and functional expression of a sodium bicarbonate cotransporter from guinea-pig parotid glands.

    PubMed

    Koo, Na-Youn; Li, Jingchao; Hwang, Sung Min; Choi, Se-Young; Lee, Sung Joong; Oh, Seog-Bae; Kim, Joong-Soo; Lee, Jong Heun; Park, Kyungpyo

    2006-04-21

    We recently found that the concentration of HCO3- in guinea-pig saliva is very similar to that of human saliva; however, the entity that regulates HCO3- transport has not yet been fully characterized. In order to investigate the mechanism of HCO3- transport, we identified, cloned, and characterized a sodium bicarbonate (Na(+)/HCO3- cotransporter found in guinea-pig parotid glands (gpNBC1). The gpNBC1 gene encodes a 1079-amino acid protein that has 95% and 96% homology with human and mouse parotid NBC1, respectively. Oocytes expressing gpNBC1 were exposed to HCO3- or Na(+)-free solutions, which resulted in a marked change in membrane potentials (V(m)), suggesting that gpNBC1 is electrogenic. Likewise, a gpNBC1-mediated pH recovery was observed in gpNBC1 transfected human hepatoma cells; however, in the presence of 4, 4-diisothiocyanostilbene-2,2-disulfonic acid, a specific NBC1 inhibitor, such changes in V(m) and pH(i) were not observed. Together, the data show that the cloned guinea-pig gene is a functional, as well as sequence homologue of human NBC1. PMID:16513089

  11. Intensity-Modulated vs. Conformal Radiotherapy of Parotid Gland Tumors: Potential Impact on Hearing Loss

    SciTech Connect

    Lamers-Kuijper, E. Schwarz, M.; Rasch, C.; Mijnheer, B.

    2007-01-01

    In 3-dimensional (3D) conformal radiotherapy of parotid gland tumors, little effort is made to avoid the auditory system or the oral cavity. Damage may occur when the ear is located inside the treatment field. The purpose of this study was to design and evaluate an intensity-modulation radiotherapy (IMRT) class solution, and to compare this technique to a 3D conformal approach with respect to hearing loss. Twenty patients with parotid gland cancer were retrospectively planned with 2 different techniques using the original planning target volume (PTV). First, a conventional technique using a wedged beam pair was applied, yielding a dose distribution conformal to the shape of the PTV. Next, an IMRT technique using a fluence map optimization with predefined constraints was designed. A dose of 66 Gy in the PTV was given at the International Commission on Radiation Units and Measures (ICRU) dose prescription point. Dose-volume histograms of the PTV and organs at risk (OARs), such as auditory system, oral cavity, and spinal cord, were compared. The dose in the OARs was lower in the IMRT plans. The mean volume of the middle ear receiving a dose higher than 50 Gy decreased from 66.5% to 33.4%. The mean dose in the oral cavity decreased from 19.4 Gy to 16.6 Gy. The auditory system can be spared if the distance between the inner ear and the PTV is 0.6 cm or larger, and if the overlap between the middle ear and the PTV is smaller than 10%. The maximum dose in the spinal cord was below 40 Gy in all treatment plans. The mean volume of the PTV receiving less than 95% of the prescribed dose increased in the IMRT plan slightly from 3.3% to 4.3 % (p = 0.01). The mean volume receiving more than 107% increased from 0.9% to 2.5% (p = 0.02). It can be concluded that the auditory system, as well as the oral cavity, can be spared with IMRT, but at the cost of a slightly larger dose inhomogeneity in the PTV. The IMRT technique can therefore, in most cases, be recommended as the treatment

  12. Preoperative Diagnostic Strategy for Parotid Gland Tumors Using Diffusion-Weighted MRI and Technetium-99m Pertechnetate Scintigraphy: A Prospective Study

    PubMed Central

    Kikuchi, Masahiro; Koyasu, Sho; Shinohara, Shogo; Imai, Yukihiro; Hino, Megumu; Naito, Yasushi

    2016-01-01

    Objective Fine needle aspiration cytology (FNAC) for diagnosis of a parotid gland tumor is widely used but its sensitivity is low and non-diagnostic rate is relatively high. In contrast, core needle biopsy (CNB) has a higher sensitivity and lower rate of sampling errors but has a higher risk of injury to adjacent organs such as facial nerve than FNAC. Screening of patients with parotid gland tumors to identify cases of pleomorphic adenoma (PA) and Warthin tumor (WT) may allow CNB to be confined to patients without PA and WT. We established an algorithm for preoperative diagnosis and management of parotid gland tumor using diffusion-weighted MRI and 99mTc pertechnetate scintigraphy. This algorithm was developed with the goal of maximal reduction of the number of patients in whom CNB is required. The purpose of the study is to validate our algorithm prospectively. Methods A prospective study was conducted in 71 cases who were newly diagnosed with parotid gland tumor and 53 cases were enrolled in the study. In the algorithm, PA (high apparent diffusion coefficient (ADC) mean≥1.5×10−3 mm2/s) and non-PA (low ADCmean<1.5×10−3 mm2/s) cases are first distinguished based on the ADCmean on diffusion-weighed MRI. Second, among suspected non-PA cases, WT and non-WT are distinguished using technetium-99m pertechnetate scintigraphy. CNB is then performed only in probable non-PA and non-WT cases. Results Although CNB was only required in 40% (21/53) of all cases, we made a preoperative histopathological diagnosis with an accuracy of 87% (46/53) and we correctly diagnosed whether a tumor was benign or malignant with an accuracy of 96% (51/53). Preoperative surgical planning had to be changed during surgery in only one case (2%) Conclusions Our algorithm is valuable in terms of clinical practice with highly potential for preoperative diagnosis and with less risk of CNB procedure. PMID:26849569

  13. FDG-PET Assessment of the Effect of Head and Neck Radiotherapy on Parotid Gland Glucose Metabolism

    SciTech Connect

    Roach, Michael C.; Turkington, Timothy G.; Higgins, Kristin A.; Hawk, Thomas C.; Hoang, Jenny K.; Brizel, David M.

    2012-01-01

    Purpose: Functional imaging with [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) provides the opportunity to define the physiology of the major salivary glands before and after radiation therapy. The goal of this retrospective study was to identify the radiation dose-response relationship of parotid gland glucose metabolism in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods: Forty-nine adults with HNSCC were identified who had curative intent intensity-modulated radiation therapy (IMRT) and FDG-PET imaging before and after treatment. Using a graphical user interface, contours were delineated for the parotid glands on axial CT slices while all authors were blinded to paired PET slices. Average and maximal standard uptake values (SUV) were measured within these anatomic regions. Changes in SUV and volume after radiation therapy were correlated with parotid gland dose-volume histograms from IMRT plans. Results: The average parotid gland volume was 30.7 mL and contracted 3.9 {+-} 1.9% with every increase of 10 Gy in mean dose (p = 0.04). However, within the first 3 months after treatment, there was a uniform reduction of 16.5% {+-} 7.3% regardless of dose. The average SUV{sub mean} of the glands was 1.63 {+-} 0.48 pretreatment and declined by 5.2% {+-} 2.5% for every increase of 10 Gy in mean dose (p = 0.04). The average SUV{sub max} was 4.07 {+-} 2.85 pretreatment and decreased in a sigmoid manner with mean dose. A threshold of 32 Gy for mean dose existed, after which SUV{sub max} declined rapidly. Conclusion: Radiation dose responses of the parotid glands can be measured by integrated CT/FDG-PET scans. Retrospective analysis showed sigmoidal declines in the maximum metabolism but linear declines in the average metabolism of the glands with dose. Future studies should correlate this decline in FDG uptake with saliva production to improve treatment planning.

  14. Myoepithelial carcinoma (malignant myoepithelioma) of the parotid gland arising in a pleomorphic adenoma.

    PubMed Central

    McCluggage, W G; Primrose, W J; Toner, P G

    1998-01-01

    A myoepithelial carcinoma, a rare malignant salivary gland neoplasm, arose in a pleomorphic adenoma of the parotid gland. The initial tumour was a pleomorphic adenoma with epithelial and myoepithelial elements. Subsequently the tumour recurred twice and was characterised by invasion of the mandible. Histological examination of the second recurrence showed a malignant spindle cell neoplasm with an infiltrative growth pattern and a high mitotic rate. There was involvement of local lymph nodes. The immunophenotype was characteristic of myoepithelial differentiation: tumour cells stained positively with anticytokeratin antibodies, S-100 protein, alpha smooth muscle actin, and vimentin. Electron microscopy confirmed myoepithelial differentiation, with small foci of keratinocytic phenotype. Large numbers of tumour cell nuclei were reactive with the anti-p53 antibody, DO-7, in contrast to the two previous resections. Thus malignant transformation of a pleomorphic adenoma may involve myoepithelial as well as epithelial elements. Accumulation of p53 protein, perhaps through mutational events, may have played a role in this malignant transformation. Images PMID:9797738

  15. Response of the parotid gland of red kangaroos, Macropus rufus, to phenylephrine stimulation.

    PubMed

    Beal, A M

    2003-01-01

    Intracarotid infusions of l-phenylephrine at 1.0 or 10 nmol kg(-1) min(-1) were accompanied by increases in salivary amylase activity, protein, potassium, magnesium and chloride relative to cholinergically-stimulated saliva. Intravenous infusions of phenylephrine at the same dose rates had a lesser effect on salivary composition particularly protein. Propranolol administered with phenylephrine via the carotid artery, at an antagonist/agonist ratio of 10:1, was much more effective in blocking the phenylephrine-induced changes in salivary composition than equimolar infusion of phentolamine with phenylephrine. It was concluded that alpha(1)-adrenoreceptors were not present in functionally significant numbers in the gland and that the effect of phenylephrine on the kangaroo parotid was mediated by beta-adrenoreceptors. As the phenylephrine dose rates in the kangaroos were comparable with those used to determine alpha-adrenergic responses of eutherian salivary glands and as phentolamine appeared to have minor beta-sympathomimetic activity, at least one subtype of beta-adrenoreceptors in macropods may not be identical to its eutherian counterpart.

  16. Tubular-trabecular type Basal cell adenoma of the parotid gland: a patient report.

    PubMed

    Nakabayashi, Motoki; Shomori, Kohei; Kiya, Shuichi; Shiomi, Tatsushi; Nosaka, Kanae; Ito, Hisao

    2010-09-01

    Basal cell adenoma (BCA) is an uncommon benign salivary gland neoplasm that includes isomorphic basaloid cells. We report on a female patient with BCA that developed in the right parotid gland in her 50s. The present patient demonstrated a few tumor nests in the fibrous capsule, and her tumor was larger than usual. These facts made us suspect of malignancy. Histopathologically, the tumor was characterized by multiple duct-like structures and tubular-trabecular masses composed of small isomorphic cells with hyperchromatic, round nuclei and an eosinophilic cytoplasm. It was difficult to determine whether the ductal structures noted in the tumor capsule were invasive. By immunohistochemistry, tumor cells of the tubular nests were positive for cytokeratin 7 and that the outer cells of tubular nests were positive for alpha smooth muscle actin (αSMA) and calponin. Tumor cells were immuno-negative for S-100 protein and glial fibrillary acidic protein. The Ki-67 labeling scores of the cells were extremely low (< 1%). We could achieve an accurate diagnosis of BCA by immunohistochemistry with MIB-1 and other markers.

  17. Reducing Xerostomia After Chemo-IMRT for Head and Neck Cancer: Beyond Sparing the Parotid Glands

    PubMed Central

    Little, Michael; Schipper, Matthew; Feng, Felix Y.; Vineberg, Karen; Cornwall, Craig; Murdoch-Kinch, Carol-Anne; Eisbruch, Avraham

    2011-01-01

    Purpose To assess whether in addition to sparing parotid glands (PGs), xerostomia after chemo-IMRT of head and neck cancer is affected by reducing doses to other salivary glands. Methods Prospective study: 78 patients with stages III/IV oropharynx/nasopharynx cancers received chemo-IMRT aiming to spare the parts outside the targets of bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) (when contralateral level I was not a target). Pretherapy and periodically through 24 months, validated patient-reported xerostomia questionnaires (XQ) scores and observer-graded xerostomia were recorded, and stimulated and unstimulated saliva measured selectively from each of the PGs and SMGs. Mean OC doses served as surrogates of minor salivary glands dysfunction. Regression models assessed XQ and observer-graded xerostomia predictors. Results Statistically significant predictors of the XQ score in univariate analysis included OC, PG, and SMG mean doses, as well as baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. OC, PG and SMG mean doses were moderately inter-correlated (r=0.47–0.55). In multivariate analyses, after adjusting for PG and SMG doses, OC mean dose (p < 0.0001), time from RT (p < 0.0001), and stimulated PG saliva (p < 0.0025) were significant predictors for XQ scores, and OC mean dose and time for observer-graded xerostomia. While scatter plots showed no thresholds, OC mean doses <40 Gy and contralateral SMG mean <50 Gy were each associated with low patient-reported and observer-rated xerostomia at almost all post-therapy time points. Conclusion PG, SMG and OC mean doses were significant predictors of both patient-reported and observer-rated xerostomia after chemo-IMRT, with OC doses remaining significant after adjusting for PG and SMG doses. These results support efforts to

  18. Cytological features of cystadenocarcinoma in cyst fluid of the parotid gland: Diagnostic pitfalls and literature review.

    PubMed

    Kawahara, Akihiko; Harada, Hiroshi; Mihashi, Hiroyuki; Akiba, Jun; Kage, Masayoshi

    2010-05-01

    Cystadenocarcinoma is a rare malignant tumor, with an estimated incidence of 2% of malignant salivary gland tumors. Cytological diagnosis of cystadenocarcinoma is important for differential diagnosis between benign lesions and malignant tumors with cystic growth. We report a case of cystadenocarcinoma causing difficulty in cytological diagnosis. A 23-year-old man presented with an asymptomatic mass in the left parotid gland that had been present for 2 years. The mass was elastic hard, measuring 30 x 35 mm in diameter. Preoperative fine-needle aspiration cytology (FNAC) showed a small number of tumor cell clusters in the cystic fluid. The cluster was arranged in a ball-like structure and was cohesive with overlapping. Tumor cells had a small vacuolated, soap-bubble appearance in the cytoplasm. The papillary-cystic variant of acinic cell carcinoma (ACC-PCV) was suggested from these findings on FNAC. Histologically, the tumor was not encapsulated, but formed large cystic spaces against a background of fibrous connective tissue. The tumor cells in the cystic dilated duct showed papillary structures, which were continuous with the lining cuboidal cells. There was neither a definite double-layered arrangement in cystic ducts and solid islands nor histological findings characteristic of the papillary-cystic or follicular pattern of ACC-PCV. As tumor cells with a small vacuolated, soap-bubble appearance of the cytoplasm are common findings of both cystadenocarcinoma and ACC-PCV, they are of little use for differentiation; however, they are so characteristic that the majority of benign salivary gland lesions with cystic structures can be excluded, if enough attention is paid.

  19. A quantitative assessment of volumetric and anatomic changes of the parotid gland during intensity-modulated radiotherapy for head and neck cancer using serial computed tomography

    SciTech Connect

    Ajani, Abdallah A.; Qureshi, Muhammad M.; Kovalchuk, Nataliya; Orlina, Lawrence; Sakai, Osamu; Truong, Minh Tam

    2013-10-01

    To evaluate the change in volume and movement of the parotid gland measured by serial contrast-enhanced computed tomography scans in patients with head and neck cancer treated with parotid-sparing intensity-modulated radiotherapy (IMRT). A prospective study was performed on 13 patients with head and neck cancer undergoing dose-painted IMRT to 69.96 Gy in 33 fractions. Serial computed tomography scans were performed at baseline, weeks 2, 4, and 6 of radiotherapy (RT), and at 6 weeks post-RT. The parotid volume was contoured at each scan, and the movement of the medial and lateral borders was measured. The patient's body weight was recorded at each corresponding week during RT. Regression analyses were performed to ascertain the rate of change during treatment as a percent change per fraction in parotid volume and distance relative to baseline. The mean parotid volume decreased by 37.3% from baseline to week 6 of RT. The overall rate of change in parotid volume during RT was−1.30% per fraction (−1.67% and−0.91% per fraction in≥31 Gy and<31 Gy mean planned parotid dose groups, respectively, p = 0.0004). The movement of parotid borders was greater in the≥31 Gy mean parotid dose group compared with the<31 Gy group (0.22% per fraction and 0.14% per fraction for the lateral border and 0.19% per fraction and 0.06% per fraction for the medial border, respectively). The median change in body weight was−7.4% (range, 0.75% to−17.5%) during RT. A positive correlation was noted between change in body weight and parotid volume during the course of RT (Spearman correlation coefficient, r = 0.66, p<0.01). Head and neck IMRT results in a volume loss of the parotid gland, which is related to the planned parotid dose, and the patient's weight loss during RT.

  20. Parotid gland tumors: correlation between routine cytology and cytomorphometry by digital image analysis using conventional and newly introduced cytomorphometric parameters.

    PubMed

    Obad-Kovačević, Dragica; Kardum-Skelin, Ika; Jelić-Puškarić, Biljana; Vidjak, Vinko; Blašković, Darko

    2013-09-01

    The objective of this study was to compare qualitative cytomorphology and morphometric characteristics of parotid gland tumor cells, with the aid of a computer-assisted system of image analysis. Routine qualitative cytologic and quantitative morphometric results from 64 parotid gland tumors were compared. Ultrasound (US)-guided fine-needle aspiration (FNA) specimens were taken from 54 patients. Eleven conventionally used morphometric parameters were studied: area, perimeter, convex area, convexity, maximal and minimal radius, length, breadth, form factor (FF), elongation factor, and nuclear- cytoplasmatic (N/C) ratio. Two newly introduced nuclear form factors were also measured: area symmetry factor and perimeter symmetry factor. The following nuclear morphometric parameters were significantly different between malignant and benign tumors: area, perimeter, convex area, convexity, maximal and minimal radius, length, breadth, FF, elongation factor, area symmetry factor, and perimeter symmetry factor. Comparing the cutoff values and receiver operating characteristic (ROC) curves the following nuclear morphometric parameters were found most useful in separating benign from malignant tumors: area, perimeter, convex area, maximal radius, length, and FF. The following whole cell morphometric parameters were significantly different between malignant and benign tumors: minimal and maximal radius, convexity, breadth, FF, and elongation factor. N/C ratio was significantly higher in malignant tumors. The quantitative morphometric analysis is a useful tool in the cytological differentiation between benign and malignant parotid gland tumors. Computerized image analysis may add to morphological evaluation by turning qualitative data into quantitative values.

  1. Automated Segmentation of the Parotid Gland Based on Atlas Registration and Machine Learning: A Longitudinal MRI Study in Head-and-Neck Radiation Therapy

    SciTech Connect

    Yang, Xiaofeng; Wu, Ning; Cheng, Guanghui; Zhou, Zhengyang; Yu, David S.; Beitler, Jonathan J.; Curran, Walter J.; Liu, Tian

    2014-12-01

    Purpose: To develop an automated magnetic resonance imaging (MRI) parotid segmentation method to monitor radiation-induced parotid gland changes in patients after head and neck radiation therapy (RT). Methods and Materials: The proposed method combines the atlas registration method, which captures the global variation of anatomy, with a machine learning technology, which captures the local statistical features, to automatically segment the parotid glands from the MRIs. The segmentation method consists of 3 major steps. First, an atlas (pre-RT MRI and manually contoured parotid gland mask) is built for each patient. A hybrid deformable image registration is used to map the pre-RT MRI to the post-RT MRI, and the transformation is applied to the pre-RT parotid volume. Second, the kernel support vector machine (SVM) is trained with the subject-specific atlas pair consisting of multiple features (intensity, gradient, and others) from the aligned pre-RT MRI and the transformed parotid volume. Third, the well-trained kernel SVM is used to differentiate the parotid from surrounding tissues in the post-RT MRIs by statistically matching multiple texture features. A longitudinal study of 15 patients undergoing head and neck RT was conducted: baseline MRI was acquired prior to RT, and the post-RT MRIs were acquired at 3-, 6-, and 12-month follow-up examinations. The resulting segmentations were compared with the physicians' manual contours. Results: Successful parotid segmentation was achieved for all 15 patients (42 post-RT MRIs). The average percentage of volume differences between the automated segmentations and those of the physicians' manual contours were 7.98% for the left parotid and 8.12% for the right parotid. The average volume overlap was 91.1% ± 1.6% for the left parotid and 90.5% ± 2.4% for the right parotid. The parotid gland volume reduction at follow-up was 25% at 3 months, 27% at 6 months, and 16% at 12 months. Conclusions: We have validated our

  2. Undifferentiated carcinoma of the parotid gland in a white patient: detection of Epstein-Barr virus by in situ hybridization.

    PubMed

    Kotsianti, A; Costopoulos, J; Morgello, S; Papadimitriou, C

    1996-01-01

    Paraffin sections of an undifferentiated salivary gland carcinoma of lymphoepithelioma type, arising in a white (Greek) patient and confirmed by immunohistochemistry, were examined for the presence of Epstein-Barr virus (EBV), using in situ hybridization to detect EBV-specific EBER1 message. Epstein-Barr virus was detected in malignant epithelial cells, but was not found in lymphoid stroma or in residual benign salivary epithelium. These results confirm the existence of an association between EBV and tumor cells of undifferentiated carcinoma of parotid gland. This is the first demonstration of EBV in a salivary gland lymphoepithelioma arising in a non-Eskimo, white patient. This finding suggests that the association of EBV with undifferentiated salivary gland carcinoma may exist in geographic regions remote from Greenland.

  3. [Therapy of benign diseases of the parotid gland by instillation of a resorbable protein solution into the duct system].

    PubMed

    Rettinger, G

    1984-02-01

    Non-neoplastic disorders of the parotid gland like chronic recurrent parotitis, asymptomatic gland enlargement or salivary fistulae present a therapeutic problem. Surgical removal of the gland is often difficult as scar tissue may be present in these benign diseases. Therefore alternative methods are suggested to eliminate parenchyma by inducing atrophy. This goal can also be attained by intraluminal duct occlusion. The principle consists of instillation of a resorbable protein solution into the duct system, a procedure similar to sialography injection. In animal experiments marked atrophy of parenchyma and complete reabsorption of the instilled substance within four weeks could be demonstrated histologically. The clinical experiences in 33 cases of major salivary gland diseases and three year follow up data are reported. The main advantages of the new method described are a simple technique, rapid onset of atrophy and preservation of facial nerve function.

  4. Radioprotection by WR-2721 of gamma-irradiated rat parotid gland: effect on gland weight and secretion at 8-10 days post irradiation.

    PubMed

    Menard, T W; Izutsu, K T; Ensign, W Y; Keller, P J; Morton, T H; Truelove, E L

    1984-09-01

    Changes in rat parotid salivary gland weight and functional parameters were evaluated at 8 to 10 days post irradiation in WR-2721 protected and non-protected animals following exposure to a single 15.3 Gy dose of Cs-137 radiation to the head. Glandular fluid secretory capacity was assessed by maximum flow rate, total volume of saliva and duration of secretion following pilocarpine stimulation. Protection against radiomucositis was also evaluated indirectly by daily monitoring of food and water intake, body weight and paraoral symptomatology. WR-2721 provided a significant degree of protection for all glandular functional parameters as well as gland weight. Relative protective factors (RPF) were computed for irradiated protected and non-protected animals compared to their sham-irradiated, pair-fed controls. The calculated RPFs were: Gland weight 1.9, maximum flow rate 2.9, volume of saliva 2.1 and duration of secretion 2.1 for a mean "relative protection" of 2.25. Substantial protection against radiomucositis in protected animals was evident by a progressive gain in body weight and lack of oral signs and symptoms as compared to non-protected animals. Protection against radiomucositis and preservation of residual parotid gland secretory capacity as determined by functional parameters suggests that WR-2721 may be of significant benefit in alleviating oral symptoms and maintaining salivary gland function for patients receiving radiotherapy for head and neck tumors. PMID:6090361

  5. Secondary radiation damage as the main cause for unexpected volume effects: A histopathologic study of the parotid gland

    SciTech Connect

    Konings, Antonius W.T. . E-mail: a.w.t.konings@med.umcg.nl; Faber, Hette; Cotteleer, Femmy; Vissink, Arjan; Coppes, Rob P.

    2006-01-01

    Purpose: To elucidate with a histopathological study the mechanism of region-dependent volume effects in the partly irradiated parotid gland of the rat. Methods and Materials: Wistar rats were locally X-irradiated with collimators with conformal radiation portals for 100% volume and 50% cranial/caudal partial volumes. Single doses up to 40 Gy were applied. Parotid saliva samples were collected, and the three lobes of the parotid gland were examined individually on the macro- and micromorphologic level up to 1 year after irradiation. Results: Dose-dependent loss of gland weight was observed 1 year after total or partial X-irradiation. Weight loss of the glands correlated very well with loss of secretory function. Irradiating the cranial 50% volume (implicating a shielded lateral lobe) resulted in substantially more damage in terms of weight loss and loss of secretory function than 50% caudal irradiation (shielding the ventral and dorsal lobe). Histologic examinations of the glands 1 year after irradiation revealed that the shielded lateral lobe was severely affected, in contrast to the shielded ventral and dorsal lobes. Time studies showed that irradiation of the cranial 50% volume caused late development of secondary damage in the shielded lateral lobe, becoming manifest between 240 and 360 days after irradiation. The possible clinical significance of this finding is discussed. Conclusion: It is concluded that the observed region-dependent volume effect for late function loss in the rat parotid gland after partial irradiation is mainly caused by secondary events in the shielded lateral lobe. The most probable first step (primary radiation event) in the development of this secondary damage is radiation exposure to the hilus region (located between the ventral and dorsal lobe). By injuring major excretory ducts and supply routes for blood and nerves in this area, the facility system necessary for proper functioning of the nonexposed lateral lobe is seriously affected

  6. Parotid gland involvement, the presenting sign of high grade non-Hodgkin lymphoma in two patients with Gaucher disease and sicca syndrome.

    PubMed

    Shvidel, L; Sigler, E; Shtalrid, M; Feldberg, E; Berrebi, A

    2007-10-01

    Increased risk of haematological malignancies has been described in Gaucher disease patients; however, high-grade lymphoma has been rarely observed. We report two patients with Gaucher disease and sicca syndrome diagnosed with aggressive lymphoma involving the parotid gland. A 29-year-old woman with Gaucher disease developed tumour of the left parotid gland. She reported chronic arthralgias, xerostomia and xerophthalmia. Parotid gland biopsy disclosed diffuse large B-cell lymphoma. No lymphadenopathy was found. Bone biopsy revealed focal lymphomatous infiltration consistent with stage IV disease. MACOP-B chemotherapy regimen (cyclophosphamide, adriamycin, methotrexate, bleomycin, vincristine, prednisone) resulted in complete remission for 15 years. A 76-year-old patient with Gaucher disease suffered from dry-mouth feeling. He developed a left parotid gland tumour. CT scan disclosed diffuse lymphadenopathy, pleural effusion and multiple lung nodules. A cervical lymph node biopsy revealed mantle cell lymphoma. Fine-needle aspiration of the parotid gland showed lymphoma cells. Immunochemotherapy with fludarabine, cyclophosphamide and rituximab resulted in complete remission. Accumulation of the glucocerebroside in Gaucher disease activates macrophages, inducing release of pro-inflammatory cytokines which may be involved in the pathogenesis of second malignancy. Patients with Gaucher disease bear an increased risk of haematological malignancies; however, aggressive lymphoma has been described only occasionally. In both our patients the presenting sign of lymphoma was tumour of the parotid gland. The patients suffered from sicca syndrome, which increases risk for developing lymphoma. The underlying Gaucher disease and sicca syndrome might be implicated as immunological triggers for lymphoma occurrence and its propensity for the parotid gland in these patients. PMID:17703372

  7. Ultrasonic Nakagami-parameter characterization of parotid-gland injury following head-and-neck radiotherapy: A feasibility study of late toxicity

    SciTech Connect

    Yang, Xiaofeng; Wu, Ning; Wang, Yuefeng; Tridandapani, Srini; Beitler, Jonathan J.; Yu, David S.; Curran, Walter J.; Liu, Tian; Bruner, Deborah W.

    2014-02-15

    Purpose: The study aims to investigate whether Nakagami parameters—estimated from the statistical distribution of the backscattered ultrasound radio-frequency (RF) signals—could provide a means for quantitative characterization of parotid-gland injury resulting from head-and-neck radiotherapy. Methods: A preliminary clinical study was conducted with 12 postradiotherapy patients and 12 healthy volunteers. Each participant underwent one ultrasound study in which ultrasound scans were performed in the longitudinal, i.e., vertical orientation on the bilateral parotids. For the 12 patients, the mean radiation dose to the parotid glands was 37.7 ± 9.5 Gy, and the mean follow-up time was 16.3 ± 4.8 months. All enrolled patients experienced grade 1 or 2 late salivary-gland toxicity (RTOG/EORTC morbidity scale). The normal parotid glands served as the control group. The Nakagami-scaling and Nakagami-shape parameters were computed from the RF data to quantify radiation-induced parotid-gland changes. Results: Significant differences in Nakagami parameters were observed between the normal and postradiotherapy parotid glands. Compared with the control group, the Nakagami-scaling parameter of the postradiotherapy group decreased by 25.8% (p < 0.001), and the Nakagami-shape parameter decreased by 31.3% (p < 0.001). The area under the receiver operating characteristic curve was 0.85 for the Nakagami-scaling parameter and was 0.95 for the Nakagami-shape parameter, which further demonstrated the diagnostic efficiency of the Nakagami parameters. Conclusions: Nakagami parameters could be used to quantitatively measure parotid-gland injury following head-and-neck radiotherapy. Moreover, the clinical feasibility was demonstrated and this study provides meaningful preliminary data for future clinical investigation.

  8. Purification and characterization of a high-Mr carbonic anhydrase from sheep parotid gland.

    PubMed Central

    Fernley, R T; Coghlan, J P; Wright, R D

    1988-01-01

    Approximately half the carbonic anhydrase activity of sheep parotid-gland homogenate is derived from a high-Mr protein [Fernley, Wright & Coghlan (1979) FEBS Lett. 105, 299-302]. This enzyme has now been purified to homogeneity, and its properties were compared with those of the well-characterized sheep carbonic anhydrase II. The protein has an apparent Mr of 540,000 as measured by gel filtration under non-denaturing conditions and an apparent subunit Mr of 45,000 as measured by SDS/polyacrylamide-gel electrophoresis. After deglycosylation with the enzyme N-glycanase the protein migrates with an apparent Mr of 36,000 on SDS/polyacrylamide-gel electrophoresis. The CO2-hydrating activity was 340 units/mg compared with 488 units/mg for sheep carbonic anhydrase II measured under identical conditions. This enzyme does not, however, hydrolyse p-nitrophenyl acetate. The enzyme contains 0.8 g-atom of zinc/mol of protein subunit. The peptide maps of the two carbonic anhydrases differ significantly from one another, indicating they are not related closely structurally. Unlike the carbonic anhydrase II isoenzyme, which has a blocked N-terminus, the high-Mr enzyme has a free glycine residue at its N-terminus. Images Fig. 4. Fig. 6. Fig. 7. PMID:3124821

  9. Nicotine derived genotoxic effects in human primary parotid gland cells as assessed in vitro by comet assay, cytokinesis-block micronucleus test and chromosome aberrations test.

    PubMed

    Ginzkey, Christian; Steussloff, Gudrun; Koehler, Christian; Burghartz, Marc; Scherzed, Agmal; Hackenberg, Stephan; Hagen, Rudolf; Kleinsasser, Norbert H

    2014-08-01

    Genotoxic effects of nicotine were described in different human cells including salivary gland cells. Based on the high nicotine concentration in saliva of smokers or patients using therapeutic nicotine patches, the current study was performed to evaluate the genotoxic potential of nicotine in human salivary gland cells. Therefore, primary salivary gland cells from 10 patients undergoing parotid gland surgery were exposed to nicotine concentrations between 1 μM and 1000 μM for 1 h in the absence of exogenous metabolic activation. The acinar phenotype was proven by immunofluorescent staining of alpha-amylase. Genotoxic effects were evaluated using the Comet assay, the micronucleus test and the chromosome aberration test. Cytotoxicity and apoptosis were determined by trypan blue exclusion test and Caspase-3 assay. Nicotine was able to induce genotoxic effects in all three assays. The chromosome aberration test was the most sensitive and increases in numerical and structural (chromatid-type and chromosome-type) aberrations were seen at ≥1 μM, whereas increases in micronuclei frequency were detected at 10 μM and DNA damage as measured in the Comet assay was noted at >100 μM. No cytotoxic damage or influence of apoptosis could be demonstrated. Nicotine as a possible risk factor for tumor initiation in salivary glands is still discussed controversially. Our results demonstrated the potential of nicotine to induce genotoxic effects in salivary gland cells. These results were observed at saliva nicotine levels similar to those found after oral or transdermal exposure to nicotine and suggest the necessity of careful monitoring of the use of nicotine in humans. PMID:24698733

  10. Radioprotection by WR-2721 of gamma-irradiated rat parotid gland: effect on gland weight and secretion at 8-10 days post irradiation

    SciTech Connect

    Menard, T.W.; Izutsu, K.T.; Ensign, W.Y.; Keller, P.J.; Morton, T.H.; Truelove, E.L.

    1984-09-01

    Changes in rat parotid salivary gland weight and functional parameters were evaluated at 8 to 10 days post irradiation in WR-2721 protected and non-protected animals following exposure to a single 15.3 Gy dose of Cs-137 radiation to the head. Glandular fluid secretory capacity was assessed by maximum flow rate, total volume of saliva and duration of secretion following pilocarpine stimulation. Protection against radiomucositis was also evaluated indirectly by daily monitoring of food and water intake, body weight and paraoral symptomatology. WR-2721 provided a significant degree of protection for all glandular functional parameters as well as gland weight. Relative protective factors (RPF) were computed for irradiated protected and non-protected animals compared to their sham-irradiated, pair-fed controls. Protection against radiomucositis and preservation of residual parotid gland secretory capacity as determined by functional parameters suggests that WR-2721 may be of significant benefit in alleviating oral symptoms and maintaining salivary gland function for patients receiving radiotherapy for head and neck tumors.

  11. Histological and histochemical study of the protective role of rosemary extract against harmful effect of cell phone electromagnetic radiation on the parotid glands.

    PubMed

    Ghoneim, Fatma M; Arafat, Eetmad A

    2016-06-01

    Electromagnetic fields (EMFs) are a class of non-ionizing radiation (NIR) that is emitted from mobile phone. It may have hazardous effects on parotid glands. So, we aimed to investigate the histological and histochemical changes of the parotid glands of rats exposed to mobile phone and study the possible protective role of rosemary against its harmful effect. Forty adult male albino rats were used in this study. They were classified into 4 equal groups. Group I (control), group II (control receiving rosemary), group III (mobile phone exposed group) and group IV (mobile exposed, rosemary treated group). Parotid glands were dissected out for histological and histochemical study. Moreover, measurement of oxidative stress markers; malondialdehyde (MDA) and total antioxidant capacity (TAC) was done. The results of this study revealed that rosemary has protective effect through improving the histological and histochemical picture of the parotid gland in addition of its antioxidant effect. It could be concluded from the current study, that exposure of parotid gland of rat models to electromagnetic radiation of mobile phone resulted in structural changes at the level of light and electron microscopic examination which could be explained by oxidative stress effect of mobile phone. Rosemary could play a protective role against this harmful effect through its antioxidant activity.

  12. Histological and histochemical study of the protective role of rosemary extract against harmful effect of cell phone electromagnetic radiation on the parotid glands.

    PubMed

    Ghoneim, Fatma M; Arafat, Eetmad A

    2016-06-01

    Electromagnetic fields (EMFs) are a class of non-ionizing radiation (NIR) that is emitted from mobile phone. It may have hazardous effects on parotid glands. So, we aimed to investigate the histological and histochemical changes of the parotid glands of rats exposed to mobile phone and study the possible protective role of rosemary against its harmful effect. Forty adult male albino rats were used in this study. They were classified into 4 equal groups. Group I (control), group II (control receiving rosemary), group III (mobile phone exposed group) and group IV (mobile exposed, rosemary treated group). Parotid glands were dissected out for histological and histochemical study. Moreover, measurement of oxidative stress markers; malondialdehyde (MDA) and total antioxidant capacity (TAC) was done. The results of this study revealed that rosemary has protective effect through improving the histological and histochemical picture of the parotid gland in addition of its antioxidant effect. It could be concluded from the current study, that exposure of parotid gland of rat models to electromagnetic radiation of mobile phone resulted in structural changes at the level of light and electron microscopic examination which could be explained by oxidative stress effect of mobile phone. Rosemary could play a protective role against this harmful effect through its antioxidant activity. PMID:27155802

  13. The Diagnostic Value of B-Mode Sonography in Differentiation of Malignant and Benign Tumors of the Parotid Gland

    PubMed Central

    Khalife, Ali; Bakhshaee, Mehdi; Davachi, Behrouz; Mashhadi, Leila; Khazaeni, Kamran

    2016-01-01

    Introduction: Different imaging modalities are used to evaluate salivary gland diseases, including tumors. Ultrasonography (US) is the preferred method on account of its ease of use, affordability, safety profile, and good tolerance among patients. The aim of this study was to evaluate the role of US in differentiating malignant from benign parotid tumors, in the context of previous controversy in the literature on this subject. Materials and Methods: A cross-sectional study was performed in patients who presented to Qaem Medical Center with parotid masses and who were candidates for parotidectomy between June 2013 and January 2015. Patients were initially referred for a diagnostic US of the parotid. US examinations were performed and sonographic features were reported. The tumors were then classified as benign or malignanton the basis of literature descriptions of the US features of parotid tumors, and were next diagnosed pathologically. The sensitivity, specificity, positive predictive value, and negative predictive value of US for the purpose of differentiating malignant from benign tumors were then calculated. Results: Twenty-eight patients (aged 18–92 years) underwent US of parotid masses. Twenty-three tumors were diagnosed as benign and five were diagnosed as malignant. The final histopathologic examination showed 21 benign and seven malignant tumors. The sensitivity, specificity, positive predictive value, and negative predictive value of US for differentiating malignant from benign tumors were calculated as 57%, 95%, 80%, and 87%, respectively. Conclusion: US has a high specificity in differentiating between malignant and benign tumors. However, fine needle aspiration or core needle biopsy is advocated for an exact diagnosis. PMID:27738606

  14. Is ultrasound alone sufficient for imaging superficial lobe benign parotid tumours before surgery?

    PubMed

    Brennan, P A; Herd, M K; Howlett, D C; Gibson, D; Oeppen, R S

    2012-06-01

    Ultrasound (US) is a valuable technique for the assessment of salivary gland disease and regional nodes. When used in combination with fine needle aspiration cytology (FNAC) or core biopsy it has a high sensitivity and specificity in the diagnosis of tumours. The role of additional cross-sectional imaging (computed tomography (CT) or magnetic resonance (MR)) to help with the diagnosis of benign parotid tumours is questionable except when there is deep lobe extension or the suggestion of malignancy. We investigated 37 FNAC-confirmed benign parotid tumours in patients who had undergone both US and CT or MRI investigations, to find out whether cross-sectional imaging had provided any further useful diagnostic information before operation. Three patients had bilateral Warthin tumours. Tumours ranged in size from 11 to 45 mm (mean 22). Of the 37 patients 35 (95%) had a clearly delineated mass in the superficial lobe of the parotid on US and no further information was gained from additional CT or MRI. On US 34 patients (92%) had features suggestive of a benign tumour, and three had features suggestive of malignancy but these were found to be benign on FNAC and after operation. CT or MRI confirmed these suspicious findings. In two different patients the deep margin was not visible on US (suggestive of deep lobe extension) and this was confirmed on MRI. The mean time delay between US and CT or MRI was four weeks (range 1-44). These results suggest that additional imaging is not required in most patients with a sonographically and FNAC confirmed benign lesion confined to the superficial lobe of the parotid and confirmed by FNAC or biopsy examination.

  15. Oncocytoma: the vanishing parotid mass.

    PubMed

    Patel, N D; van Zante, A; Eisele, D W; Harnsberger, H R; Glastonbury, C M

    2011-10-01

    Parotid gland oncocytoma is an uncommon, benign salivary neoplasm composed of mitochondria-rich oncocytes. The purpose of this study was to correlate MR imaging and histopathology of parotid gland oncocytomas and to define the features that may distinguish these neoplasms from other benign and malignant parotid gland tumors. The MR imaging features in 9 patients with a pathologic diagnosis of oncocytoma were retrospectively reviewed. The imaging features were strikingly similar for 8 of the 9 patients. All lesions appeared T1 hypointense but isointense to the native parotid gland on fat-saturated T2 and postcontrast T1 imaging. On MR imaging, parotid gland oncocytomas share specific imaging characteristics that have not been described for benign or malignant parotid gland tumors. Oncocytomas are isointense to native parotid gland on fat-saturated T2 and T1 postcontrast MR images. Preoperative identification of correct histology may help surgical planning.

  16. A Case of Metastatic Head and Neck Squamous Cell Carcinoma with Multiple Treatments Including Stereotactic Ablative Body Radiotherapy Alone for Oligometastases to the Parotid Gland

    PubMed Central

    Pederson, Aaron

    2015-01-01

    Head and neck squamous cell carcinoma (HNSCC) has a reported average of around 15% metastases at presentation with chemotherapy being the mainstay of treatment for widely metastatic disease. However, in select patients with oligometastatic disease, local ablative therapy (commonly including surgery or radiotherapy) can be utilized with the possibility of improving survival, decreasing morbidity from the metastases, and obviating the need for systemic therapy with its possible side effects. However, most research has been of ablative therapy has been performed for pulmonary and hepatic oligometastatic lesions.  In this case, we present a patient who initially presented with a metastatic base of tongue malignancy with left axilla metastases who was treated palliatively with systemic therapy with an initial complete response. She subsequently progressed on maintenance therapy with a locoregional recurrence that was treated with definitive chemoradiation with complete response. There was a subsequent recurrence again in the left axilla that was treated as well with chemoradiation with complete response. Next, there was a recurrence in the right occipital lobe and left parotid gland with treatment with surgical resection, plus stereotactic radiotherapy boost and stereotactic ablative body radiotherapy (SABR), respectively. This all occurred over a 30-month time frame from initial therapy to her last treatment, with an additional 42 months at the present time with no recurrence.  This case highlights the future of care of oligometastatic disease of HNSCC with potential long-term survival in appropriately selected patients treated with stereotactic ablative body radiotherapy. Furthermore, this is one of the first reported cases in the literature of SABR for an oligometastatic lesion of the parotid gland, especially from squamous cell carcinoma (SCC) of the oral cavity, with no recurrence of disease over 40 months removed from treatment. PMID:26858919

  17. The effect of carbonic anhydrase inhibitors on secretion by the parotid and mandibular glands of red kangaroos Macropus rufus.

    PubMed

    Beal, A M

    1991-01-01

    The effects of carbonic anhydrase inhibitors on secretion by macropodine parotid and mandibular glands were investigated using anaesthetized red kangaroos. In the parotid gland, acetazolamide (500 mumol.l-1) reduced a stable acetylcholine-evoked, half-maximal flow rate of 2.02 +/- 0.034 to 0.27 +/- 0.023 ml.min-1 (87% reduction). Concurrently, salivary bicarbonate concentration and secretion fell (129.4 +/- 1.46 to 80.9 +/- 1.63 mmol.l-1 and 264.8 +/- 7.96 to 22.3 +/- 2.30 mumol.min-1, respectively), phosphate and chloride concentrations rose (14.0 +/- 0.79 to 27.6 +/- 0.85 mmol.l-1 and 5.6 +/- 0.25 to 27.5 +/- 1.32 mmol.l-1, respectively), sodium concentration and osmolality were unaltered, and potassium concentration fell (8.8 +/- 0.33 to 6.4 +/- 0.29 mmol.l-1). High-rate cholinergic stimulation during acetazolamide blockade was unable to increase salivary flow beyond 11 +/- 0.9% of that for equivalent unblocked control stimulation. However, superimposition of isoprenaline infusion on the acetylcholine stimulation caused a three-fold increase in the blocked flow rate. These treatments were accompanied by small increases in salivary phosphate and chloride concentrations but not bicarbonate concentration. Methazolamide infusion caused similar changes in parotid secretion. In the mandibular gland, acetazolamide infusion had no effect on salivary flow rate during either low- or high-level acetylcholine stimulation. Acetazolamide caused no alterations in salivary electrolyte secretion at low flow rates, but curtailed the rise in bicarbonate concentration associated with high-level acetylcholine stimulation. Acetazolamide administration did not affect the increase in salivary flow rate associated with isoprenaline infusion, but did block the concomitant increase in bicarbonate concentration and secretion substantially.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Carcinoma ex-pleomorphic adenoma of the parotid gland consisting of high-grade salivary duct carcinoma and keratinizing squamous cell carcinoma.

    PubMed

    Magaki, Shino D; Bhuta, Sunita; Abemayor, Elliot; Nabili, Vishad; Sepahdari, Ali R; Lai, Chi K

    2015-09-01

    Carcinoma ex-pleomorphic adenoma (CXPA) is a rare salivary gland malignancy that presents diagnostic difficulties partly because of its wide range of histologic presentations. We report a case of a 77-year-old man, who presented with a 6-year history of a parotid mass that had undergone rapid growth within weeks. Magnetic resonance imaging revealed an infiltrative mass in the parotid gland, and the fine-needle aspiration (FNA) biopsy result was highly suspicious for carcinoma. Subsequent excision of the tumor demonstrated a poorly differentiated epithelial neoplasm consisting of keratinizing squamous cell carcinoma (SCC) and adenocarcinoma with regions of both ductal carcinoma in situ and invasive salivary duct carcinoma (SDC). Only focal areas exhibited a benign pleomorphic adenoma component. To our knowledge, this is the first case of a CXPA that consists of both a high-grade SDC and a keratinizing SCC in the parotid gland.

  19. Jacques-Louis David's tumour: an opportunity to study the natural history of a pleomorphic adenoma of the parotid gland.

    PubMed

    Wine, Humphrey; Baum, Michael

    2008-12-01

    The great artist and one-time revolutionary, Jacques-Louis David died in 1825. The cause of his death has been open to speculation. An extraordinary sequence of portraits of the artist describes his transition from handsome middle age to a deformed old man. During this phase a swelling appears at the angle of his left jaw and over a period of 20 years a facial palsy can be diagnosed. We submit that this evidence suggests that malignant transformation of a pleomorphic adenoma of the parotid gland was the proximal cause of his death.

  20. Impact of Node Negative Target Volume Delineation on Contralateral Parotid Gland Dose Sparing Using IMRT in Head and Neck Cancer.

    PubMed

    Magnuson, William J; Urban, Erich; Bayliss, R Adam; Harari, Paul M

    2015-06-01

    There is considerable practice variation in treatment of the node negative (N0) contralateral neck in patients with head and neck cancer. In this study, we examined the impact of N0 neck target delineation volume on radiation dose to the contralateral parotid gland. Following institutional review board approval, 12 patients with head and neck cancer were studied. All had indications for treatment of the N0 neck, such as midline base of tongue or soft palate extension or advanced ipsilateral nodal disease. The N0 neck volumes were created using the Radiation Therapy Oncology Group head and neck contouring atlas. The physician-drawn N0 neck clinical target volume (CTV) was expanded by 25% to 200% to generate volume variation, followed by a 3-mm planning target volume (PTV) expansion. Surrounding organs at risk were contoured and complete intensity-modulated radiation therapy plans were generated for each N0 volume expansion. The median N0 target volume drawn by the radiation oncologist measured 93 cm(3) (range 71-145). Volumetric expansion of the N0 CTV by 25% to 200% increased the resultant mean dose to the contralateral parotid gland by 1.4 to 8.5 Gray (Gy). For example, a 4.1-mm increase in the N0 neck CTV translated to a 2.0-Gy dose increase to the parotid, 7.4 mm to a 4.5 Gy dose increase, and 12.5 mm to an 8.5 Gy dose increase, respectively. The treatment volume designated for the N0 neck has profound impact on resultant dose to the contralateral parotid gland. Variations of up to 15 mm are routine across physicians in target contouring, reflecting individual preference and training expertise. Depending on the availability of immobilization and image guidance techniques, experts commonly recommend 3 to 10 mm margin expansions to generate the PTV. Careful attention to the original volume of the N0 neck CTV, as well as expansion margins, is important in achieving effective contralateral gland sparing to reduce the resultant xerostomia and dysguesia that may ensue

  1. Metastasizing mixed tumor of the parotid gland: a rare tumor with unusually rapid progression in a cardiac transplant recipient.

    PubMed

    Sampson, B A; Jarcho, J A; Winters, G L

    1998-11-01

    We report the case of a 69-year-old man who had a mixed tumor (pleomorphic adenoma) removed from his parotid gland 3 years after orthotopic heart transplantation. Two years later, he presented with widely metastatic mixed tumor, which resulted in his death within 6 months. Metastatic mixed tumor is histologically identical to a benign mixed tumor, but it inexplicably metastasizes. Such tumors are rare and have not been reported to date in a transplant recipient. This case illustrates the rapid and aggressive course that malignancies can follow in an immunosuppressed population. Mixed tumors are common salivary neoplasms, so transplant recipients should be carefully followed after resection for evidence of metastatic spread.

  2. [Problems in diagnosis and therapy of carcinoma in stroma-abundant pleomorphic adenoma of the parotid gland].

    PubMed

    Stojadinovic, S; Reinert, S; Philippou, S

    1998-09-01

    The case is reported of a 27-year-old patient who developed multiple recurrences of a carcinoma arising from richly stromal pleomorphic adenoma of the parotid gland over 13 years. Originally the tumor was classified as a benign pleomorphic adenoma because there were no cytological characteristics of malignancy. Later on the diagnosis had to be modified to that of a carcinoma arising from a pleomorphic adenoma because of the infiltrating growth pattern of the tumor. A multicentric local recurrence and metastases on the left side of the neck supported the correct diagnosis. This case demonstrates that, beside the classic cytological criteria of malignancy invasion and penetration of the capsule can be decisive for the diagnosis of malign transformed pleomorphic adenoma. Treatment and prognosis of salivary gland tumors assume a clear determination of their diguity. The unusual course in this case of a pleomorphic adenoma originally diagnosed as benign demonstrates the importance of regular follow-up.

  3. Parotid Glands Dose–Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Replanning in Radiation Therapy of Head-and-Neck Cancer

    SciTech Connect

    Hunter, Klaudia U.; Fernandes, Laura L.; Vineberg, Karen A.; McShan, Daniel; Antonuk, Alan E.; Cornwall, Craig; Feng, Mary; Schipper, Mathew J.; Balter, James M.; Eisbruch, Avraham

    2013-11-15

    Purpose: Doses actually delivered to the parotid glands during radiation therapy often exceed planned doses. We hypothesized that the delivered doses correlate better with parotid salivary output than the planned doses, used in all previous studies, and that determining these correlations will help make decisions regarding adaptive radiation therapy (ART) aimed at reducing the delivered doses. Methods and Materials: In this prospective study, oropharyngeal cancer patients treated definitively with chemoirradiation underwent daily cone-beam computed tomography (CBCT) with clinical setup alignment based on the C2 posterior edge. Parotid glands in the CBCTs were aligned by deformable registration to calculate cumulative delivered doses. Stimulated salivary flow rates were measured separately from each parotid gland pretherapy and periodically posttherapy. Results: Thirty-six parotid glands of 18 patients were analyzed. Average mean planned doses was 32 Gy, and differences from planned to delivered mean gland doses were −4.9 to +8.4 Gy, median difference +2.2 Gy in glands in which delivered doses increased relative to planned. Both planned and delivered mean doses were significantly correlated with posttreatment salivary outputs at almost all posttherapy time points, without statistically significant differences in the correlations. Large dispersions (on average, SD 3.6 Gy) characterized the dose–effect relationships for both. The differences between the cumulative delivered doses and planned doses were evident at first fraction (r=.92, P<.0001) because of complex setup deviations (eg, rotations and neck articulations), uncorrected by the translational clinical alignments. Conclusions: After daily translational setup corrections, differences between planned and delivered doses in most glands were small relative to the SDs of the dose–saliva data, suggesting that ART is not likely to gain measurable salivary output improvement in most cases. These differences were

  4. Plasma membrane of the rat parotid gland: preparation and partial characterization of a fraction containing the secretory surface

    PubMed Central

    1982-01-01

    A plasma membrane fraction from the rat parotid gland has been prepared by a procedure which selectively enriches for large membrane sheets. This fraction appears to have preserved several ultrastructural features of the acinar cell surface observed in situ. Regions of membrane resembling the acinar luminal border appear as compartments containing microvillar invaginations, bounded by elements of the junctional complex, and from which basolateral membranes extend beyond the junctional complex either to contact other apical compartments or to terminate as free ends. Several additional morphological features of the apical compartments suggest that they are primarily derived from the surface of acinar cells, rather than from the minority of other salivary gland cell types. Enzymatic activities characteristically associated with other cellular organelles are found at only low levels in the plasma membrane fraction. The fraction is highly enriched in two enzyme activities--K+ -dependent p-nitrophenyl phosphatase (K+ -NPPase, shown to be Na+/K+ adenosine triphosphatase; 20-fold) and gamma- glutamyl transpeptidase (GGTPase; 26-fold)--both known to mark plasma membranes in other tissues. These activities exhibit different patterns of recovery during fractionation, suggesting their distinct distributions among parotid cellular membranes. Secretion granule membranes also exhibit GGTPase, but no detectable K+ -NPPase. Since Na+/K+ adenosine triphosphatase and GGTPase, respectively, mark the basolateral and apical cellular surfaces in other epithelia, we hypothesize that these two enzymes mark distinct domains in the parotid plasmalemma, and that GGTPase, as the putative apical marker, may signify a compositional overlap between the two types of membranes which fuse during exocytosis. PMID:6128347

  5. Retrospective analysis of a combined endoscopic and transcutaneous technique for the management of parotid salivary gland stones.

    PubMed

    Numminen, Jura; Sillanpää, Saara; Virtanen, Jussi; Sipilä, Markku; Rautiainen, Markus

    2014-01-01

    Sialendoscopy is used in the diagnosis and treatment of various symptoms relating to the salivary gland, e.g. chronic swelling or obstruction and inflammation of the salivary duct. Small intraductal stones can be removed with various instruments during sialendoscopy, whereas larger ones can be fragmented with extracorporeal shockwave lithotripsy or laser. However, 5-10% of the patients with parotid stones cannot be treated with these methods. In patients with large impacted stones or stones in a hilus area, a combined endoscopic and transcutaneous technique can be employed. The stone is approached endoscopically, a skin flap is raised over or a small incision is made through the illuminated area, and the stone is removed by an external route with minimal morbidity. This retrospective study analysed the cases of 8 patients treated using the combined technique, 6 of whom became symptom free. Superficial parotidectomy was performed in 1 patient. No complications were observed, and ductal stents were not used. The average diameter of the stones was 7.6 mm (range 7.0-10.2). The combined technique is recommended for the removal of large and impacted intraductal stones in the parotid gland. No major complications have been reported.

  6. Quantification of Trade-Off Between Parotid Gland Sparing and Planning Target Volume Underdosages in Clinically Node-Negative Head-and-Neck Intensity-Modulated Radiotherapy

    SciTech Connect

    Kruijf, Wilhelmus de . E-mail: kruijf.de.w@bvi.nl; Heijmen, Ben; Levendag, Peter C.

    2007-05-01

    Purpose: To quantify the trade-off between parotid gland sparing and planning target volume (PTV) underdosages for head-and-neck intensity-modulated radiotherapy. Methods and Materials: A planning study was performed for 4 patients with either soft palate or tonsil tumors treated with external radiotherapy up to 46 Gy. The trade-off between underdosages in the PTV and sparing of the parotid glands was investigated by systematically varying the optimization objectives for the inverse planning. A new way of presenting dose-volume information allows easy detection of small PTV subvolumes with underdosages that cannot be assessed in conventional cumulative dose-volume histograms. A simple radiobiological model to estimate the control probability for an electively irradiated neck level was developed. Results: The average dose to the parotid glands can decrease by >10 Gy by allowing the PTV to be underdosed in such a way that the radiobiological model predicts a decrease in subclinical disease control probability of (typically) 1% to a few percent. Conclusion: The trade-off between parotid gland sparing and underdosages in the PTV has been quantified by the use of an alternative method to present dose-volume information and by the use of a radiobiological model to predict subclinical disease control probability.

  7. A Comparison of Dose-Response Models for the Parotid Gland in a Large Group of Head-and-Neck Cancer Patients

    SciTech Connect

    Houweling, Antonetta C.; Philippens, Marielle E.P.; Dijkema, Tim; Roesink, Judith M.; Terhaard, Chris H.J.; Schilstra, Cornelis; Ten Haken, Randall K.; Eisbruch, Avraham; Raaijmakers, Cornelis P.J.

    2010-03-15

    Purpose: The dose-response relationship of the parotid gland has been described most frequently using the Lyman-Kutcher-Burman model. However, various other normal tissue complication probability (NTCP) models exist. We evaluated in a large group of patients the value of six NTCP models that describe the parotid gland dose response 1 year after radiotherapy. Methods and Materials: A total of 347 patients with head-and-neck tumors were included in this prospective parotid gland dose-response study. The patients were treated with either conventional radiotherapy or intensity-modulated radiotherapy. Dose-volume histograms for the parotid glands were derived from three-dimensional dose calculations using computed tomography scans. Stimulated salivary flow rates were measured before and 1 year after radiotherapy. A threshold of 25% of the pretreatment flow rate was used to define a complication. The evaluated models included the Lyman-Kutcher-Burman model, the mean dose model, the relative seriality model, the critical volume model, the parallel functional subunit model, and the dose-threshold model. The goodness of fit (GOF) was determined by the deviance and a Monte Carlo hypothesis test. Ranking of the models was based on Akaike's information criterion (AIC). Results: None of the models was rejected based on the evaluation of the GOF. The mean dose model was ranked as the best model based on the AIC. The TD{sub 50} in these models was approximately 39 Gy. Conclusions: The mean dose model was preferred for describing the dose-response relationship of the parotid gland.

  8. An automatic contour propagation method to follow parotid gland deformation during head-and-neck cancer tomotherapy.

    PubMed

    Faggiano, E; Fiorino, C; Scalco, E; Broggi, S; Cattaneo, M; Maggiulli, E; Dell'Oca, I; Di Muzio, N; Calandrino, R; Rizzo, G

    2011-02-01

    We developed an efficient technique to auto-propagate parotid gland contours from planning kVCT to daily MVCT images of head-and-neck cancer patients treated with helical tomotherapy. The method deformed a 3D surface mesh constructed from manual kVCT contours by B-spline free-form deformation to generate optimal and smooth contours. Deformation was calculated by elastic image registration between kVCT and MVCT images. Data from ten head-and-neck cancer patients were considered and manual contours by three observers were included in both kVCT and MVCT images. A preliminary inter-observer variability analysis demonstrated the importance of contour propagation in tomotherapy application: a high variability was reported in MVCT parotid volume estimation (p = 0.0176, ANOVA test) and a larger uncertainty of MVCT contouring compared with kVCT was demonstrated by DICE and volume variability indices (Wilcoxon signed rank test, p < 10(-4) for both indices). The performance analysis of our method showed no significant differences between automatic and manual contours in terms of volumes (p > 0.05, in a multiple comparison Tukey test), center-of-mass distances (p = 0.3043, ANOVA test), DICE values (p = 0.1672, Wilcoxon signed rank test) and average and maximum symmetric distances (p = 0.2043, p = 0.8228 Wilcoxon signed rank tests). Results suggested that our contour propagation method could successfully substitute human contouring on MVCT images.

  9. Cytological diagnosis of deep-seated cellular hemangioma of the parotid gland by using cell button technique

    PubMed Central

    Sharma, Sonam; Mannan, Rahul; Bhasin, Tejinder

    2016-01-01

    Intraparotid hemangioma of the children is a rare neoplasm, posing diagnostic dilemma to the diagnosticians as well as treating clinicians. A 2-month-old male infant presented with a diffuse swelling in the parotid region since birth that was gradually increasing in size. The ultrasonography (USG) report was suggestive of a right intraparotid mass of uncertain etiology; whereas magnetic resonance imaging (MRI) report inclined toward a mass associated with chronic inflammatory pathology. Fine-needle aspiration cytology (FNAC) suggested two differentials — a vascular neoplasm of the parotid gland and a spindle cell neoplasm with increased vascularity. The lesion was reaspirated and a cell button was constructed from the aspirated material to reach a conclusive diagnosis by histopathological evaluation and immunohistochemistry (IHC) before attempting any intervention to treat the infant. The final diagnosis after histopathological and IHC studies was given as deep cellular intraparotid hemangioma. Subsequently, the patient was treated with single sitting bleomycin sclerotherapy. A simple technique of cell button resulted in sparing of hospitalization and surgical procedure in the infant.

  10. TH-E-BRF-09: Gaussian Mixture Model Analysis of Radiation-Induced Parotid-Gland Injury: An Ultrasound Study of Acute and Late Xerostomia in Head-And-Neck Radiotherapy

    SciTech Connect

    Liu, T; Yu, D; Beitler, J; Curran, W; Yang, X; Tridandapani, S; Bruner, D

    2014-06-15

    Purpose: Xerostomia (dry mouth), secondary to parotid-gland injury, is a distressing side-effect in head-and-neck radiotherapy (RT). This study's purpose is to develop a novel ultrasound technique to quantitatively evaluate post-RT parotid-gland injury. Methods: Recent ultrasound studies have shown that healthy parotid glands exhibit homogeneous echotexture, whereas post-RT parotid glands are often heterogeneous, with multiple hypoechoic (inflammation) or hyperechoic (fibrosis) regions. We propose to use a Gaussian mixture model to analyze the ultrasonic echo-histogram of the parotid glands. An IRB-approved clinical study was conducted: (1) control-group: 13 healthy-volunteers, served as the control; (2) acutetoxicity group − 20 patients (mean age: 62.5 ± 8.9 years, follow-up: 2.0±0.8 months); and (3) late-toxicity group − 18 patients (mean age: 60.7 ± 7.3 years, follow-up: 20.1±10.4 months). All patients experienced RTOG grade 1 or 2 salivary-gland toxicity. Each participant underwent an ultrasound scan (10 MHz) of the bilateral parotid glands. An echo-intensity histogram was derived for each parotid and a Gaussian mixture model was used to fit the histogram using expectation maximization (EM) algorithm. The quality of the fitting was evaluated with the R-squared value. Results: (1) Controlgroup: all parotid glands fitted well with one Gaussian component, with a mean intensity of 79.8±4.9 (R-squared>0.96). (2) Acute-toxicity group: 37 of the 40 post-RT parotid glands fitted well with two Gaussian components, with a mean intensity of 42.9±7.4, 73.3±12.2 (R-squared>0.95). (3) Latetoxicity group: 32 of the 36 post-RT parotid fitted well with 3 Gaussian components, with mean intensities of 49.7±7.6, 77.2±8.7, and 118.6±11.8 (R-squared>0.98). Conclusion: RT-associated parotid-gland injury is common in head-and-neck RT, but challenging to assess. This work has demonstrated that the Gaussian mixture model of the echo-histogram could quantify acute and late

  11. Unusual clinical presentation of cutaneous malignant melanoma metastatic to the parotid gland; initially discovered by fine needle aspiration: case report and review of literature.

    PubMed

    Elshenawy, Yasmin; Youngberg, George; Al-Abbadi, Mousa A

    2011-05-01

    We report a case of malignant melanoma (MM) metastatic to the parotid gland, initially discovered on fine needle aspiration (FNA). The patient presented with a mass in the parotid gland area with previous history only significant for prostatic carcinoma. The initial FNA impression was melanoma. The smears were hypercellular with bloody necrotic background. The cells were epithelioid with mild nuclear atypia. Discrete cytoplasmic pigmentation was seen. No lymphoglandular bodies were noticed. Fragments of benign salivary gland were also identified. The cytological diagnosis of MM triggered onsite thorough physical examination for potential primary, where a scalp pigmented lesion was discovered hidden by overlying covering hair. Our differential diagnosis included melanoma, metastatic carcinoma, and lymphoma. Further work up for melanoma with S100, HMB45, and Mart 1 confirmed our top differential diagnosis. We emphasize thorough physical examination in such circumstances, and the importance of onsite evaluation guiding clinicians looking for primary.

  12. Tenosynovial giant cell tumor presenting as a parotid gland mass: Expanding the differential diagnosis of giant cell-rich lesions in salivary glands.

    PubMed

    Guo, Ling; Qasem, Shadi; Bergman, Simon; Salih, Ziyan T

    2014-01-01

    Tenosynovial giant cell tumors (TGCT) are rare benign soft tissue tumors affecting mostly young adults. The most common affected sites include the knee, ankle, elbow, shoulder, and fingers. The temporomandibular joint is occasionally affected. Herein, we report a case of a 31-year-old Caucasian male who presented clinically with a parotid gland mass. The initial clinical and radiological work-up failed to reveal any involvement of the adjacent temporomandibular joint. Fine-needle aspiration revealed a cellular tumor composed of mononuclear and multinucleated giant cells with fibrosis and hemosiderin deposition. This was subsequently found to be a TGCT arising from the temporomandibular joint. Giant cell-rich lesions are uncommon in salivary glands. Herein, we describe the cytomorphology and clinico-radiographic features of this tumor with emphasis on the differential diagnosis of giant cell-rich lesions presenting in salivary glands. Despite its rare occurrence, this entity should be considered when giant cells are prominent in specimens acquired from this location.

  13. Ultrasound-assisted nonviral gene transfer of AQP1 to the irradiated minipig parotid gland restores fluid secretion.

    PubMed

    Wang, Z; Zourelias, L; Wu, C; Edwards, P C; Trombetta, M; Passineau, M J

    2015-09-01

    Xerostomia is a common side effect of ionizing radiation used to treat head and neck cancer. A groundbreaking Phase I human clinical trial using Adenoviral gene transfer of Aquaporin-1 (AQP1) to a single salivary gland of individuals suffering from radiation-induced xerostomia has recently been reported. Unfortunately, the limitations of the Adenoviral vector system used in this pioneering trial preclude its advancement to a Phase II trial, and we have thus undertaken to evaluate the therapeutic potential of ultrasound-assisted nonviral gene transfer (UAGT) as an alternative means of delivering AQP1 gene therapy to the salivary gland by comparing head-to-head with the canonical Adenoviral vector in a swine model. Swine irradiated unilaterally with a 10-Gy electron beam targeted at the parotid gland suffered from significant, sustained hyposalivation that was bilateral, despite irradiation being confined to the targeted gland. Unilateral AQP1 gene therapy with UAGT resulted in bilateral restoration of stimulated salivary flow at 48 h and 1 week post treatment (1.62±0.48 ml and 1.87±0.45 ml) to preinjury levels (1.34±0.14 ml) in a manner comparable to Adenoviral delivery (2.32±0.6 ml and 1.33±0.97 ml). UAGT can replace the Adenoviral vector as a means of delivering AQP1 gene therapy in the irradiated swine model, and it is a candidate for advancement to a Phase I human clinical trial.

  14. Ultrasound-assisted non-viral gene transfer of AQP1 to the irradiated minipig parotid gland restores fluid secretion

    PubMed Central

    Wang, Z; Zourelias, L; Wu, C; Edwards, PC; Trombetta, M; Passineau, MJ

    2015-01-01

    Rationale Xerostomia is a common side effect of ionizing radiation used to treat head and neck cancer. A groundbreaking Phase I human clinical trial utilizing Adenoviral gene transfer of Aquaporin-1 (AQP1) to a single salivary gland of individuals suffering from radiation-induced xerostomia has recently been reported. Unfortunately, the limitations of the Adenoviral vector system utilized in this pioneering trial preclude its advancement to a Phase II trial and we have thus undertaken to evaluate the therapeutic potential of ultrasound-assisted non-viral gene transfer (UAGT) as an alternative means of delivering AQP1 gene therapy to the salivary gland by comparing head-to-head with the canonical Adenoviral vector in a swine model. Findings Swine irradiated unilaterally with a 10Gy electron beam targeted at the parotid gland suffered from significant, sustained hyposalivation that was bilateral, despite irradiation being confined to the targeted gland. Unilateral AQP1 gene therapy with UAGT resulted in bilateral restoration of stimulated salivary flow at 48 hours and one week post-treatment (1.62+/−0.48ml, 1.87+/−0.45ml) to pre-injury levels (1.34+/−0.14ml) in a manner comparable to Adenoviral delivery (2.32+/−0.6ml, 1.33+/−0.97ml). Conclusions UAGT can replace the Adenoviral vector as a means of delivering AQP1 gene therapy in the irradiated swine model and is a candidate for advancement to a Phase I human clinical trial. PMID:25871828

  15. Primary Neuroendocrine Tumor of the Parotid Gland: A Case Report and a Comprehensive Review of a Rare Entity.

    PubMed

    Martínez-Sáez, Olga; Molina-Cerrillo, Javier; Moreno García Del Real, Carmen; Barberá Durban, Rafael; Díez, Juan J; Alonso-Gordoa, Teresa; Pulido, Enrique Grande

    2016-01-01

    Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies from cells derived from the neural crest with neuroendocrine differentiation. Despite the differences in the site of origin, nomenclature, biological behavior, and functional status, NETs share certain ultrastructural and immunohistochemical features. NETs are relative rare tumors with an annual incidence of 5.76 new cases per 100.000 inhabitants and they usually appear in the gastrointestinal tract or in the pulmonary system. Head and neck NETs are uncommon with limited information regarding frequency, most of them showing small cell carcinoma features. NETs that arise from the salivary glands are exceedingly rare. Regardless of their low frequency, it is imperative to accurately differentiate these tumors from the much more common squamous cell carcinomas and from metastasis from another primary tumor due to the completely different therapeutic approaches and prognosis. The diagnosis is based on the recognition of the typical neuroendocrine architecture and immunohistochemical staining and on an exhaustive work-up. Hereby, we report a case of a moderately differentiated NET of the parotid gland that was treated with a complete parotidectomy. We summarize the clues that led to the final diagnosis and major strategies that were employed to manage the patient. We also perform a comprehensive review of the scarce available literature on this topic.

  16. Primary Neuroendocrine Tumor of the Parotid Gland: A Case Report and a Comprehensive Review of a Rare Entity.

    PubMed

    Martínez-Sáez, Olga; Molina-Cerrillo, Javier; Moreno García Del Real, Carmen; Barberá Durban, Rafael; Díez, Juan J; Alonso-Gordoa, Teresa; Pulido, Enrique Grande

    2016-01-01

    Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies from cells derived from the neural crest with neuroendocrine differentiation. Despite the differences in the site of origin, nomenclature, biological behavior, and functional status, NETs share certain ultrastructural and immunohistochemical features. NETs are relative rare tumors with an annual incidence of 5.76 new cases per 100.000 inhabitants and they usually appear in the gastrointestinal tract or in the pulmonary system. Head and neck NETs are uncommon with limited information regarding frequency, most of them showing small cell carcinoma features. NETs that arise from the salivary glands are exceedingly rare. Regardless of their low frequency, it is imperative to accurately differentiate these tumors from the much more common squamous cell carcinomas and from metastasis from another primary tumor due to the completely different therapeutic approaches and prognosis. The diagnosis is based on the recognition of the typical neuroendocrine architecture and immunohistochemical staining and on an exhaustive work-up. Hereby, we report a case of a moderately differentiated NET of the parotid gland that was treated with a complete parotidectomy. We summarize the clues that led to the final diagnosis and major strategies that were employed to manage the patient. We also perform a comprehensive review of the scarce available literature on this topic. PMID:27610258

  17. Formation of post-confluence structure in human parotid gland acinar cells on PLGA through regulation of E-cadherin.

    PubMed

    Chan, Yen-Hui; Huang, Tsung-Wei; Chou, Ya-Shuan; Hsu, Sheng-Hao; Su, Wei-Fang; Lou, Pei-Jen; Young, Tai-Horng

    2012-01-01

    As a potential solution for patients to retrieve their lost salivary gland functions, tissue engineering of an auto-secretory device is profoundly needed. Under serum-free environment, primary human parotid gland acinar (PGAC) cells can be obtained. After reaching confluence, PGAC cells spontaneously form three-dimension (3D) cell aggregations, termed post-confluence structure (PCS), and change their behaviors. Poly (lactic-co-glycolic acid) (PLGA) has been widely used in the field of biomedical applications because of its biodegradable properties for desired functions. Nonetheless, the role of PLGA in facilitating PGAC cells to form PCS has seldom been explored to recover epithelial characteristics. In this study, PGAC cells were found to have a greater tendency to form PCS on PLGA than on tissue culture polystyrene (TCPS). By tracing cell migration paths and modulating E-cadherin activity with specific inhibitor or antibody, we demonstrated that the static force of homophilic interaction on surfaces of individual cells, but not the dynamics of cell migration, played a more important role in PCS formation. Thus, PLGA was successfully confirmed to support PGAC cells to form more PCS through the effects on enhancing E-cadherin expression, which is associated with FAK/ILK/Snail expression in PGAC cells. This result indicates that selective appropriate biomaterials may be potentially useful in generating 3D PCS on two-dimension (2D) substrate without fabricating a complex 3D scaffold.

  18. Primary Neuroendocrine Tumor of the Parotid Gland: A Case Report and a Comprehensive Review of a Rare Entity

    PubMed Central

    Molina-Cerrillo, Javier; Moreno García del Real, Carmen; Díez, Juan J.; Alonso-Gordoa, Teresa; Pulido, Enrique Grande

    2016-01-01

    Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies from cells derived from the neural crest with neuroendocrine differentiation. Despite the differences in the site of origin, nomenclature, biological behavior, and functional status, NETs share certain ultrastructural and immunohistochemical features. NETs are relative rare tumors with an annual incidence of 5.76 new cases per 100.000 inhabitants and they usually appear in the gastrointestinal tract or in the pulmonary system. Head and neck NETs are uncommon with limited information regarding frequency, most of them showing small cell carcinoma features. NETs that arise from the salivary glands are exceedingly rare. Regardless of their low frequency, it is imperative to accurately differentiate these tumors from the much more common squamous cell carcinomas and from metastasis from another primary tumor due to the completely different therapeutic approaches and prognosis. The diagnosis is based on the recognition of the typical neuroendocrine architecture and immunohistochemical staining and on an exhaustive work-up. Hereby, we report a case of a moderately differentiated NET of the parotid gland that was treated with a complete parotidectomy. We summarize the clues that led to the final diagnosis and major strategies that were employed to manage the patient. We also perform a comprehensive review of the scarce available literature on this topic.

  19. [Carcinoma in pre-existing Warthin tumors (cystadenolymphoma) of the parotid gland. Classification, pathogenesis and differential diagnosis].

    PubMed

    Seifert, G

    1997-09-01

    Malignant transformation of pre-existing Warthin tumours of the parotid gland in carcinomas is very rare compared with the development of carcinomas in pre-existing pleomorphic adenomas. Five cases examined in the Salivary Gland Register of Hamburg 1965-1996 were classified in 2 cases as mucoepidermoid carcinoma and in each of one case as oncocytic carcinoma, squamous cell carcinoma and acinic cell carcinoma. In the pathogenesis the benign oncocytic epithelial formations at the surface of the cystic spaces are restricted by malignant neoplastic epithelial cells in the course of which transitions of squamous cell metaplasia or goblet cell metaplasia can be observed. In the further course an infiltrating spread of the carcinoma takes place into the lymphoid stromal component of the Warthin tumour, sometimes also an infiltration of the surrounding tissue und rarely to cervical lymph node metastases. The own findings are analysed concerning the classification of the carcinomas and the differential diagnosis under consideration of the until now reported cases of the literature.

  20. Simian virus 40 sequences and expression of the viral large T antigen oncoprotein in human pleomorphic adenomas of parotid glands.

    PubMed

    Martinelli, Marcella; Martini, Fernanda; Rinaldi, Eliana; Caramanico, Laura; Magri, Eros; Grandi, Enrico; Carinci, Francesco; Pastore, Antonio; Tognon, Mauro

    2002-10-01

    Simian virus 40 (SV40) sequences of the early region coding for the large T antigen (Tag) oncoprotein were investigated in DNA samples from human pleomorphic adenoma (PA) of parotid glands. Specific SV40 sequences were detected, by PCR and filter hybridization with an internal oligoprobe, in 28 of 45 (62%) human PA specimens. None of the DNA samples from 11 normal salivary gland tissues was SV40-positive. DNA sequence analysis, carried out in all PCR amplified products from SV40-positive PA specimens, confirmed the SV40 specificity and indicated that PCR products had a sequence not distinguishable from SV40 DNA wild-type strain 776. SV40 Tag expression was revealed by immunohistochemistry with the specific monoclonal antibody Pab 101 in PA thin sections with a highly sensitive technical approach which retrieved the nuclear viral oncoprotein in 26 out of 28 (93%) samples previously found SV40-positive by PCR. Detection of SV40 sequences and Tag expression in human PA suggests that this oncogenic virus may play a role as a cofactor in the onset and/or progression of this benign neoplasm, or that SV40 DNA could replicate and express the Tag in PA cells.

  1. Primary Neuroendocrine Tumor of the Parotid Gland: A Case Report and a Comprehensive Review of a Rare Entity

    PubMed Central

    Molina-Cerrillo, Javier; Moreno García del Real, Carmen; Díez, Juan J.; Alonso-Gordoa, Teresa; Pulido, Enrique Grande

    2016-01-01

    Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies from cells derived from the neural crest with neuroendocrine differentiation. Despite the differences in the site of origin, nomenclature, biological behavior, and functional status, NETs share certain ultrastructural and immunohistochemical features. NETs are relative rare tumors with an annual incidence of 5.76 new cases per 100.000 inhabitants and they usually appear in the gastrointestinal tract or in the pulmonary system. Head and neck NETs are uncommon with limited information regarding frequency, most of them showing small cell carcinoma features. NETs that arise from the salivary glands are exceedingly rare. Regardless of their low frequency, it is imperative to accurately differentiate these tumors from the much more common squamous cell carcinomas and from metastasis from another primary tumor due to the completely different therapeutic approaches and prognosis. The diagnosis is based on the recognition of the typical neuroendocrine architecture and immunohistochemical staining and on an exhaustive work-up. Hereby, we report a case of a moderately differentiated NET of the parotid gland that was treated with a complete parotidectomy. We summarize the clues that led to the final diagnosis and major strategies that were employed to manage the patient. We also perform a comprehensive review of the scarce available literature on this topic. PMID:27610258

  2. Regional radiation dose susceptibility within the parotid gland: Effects on salivary loss and recovery

    SciTech Connect

    Clark, Haley Reinsberg, Stefan; Hovan, Allan; Thomas, Steven; Wu, Jonn

    2015-04-15

    Purpose: Xerostomia is one of the most likely late toxic effects of radiotherapy treatment in patients with head-and-neck cancers. Modern treatment techniques can incorporate knowledge of complication risk into treatment plans. To this end, the authors attempt to quantify the regional radiotherapy dose-dependence of salivary output loss and recovery in a prospective study. Methods: Salivary output was collected from patients undergoing radiotherapy treatment for head-and-neck cancers at the BC Cancer Agency between February 2008 and May 2013. Regional dose-dependence (i.e., dose susceptibility) of loss and recovery is quantified using nonparametric (Spearman’s rank correlation coefficients, local linear regression) and parametric (least-sum of squares, least-median of squares) techniques. Results: Salivary flow recovery was seen in 79 of 102 patients considered (p < 0.0001, Wilcoxon sign rank test). Output loss was strongly correlated with left- and right parotid combined dose φ = min (D{sub L},  45 Gy) + min (D{sub R},  45 Gy), and can be accurately predicted. Median early loss (three months) was 72% of baseline, while median overall loss (1 yr) was 56% of baseline. Fitting an exponential model to whole parotid yields dose sensitivities A{sub 3m} = 0.0604 Gy{sup −1} and A{sub 1y} = 0.0379 Gy{sup −1}. Recovery was not significantly associated with dose. Hints of lateral organ sub-segment dose–response dimorphism were observed. Conclusions: Sub-segmentation appears to predict neither loss nor recovery with any greater precision than whole parotid mean dose, though it is not any worse. Sparing the parotid to a combined dose φ of <50 Gy is recommended for a patient to keep ≈40% of baseline function and thus avoid severe xerostomia at 12 months post-treatment. It seems unlikely that a population’s mean recovery will exceed 20%–30% of baseline output at 1 yr after radiotherapy treatment using current (whole-organ based) clinical guidelines.

  3. Parotid Glands Dose-Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Re-Planning in Radiotherapy of Head and Neck Cancer

    PubMed Central

    Hunter, Klaudia U.; Fernandes, Laura; Vineberg, Karen A.; McShan, Daniel; Antonuk, Alan E.; Cornwall, Craig; Feng, Mary; Schipper, Mathew; Balter, James; Eisbruch, Avraham

    2013-01-01

    Purpose Doses actually delivered to the parotid glands during radiotherapy often exceed planned doses. We hypothesized that the delivered doses correlate better with parotid salivary output than the planned doses, used in all previous studies, and that determining these correlations will help decisions regarding adaptive re-planning (ART) aimed at reducing the delivered doses. Methods and Materials Prospective study: oropharyngeal cancer patients treated definitively with chemo-irradiation underwent daily cone beam CT (CBCT) with clinical set-up alignment based on C2 posterior edge. Parotid glands in the CBCTs were aligned by deformable registration to calculate cumulative delivered doses. Stimulated salivary flow rates were measured separately from each parotid gland pretherapy and periodically posttherapy. Results 36 parotid glands of 18 patients were analyzed. Average mean planned doses was 32 Gy and differences from planned to delivered mean gland doses were −4.9 to +8.4 Gy, median difference +2.2 Gy in glands whose delivered doses increased relative to planned. Both planned and delivered mean doses were significantly correlated with post-treatment salivary outputs at almost all post-therapy time points, without statistically significant differences in the correlations. Large dispersions [on average, standard deviation (SD) 3.6 Gy] characterized the dose/effect relationships for both. The differences between the cumulative delivered doses and planned doses were evident already at first fraction (r=0.92, p<0.0001) due to complex set-up deviations, e.g. rotations and neck articulations, uncorrected by the translational clinical alignments. Conclusions After daily translational set-up corrections, differences between planned and delivered doses in most glands were small relative to the SDs of the dose/saliva data, suggesting that ART is not likely to gain measurable salivary output improvement in most cases. These differences were observed already at first

  4. Reducing Xerostomia After Chemo-IMRT for Head-and-Neck Cancer: Beyond Sparing the Parotid Glands

    SciTech Connect

    Little, Michael; Schipper, Matthew; Feng, Felix Y.; Vineberg, Karen; Cornwall, Craig; Murdoch-Kinch, Carol-Anne; Eisbruch, Avraham

    2012-07-01

    Purpose: To assess whether, in addition to sparing the parotid glands (PGs), xerostomia after chemotherapy plus intensity-modulated radiotherapy (chemo-IMRT) for head-and-neck cancer is affected by reducing the dose to the other salivary glands. Patients and Methods: In a prospective study, 78 patients with Stage III-IV oropharynx/nasopharynx cancer underwent chemo-IMRT, with the aim of sparing the parts of the bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) outside the target (when contralateral level I was not a target). Before therapy and periodically for 24 months, validated patient-reported xerostomia questionnaire (XQ) scores and observer-graded xerostomia scores were recorded. Also, the stimulated and unstimulated saliva was measured selectively from each of the PGs and SMGs. The mean OC doses served as surrogates of minor salivary gland dysfunction. Regression models assessed the XQ and observer-graded xerostomia predictors. Results: Statistically significant predictors of the XQ score on univariate analysis included the OC, PG, and SMG mean doses and the baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. The OC, PG, and SMG mean doses were moderately intercorrelated (r = 0.47-0.55). On multivariate analyses, after adjusting for the PG and SMG doses, the OC mean dose (p < .0001), interval from RT (p < .0001), and stimulated PG saliva (p < .0025) were significant predictors of the XQ scores and the OC mean dose and time for observer-graded xerostomia. Although scatter plots showed no thresholds, an OC mean dose of <40 Gy and contralateral SMG mean dose of <50 Gy were each associated with low patient-reported and observer-rated xerostomia at almost all post-therapy points. Conclusion: The PG, SMG, and OC mean doses were significant predictors of both patient

  5. Hyalinizing clear cell carcinoma of the parotid gland: report of a recurrent case with aggressive cytomorphology and behavior diagnosed on fine-needle cytology sample.

    PubMed

    Fulciniti, Franco; Pia Curcio, Maria; Liguori, Giuseppina; Aquino, Gabriella; Botti, Gerardo; Campanile, Anna Cipolletta; De Cecio, Rossella; Pavone, Ettore; Aversa, Corrado; Perri, Francesco; Caponigro, Francesco; Ionna, Franco

    2014-01-01

    A case of recurrent hyalinizing clear cell carcinoma (HCCC) of the parotid gland in a 46-year-old female is here introduced. The patient had undergone a left superficial parotidectomy 6 months ago in another institution for an alleged benign, circumscribed mass 2.4 cm in diameter of the left parotid gland. Histopathological examination revealed a poorly differentiated HCCC bearing a EWSR-1 translocation on FISH examination. Fine Needle Cytology (FNC) was performed on three separate soft tissue masses in the pre-masseterine area and a cytological diagnosis of recurrent, poorly differentiated, possibly aggressive variant of HCCC, was rendered. FISH performed on a destained Diff Quik stained smear demonstrated an ESWR-1 translocation, which supported the cytopathological diagnosis. The cytomorphologic features and the differential diagnosis of this aggressive variant of HCCC are briefly discussed.

  6. Parotid tumors in children.

    PubMed

    Jaques, D A; Krolls, S O; Chambers, R G

    1976-10-01

    Most salivary gland tumors, both benign and malignant, develop within the parotid glands. Although an overwhelming majority of tumors are reported in the adult population, the parotid glands are also the most frequently involved salivary glands in the pediatric age group. This study represents a combination of case material from the Armed Forces Institute of Pathology and our personal experiences. Of approximately 10,000 salivary gland lesions accessioned in all ages, only 124 tumors occurred in the parotid gland in children less than fifteen years old. There were ninety benign and thirty-four malignant lesions. The two most common benign masses were mixed tumors and vascular lesions. The most common malignancies were the mucoepidermoid and acinic cell carcinomas. We recommended that all solid tumors be removed by parotidectomy.

  7. Cytomorphological features of papillary cystadenocarcinoma of parotid gland: A case report with review of literature.

    PubMed

    Joshi, Usha; Chufal, Sanjay Singh; Thapliyal, Naveen; Khetan, Harsh

    2016-01-01

    Papillary cystadenocarcinoma is a very rare slow growing malignant neoplasm characterized by cysts and intraluminal papillary projections. It is defined by WHO as a separate entity. On FNA, cytological features can mimic with various papillary and cystic neoplasms of salivary gland. It is also difficult to distinguish from benign salivary gland neoplasms as it has bland nuclear features. Thus we present cytomorphological features and discuss its differential diagnosis with neoplasms having prominent papillary architecture with review of literature.

  8. Low-level (gallium-aluminum-arsenide) laser irradiation of Par-C10 cells and acinar cells of rat parotid gland.

    PubMed

    Onizawa, Katsuhiro; Muramatsu, Takashi; Matsuki, Miwako; Ohta, Kazumasa; Matsuzaka, Kenichi; Oda, Yutaka; Shimono, Masaki

    2009-03-01

    We investigated cell response, including cell proliferation and expression of heat stress protein and bcl-2, to clarify the influence of low-level [gallium-aluminum-arsenide (Ga-Al-As) diode] laser irradiation on Par-C10 cells derived from the acinar cells of rat parotid glands. Furthermore, we also investigated amylase release and cell death from irradiation in acinar cells from rat parotid glands. The number of Par-C10 cells in the laser-irradiated groups was higher than that in the non-irradiated group at days 5 and 7, and the difference was statistically significant (P < 0.01). Greater expression of heat shock protein (HSP)25 and bcl-2 was seen on days 1 and 3 in the irradiated group. Assay of the released amylase showed no significant difference statistically between the irradiated group and the non-irradiated group. Trypan blue exclusion assay revealed that there was no difference in the ratio of dead to live cells between the irradiated and the non-irradiated groups. These results suggest that low-level laser irradiation promotes cell proliferation and expression of anti-apoptosis proteins in Par-C10 cells, but it does not significantly affect amylase secretion and does not induce rapid cell death in isolated acinar cells from rat parotid glands.

  9. Augmentation of cholinergic-mediated amylase release by forskolin in mouse parotid gland

    SciTech Connect

    Watson, E.L.; Singh, J.C.; Jacobson, K.L.

    1985-12-30

    Cholinergic-mediated amylase release in mouse parotid acini was augmented by forskolin; the potency but not the maximal response to carbachol was altered. Amylase released by carbachol plus forskolin was dependent on extracellular calcium and was mimicked by the calcium ionophore, A23187 plus forskolin. Forskolin was also shown to enhance carbachol-stimulated /sup 45/Ca/sup 2 +/ uptake into isolated acini. Hydroxylamine, nitroprusside, and 8-bromo-c-GMP each in combination with forskolin mimicked the effects of carbachol plus forskolin on amylase release. In the presence of carbachol (10/sup -8/M) forskolin did not augment c-AMP levels. However, in the presence of carbachol (5 x 10/sup -7/ M) or hydroxylamine (50 ..mu..M) forskolin did significantly augment c-AMP accumulation. These results suggest that calcium and c-GMP may mediate the augmentation of cholinergic-mediated amylase release by effects on c-AMP metabolism. 21 references, 1 figure, 3 tables.

  10. Prevention of irradiation-induced salivary hypofunction by rapamycin in swine parotid glands

    PubMed Central

    Zhu, Zhao; Pang, Baoxing; Iglesias-Bartolome, Ramiro; Wu, Xiaoshan; Hu, Lei; Zhang, Chunmei; Wang, Jinsong; Silvio Gutkind, J; Wang, Songlin

    2016-01-01

    Radiotherapy is commonly used in patients with oral cavity and pharyngeal cancers, usually resulting in irreversible salivary hypofunction. Currently management of radiation damage to salivary glands still remains a great challenge. Recent studies show that activation of mammalian target of rapamycin (mTOR) occurs in salivary gland lesions, making it possible to apply mTOR inhibitor for treatment. Our results indicate inhibition of mTOR by rapamycin significantly alleviated irradiation-induced salivary hypofunction by restoring 46% salivary flow rate and protecting histological structures in swine. Furthermore, rapamycin protected human submandibular gland cell line (HSG) from irradiation-induced cell depletion and loss of cell proliferation capacity. These findings lay the foundation for a new clinical application of rapamycin to prevent irradiation-induced salivary hypofunction. PMID:26958808

  11. Basal cell adenoma of the parotid gland: Cytological diagnosis of an uncommon tumor.

    PubMed

    Bhat, Amoolya; Rao, Madhuri; Geethamani, V; Shetty, Archana C

    2015-01-01

    Basal cell adenoma (BCA) is a rare benign epithelial tumor of the salivary gland, displaying monomorphic basaloid cells without a myxochondroid component, representing 1-3% of all salivary gland neoplasms seen predominantly in women over 50 years of age. It is uncommon in young adults. Cytodiagnosis of basaloid tumors chiefly basal cell adenoma of the salivary gland, is extremely challenging. The cytological differential diagnoses range from benign to malignant, neoplastic to non- neoplastic lesions. Histopathological examination is a must for definitive diagnosis, as these entities differ in prognosis and therapeutic aspects. We present a 22-years-old male with this uncommon diagnosis with a discussion on the role of cytological diagnosis. Fine needle aspiration cytology is a simple, minimally invasive method for the preoperative diagnosis of various types of neoplastic and non-neoplastic lesions. The knowledge of its pitfalls and limitations contributes to a more effective approach to treatment.

  12. Toxicity and Biodistribution of the Serotype 2 Recombinant Adeno-Associated Viral Vector, Encoding Aquaporin-1, after Retroductal Delivery to a Single Mouse Parotid Gland

    PubMed Central

    Yin, Hongen; Elbekai, Reem H.; Vallant, Molly; Chiorini, John A.

    2014-01-01

    In preparation for testing the safety of using serotype 2 recombinant adeno-associated vector, encoding Aquaporin-1 to treat radiation-induced salivary gland damage in a phase 1 clinical trial, we conducted a 13 week GLP biodistribution and toxicology study using Balb/c mice. To best assess the safety of rAAV2hAQP1 as well as resemble clinical delivery, vector (108, 109, 1010, or 4.4×1010 vector particles/gland) or saline was delivered to the right parotid gland of mice via retroductal cannulation. Very mild surgically induced inflammation was caused by this procedure, seen in 3.6% of animals for the right parotid gland, and 5.3% for the left parotid gland. Long term distribution of vector appeared to be localized to the site of cannulation as well as the right and left draining submandibular lymph nodes at levels >50 copies/μg in some animals. As expected, there was a dose-related increase in neutralizing antibodies produced by day 29. Overall, animals appeared to thrive, with no differences in mean body weight, food or water consumption between groups. There were no significant adverse effects due to treatment noted by clinical chemistry and pathology evaluations. Hematology assessment of serum demonstrated very limited changes to the white blood cell, segmented neutrophils, and hematocrit levels and were concluded to not be vector-associated. Indicators for liver, kidney, cardiac functions and general tissue damage showed no changes due to treatment. All of these indicators suggest the treatment is clinically safe. PMID:24667436

  13. Oncocytic mucoepidermoid carcinoma of the parotid gland: A case report and review of the literature.

    PubMed

    Jain, Deepali; Nayak, Nabeen C

    2015-07-01

    Oncocytic metaplasia rarely has been reported in mucoepidermoid carcinomas. Most salivary gland lesions with oncocytic change are benign; therefore, it is important to distinguish mucoepidermoid carcinoma from other entities that may show prominent oncocytic change. We report a rare case of oncocytic mucoepidermoid carcinoma in a 65-year-old woman.

  14. The Proteomes of Human Parotid and Submandibular/Sublingual Gland Salivas Collected as the Ductal Secretions

    PubMed Central

    Denny, Paul; Hagen, Fred K.; Hardt, Markus; Liao, Lujian; Yan, Weihong; Arellanno, Martha; Bassilian, Sara; Bedi, Gurrinder S.; Boontheung, Pinmannee; Cociorva, Daniel; Delahunty, Claire M.; Denny, Trish; Dunsmore, Jason; Faull, Kym F.; Gilligan, Joyce; Gonzalez-Begne, Mireya; Halgand, Frédéric; Hall, Steven C.; Han, Xuemei; Henson, Bradley; Hewel, Johannes; Hu, Shen; Jeffrey, Sherry; Jiang, Jiang; Loo, Joseph A.; Ogorzalek Loo, Rachel R.; Malamud, Daniel; Melvin, James E.; Miroshnychenko, Olga; Navazesh, Mahvash; Niles, Richard; Park, Sung Kyu; Prakobphol, Akraporn; Ramachandran, Prasanna; Richert, Megan; Robinson, Sarah; Sondej, Melissa; Souda, Puneet; Sullivan, Mark A.; Takashima, Jona; Than, Shawn; Wang, Jianghua; Whitelegge, Julian P.; Witkowska, H. Ewa; Wolinsky, Lawrence; Xie, Yongming; Xu, Tao; Yu, Weixia; Ytterberg, Jimmy; Wong, David T.; Yates, John R.; Fisher, Susan J.

    2009-01-01

    Saliva is a body fluid with important functions in oral and general health. A consortium of three research groups catalogued the proteins in human saliva collected as the ductal secretions: 1166 identifications—914 in parotid and 917 in submandibular/sublingual saliva—were made. The results showed that a high proportion of proteins that are found in plasma and/or tears are also present in saliva along with unique components. The proteins identified are involved in numerous molecular processes ranging from structural functions to enzymatic/catalytic activities. As expected, the majority mapped to the extracellular and secretory compartments. An immunoblot approach was used to validate the presence in saliva of a subset of the proteins identified by mass spectrometric approaches. These experiments focused on novel constituents and proteins for which the peptide evidence was relatively weak. Ultimately, information derived from the work reported here and related published studies can be used to translate blood-based clinical laboratory tests into a format that utilizes saliva. Additionally, a catalogue of the salivary proteome of healthy individuals allows future analyses of salivary samples from individuals with oral and systemic diseases, with the goal of identifying biomarkers with diagnostic and/or prognostic value for these conditions; another possibility is the discovery of therapeutic targets. PMID:18361515

  15. The proteomes of human parotid and submandibular/sublingual gland salivas collected as the ductal secretions.

    PubMed

    Denny, Paul; Hagen, Fred K; Hardt, Markus; Liao, Lujian; Yan, Weihong; Arellanno, Martha; Bassilian, Sara; Bedi, Gurrinder S; Boontheung, Pinmannee; Cociorva, Daniel; Delahunty, Claire M; Denny, Trish; Dunsmore, Jason; Faull, Kym F; Gilligan, Joyce; Gonzalez-Begne, Mireya; Halgand, Frédéric; Hall, Steven C; Han, Xuemei; Henson, Bradley; Hewel, Johannes; Hu, Shen; Jeffrey, Sherry; Jiang, Jiang; Loo, Joseph A; Ogorzalek Loo, Rachel R; Malamud, Daniel; Melvin, James E; Miroshnychenko, Olga; Navazesh, Mahvash; Niles, Richard; Park, Sung Kyu; Prakobphol, Akraporn; Ramachandran, Prasanna; Richert, Megan; Robinson, Sarah; Sondej, Melissa; Souda, Puneet; Sullivan, Mark A; Takashima, Jona; Than, Shawn; Wang, Jianghua; Whitelegge, Julian P; Witkowska, H Ewa; Wolinsky, Lawrence; Xie, Yongming; Xu, Tao; Yu, Weixia; Ytterberg, Jimmy; Wong, David T; Yates, John R; Fisher, Susan J

    2008-05-01

    Saliva is a body fluid with important functions in oral and general health. A consortium of three research groups catalogued the proteins in human saliva collected as the ductal secretions: 1166 identifications--914 in parotid and 917 in submandibular/sublingual saliva--were made. The results showed that a high proportion of proteins that are found in plasma and/or tears are also present in saliva along with unique components. The proteins identified are involved in numerous molecular processes ranging from structural functions to enzymatic/catalytic activities. As expected, the majority mapped to the extracellular and secretory compartments. An immunoblot approach was used to validate the presence in saliva of a subset of the proteins identified by mass spectrometric approaches. These experiments focused on novel constituents and proteins for which the peptide evidence was relatively weak. Ultimately, information derived from the work reported here and related published studies can be used to translate blood-based clinical laboratory tests into a format that utilizes saliva. Additionally, a catalogue of the salivary proteome of healthy individuals allows future analyses of salivary samples from individuals with oral and systemic diseases, with the goal of identifying biomarkers with diagnostic and/or prognostic value for these conditions; another possibility is the discovery of therapeutic targets.

  16. Effect of beta-antagonists on isoprenaline-induced secretion of fluid, amylase and protein by the parotid gland of the red kangaroo, Macropus rufus.

    PubMed

    Beal, A M

    2000-02-01

    Selective and non-selective beta-adrenoceptor antagonists were used to block the increases in fluid, protein and amylase secretion caused by sympathomimetic stimulation of the parotid gland of red kangaroos during intracarotid infusion of isoprenaline. ICI118551 at antagonist/agonist ratios up to 300:1 caused increasing but incomplete blockade of fluid secretion, and protein/amylase release. Atenolol at antagonist/agonist ratios up to 300:1 was only marginally more potent than ICI118551 at blocking the fluid, protein and amylase responses. Propranolol at antagonist/agonist ratios of 30:1 was as effective at blocking fluid and protein secretion as the highest ratios of either atenolol or ICI118551. Simultaneous administration of atenolol (30:1) with ICI118551 (30:1) was not as potent as propranolol (30:1). Thus, the beta-adrenoceptor/s in the acini of the kangaroo parotid gland appear to have antagonist-binding affinities atypical of those found for eutherian tissues. The data are consistent with the gland possessing either a single anomalous beta-adrenoceptor or functional beta(2)-receptors in addition to the beta(1)-receptors which are characteristic of eutherian salivary glands.

  17. Assessment of Parotid Gland Dose Changes During Head and Neck Cancer Radiotherapy Using Daily Megavoltage Computed Tomography and Deformable Image Registration

    SciTech Connect

    Lee, Choonik Langen, Katja M.; Lu Weiguo; Haimerl, Jason; Schnarr, Eric; Ruchala, Kenneth J.; Olivera, Gustavo H.; Meeks, Sanford L.; Kupelian, Patrick A.; Shellenberger, Thomas D.; Manon, Rafael R.

    2008-08-01

    Purpose: To analyze changes in parotid gland dose resulting from anatomic changes throughout a course of radiotherapy in a cohort of head-and-neck cancer patients. Methods and Materials: The study population consisted of 10 head-and-neck cancer patients treated definitively with intensity-modulated radiotherapy on a helical tomotherapy unit. A total of 330 daily megavoltage computed tomography images were retrospectively processed through a deformable image registration algorithm to be registered to the planning kilovoltage computed tomography images. The process resulted in deformed parotid contours and voxel mappings for both daily and accumulated dose-volume histogram calculations. The daily and cumulative dose deviations from the original treatment plan were analyzed. Correlations between dosimetric variations and anatomic changes were investigated. Results: The daily parotid mean dose of the 10 patients differed from the plan dose by an average of 15%. At the end of the treatment, 3 of the 10 patients were estimated to have received a greater than 10% higher mean parotid dose than in the original plan (range, 13-42%), whereas the remaining 7 patients received doses that differed by less than 10% (range, -6-8%). The dose difference was correlated with a migration of the parotids toward the high-dose region. Conclusions: The use of deformable image registration techniques and daily megavoltage computed tomography imaging makes it possible to calculate daily and accumulated dose-volume histograms. Significant dose variations were observed as result of interfractional anatomic changes. These techniques enable the implementation of dose-adaptive radiotherapy.

  18. Multinodular oncocytoma of the parotid gland: a benign lesion simulating malignancy.

    PubMed

    Ghandur-Mnaymneh, L

    1984-05-01

    Oncocytomas of the salivary glands are rare. Occasionally, they are multinodular, which imparts a malignant appearance. Only eight such cases have been reported, and an additional case is reported herein. Dense cytoplasmic acidophilia is an important clue in the identification of the lesion. When this feature is lacking, the lesion may be mistaken for the more aggressive acinic cell tumor. Histochemical strains are not as useful as generally believed. Electron miscroscopy confirms the diagnosis by demonstrating an abundance of mitochondria. The presence of oncocytic cellular buddings from the intercalated ducts and ductules surrounding the tumor and the lobular oncocytic transformation were important aids in the recognition of multinodular oncocytoma.

  19. High-grade adenocarcinoma, (ductal type) arising in unilateral Warthin tumor of the parotid gland.

    PubMed

    Deodhar, Kedar K; Shah, Milap; Chaturvedi, Pankaj

    2011-01-01

    Warthin tumor is a well-recognized benign salivary gland neoplasm consisting of an epithelial as well as a lymphoid component. Malignant transformation in Warthin tumor is rare and its reported incidence is up to 1%. The more common types of carcinomas described in Warthin tumor are the squamous and mucoepidermoid types, with high-grade adenocarcinoma being extremely rare. A high-grade adenocarcinoma (ductal type) arising in the Warthin tumor in a 72-year-old man is presented for its rarity and diagnostic difficulties.

  20. Evaluation of diagnostic parameters from parotid and submandibular dynamic salivary glands scintigraphy and unstimulated sialometry in Sjögren's syndrome.

    PubMed

    Dugonjić, Sanja; Stefanović, Dušan; Ethurović, Branka; Spasić-Jokić, Vesna; Ajdinović, Boris

    2014-01-01

    Our aim was to validate eight scintigraphic salivary gland (SG) parameters, as diagnostic parameters in patients with Sjögren's syndrome (SS). We used the standardized stimulated dynamic salivary gland scintigraphy (DSGS) protocol and correlated this with the unstimulated whole sialometry (UWS) functions. The DSGS and UWS tests meeting the European and the USA diagnostic classification criteria for SS were applied in twenty patients and in ten normal controls. The DSGS tests were performed 60min after the intravenous (i.v.) injection of 370MBq of technetium-99m-pertechnetate ((99m)TcO(-)4) and after per os stimulation with a 0.5g tablet of ascorbic acid administered 40min after the injection. Using time-activity curves, eight different parameters were calculated for each parotid gland (PG) and each submandibular salivary gland (SMG): a) time at maximum counts (Tmax), b) time at minimum counts (Tmin), c) maximum accumulation (MA), d) accumulation velocity (AV), e) maximum secretion (MS), f) maximum stimulated secretion (MSS), g) stimulated secretion velocity (SSV), and h) uptake ratio (UR). Values of UWS below 2.5mL/15min, were considered abnormal. All these parameters, as for the PG, showed significant abnormality in SS patients (P<0.001), especially of the secretion function. All SMG parameters also showed a significant abnormality (P<0.001), but especially of the accumulation function. There was a greater impairment of the above parameters in SMG than in PG in the SS patients. Sensitivity of the standardized DSGS was 100%, specificity 80%, negative prognostic value 100%, and positive prognostic value 91%. Sensitivity of UWS was 75%. In conclusion, this paper suggested that the best diagnostic parameters for the SS patients were those of: a) the maximum secretion, b) the maximum stimulated secretion for both the parotid and the submandibular glands, c) maximum accumulation and d) accumulation velocity of submandibular glands. The times at maximum and at minimum

  1. Pharmacological characterization of muscarinic receptors implicated in rabbit detrusor muscle contraction and activation of inositol phospholipid hydrolysis in rabbit detrusor and parotid gland.

    PubMed

    Barras, M; Coste, A; Eon, M T; Guillot, E

    1999-01-01

    In the present study, we evaluated the pharmacological characteristics of the functional muscarinic receptors implicated in rabbit detrusor contraction and coupled to inositol phospholipid turnover in rabbit detrusor and parotid gland. The selectivity of several muscarinic antagonists for detrusor vs. salivary gland muscarinic receptors was also examined. The affinities for the muscarinic m1-, m2- and m3-receptor subtypes were determined using membranes from human cloned receptors expressed in CHO-K1 cells using [3H]-N-methyl scopolamine as a radioligand. Anti-muscarinic activity was determined in isolated rabbit detrusor by measuring the displacement of the contractile response to carbachol, and in rabbit detrusor and rabbit parotid by measuring the displacement of inositol phospholipid hydrolysis (total inositol phosphate accumulation) to carbachol. A significant correlation was found between the potencies to antagonize carbachol-induced rabbit detrusor contraction (pK(B)) and the affinities (pKi) for the m3-receptor subtype (r = 0.93, P = 5 x 10(-6)). Lower, but significant, correlations [0.88 (P = 6.3 x 10(-5)), 0.72 (P = 4.6 x 10(-3))] were obtained with m1- or m2-receptor subtypes, respectively. Each muscarinic antagonist tested displayed similar potency to antagonize carbachol-stimulated inositol phospholipid hydrolysis in rabbit detrusor and parotid (r = 0.96, P = 8 x 10(-3)). A significant correlation was found between the potencies to antagonize carbachol-stimulated inositol phospholipid hydrolysis (pK(B)), determined in rabbit detrusor and rabbit parotid, and the affinities (pK(i)) for the m3-receptor subtype [r = 0.96 (P = 0.01), 0.99 (P = 5 x 10(-5)), respectively] and for the m1-receptor subtype [r = 0.98 (P = 3.5 x 10(-3)), 0.94 (P = 0.02), respectively] but not for the m2-receptor subtype [r = 0.33, 0.57, ns, respectively]. In each in vitro assay, methoctramine (preferential M2 selective antagonist) and pirenzepine (preferential M1 selective

  2. Mucoepidermoid carcinoma of parotid gland as a subsequent neoplasm in children treated for acute lymphoblastic leukemia.

    PubMed

    Sukumaran Nair, Reghu K; Rajeswari, Binitha; Thankamony, Priyakumari; Parukuttyamma, Kusumakumary

    2015-01-01

    We report two cases of mucoepidermoid carcinoma occurring as a second neoplasm following treatment for acute lymphoblastic leukemia. Both patients underwent parotidectomy as the primary treatment. One of them received irradiation in addition to surgery. We discuss the risk of developing MEC as a second malignancy, prognosis, and treatment options. PMID:26458645

  3. Bilateral parotid neoplasms.

    PubMed

    Williams, C

    1980-09-01

    We are reporting what we believe to be the second case of bilateral parotid neoplasm occuring synchronously with differing histologies. We believe that this neoplasm may represent a specific propensity of parotid tissue in a given individual to develop neoplasia in a multipotential glandular organ subject to many neoplastic diseases. There also exists the possibility that this condition may represent an immune deficiency specific to the parotid gland. The case reports that have been reviewed demonstrate that a secondary neoplasm may arise from benign mixed tumors. We question whether this is an example of monistic origin of acinic cell tumor from a mixed-cell tumor or, perhaps, dualistic expression for this salivary gland to develop a multiplicity of anaplastic and metaplastic growth variants. In approaching a case with bilateral parotid involvement, the physician must be aware of the rare possibility that benign and malignant tumors may coexist. He must be prepared to proceed with more radical extirpation than simple superficial parotidectomy.

  4. [The synchroneous tumors of different histopathology in the parotid salivary gland].

    PubMed

    Bień, Stanisław; Kamiński, Bartłomiej; Kopczyński, Janusz; Sygut, Jacek

    2006-01-01

    Ipsilateral salivary gland tumors of different histological types are very rare. Out of 196 parotidectomies performed (from 03. 2001 to 12. 2005), in 6 (3.06%) cases synchronous tumors of different type has been found in pathologic specimens. In 5 cases pleomorphic adenoma was one of synchronous tumor--in 2 cases with adenocarcinoma and in single cases with salivary duct carcinoma, adenolymphoma, and myoepithelioma. In one case, the adenolymphoma was synchronous with carcinoma planoepitheliale metastaticum from the primary in the skin post auricular area (late metastasis). Following the review of literature concerning the problem, two concepts has been critically discussed--the real synchronous occurrence of two different tumors, and transformation of benign tumor of salivary neoplasm to its malignant form.

  5. [Primary malignant solitary fibrous tumor/hemangiopericytoma of the parotid gland].

    PubMed

    Messa-Botero, Oscar Alberto; Romero-Rojas, Alfredo Ernesto; Chinchilla Olaya, Sandra Isabel; Díaz-Pérez, Julio Alexander; Tapias-Vargas, Luis Felipe

    2011-01-01

    Solitary fibrous tumor (SFT) was first described in the pleura by Lietaud in 1767; later in 1870, Wagner described the localized nature of this type of tumor and Klemperer and Rabin classified pleural tumors into two types: diffuse mesotheliomas and localized mesotheliomas. Recent years have seen the redefinition of this neoplasm, due to better technology; it is now proven that this neoplasm may have multiple different extrapleural origins including the head and neck regions. This diversity of locations is related to the particular mesenchymal histogenesis of SFT which allows its development from very unusual sites such as the salivary glands (SGs). In this particular site, this neoplasm is very infrequent and most of reported cases refer to benign disease, with just one case informed so far of primary malignant SFT.

  6. Cutaneous leiomyomatosis and parotid pleomorphic adenoma.

    PubMed

    Ocampo-Candiani, Jorge; Vázquez-Martínez, Osvaldo; Regalado-Briz, Arturo; Barboza-Quintana, Oralia; Méndez-Olvera, Nora

    2005-01-01

    We present a case of cutaneous leiomyomas (CL) arising in a pleomorphic adenoma (PA) of the parotid gland. PA and CL are benign tumors arising from the parotid gland and the erector pilli muscle, respectively. They both have a benign clinical course and in most cases leiomyomas are multiple in nature. PAs of the parotid are the most frequent benign tumors of the major salivary glands. To our knowledge this is the first case of PA with CL.

  7. Sci—Fri PM: Topics — 06: The influence of regional dose sensitivity on salivary loss and recovery in the parotid gland

    SciTech Connect

    Clark, H; Thomas, S; Moiseenko, V; Hovan, A; Wu, J

    2014-08-15

    Purpose: The Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC 2010) survey of radiation dose-volume effects on salivary gland function has called for improved understanding of intragland dose sensitivity and the effectiveness of partial sparing in salivary glands. Regional dose susceptibility of sagittally- and coronally-sub-segmented parotid gland has been studied. Specifically, we examine whether individual consideration of sub-segments leads to improved prediction of xerostomia compared with whole parotid mean dose. Methods: Data from 102 patients treated for head-and-neck cancers at the BC Cancer Agency were used in this study. Whole mouth stimulated saliva was collected before (baseline), three months, and one year after cessation of radiotherapy. Organ volumes were contoured using treatment planning CT images and sub-segmented into regional portions. Both non-parametric (local regression) and parametric (mean dose exponential fitting) methods were employed. A bootstrap technique was used for reliability estimation and cross-comparison. Results: Salivary loss is described well using non-parametric and mean dose models. Parametric fits suggest a significant distinction in dose response between medial-lateral and anterior-posterior aspects of the parotid (p<0.01). Least-squares and least-median squares estimates differ significantly (p<0.00001), indicating fits may be skewed by noise or outliers. Salivary recovery exhibits a weakly arched dose response: the highest recovery is seen at intermediate doses. Conclusions: Salivary function loss is strongly dose dependent. In contrast no useful dose dependence was observed for function recovery. Regional dose dependence was observed, but may have resulted from a bias in dose distributions.

  8. Analysis of parotid glands of primary Sjögren's syndrome patients using proteomic technology reveals altered autoantigen composition and novel antigenic targets

    PubMed Central

    Stea, E A; Routsias, J G; Samiotaki, M; Panayotou, G; Papalambros, E; Moutsopoulos, H M; Tzioufas, A G

    2007-01-01

    Sjögren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration, destruction of the salivary and lacrimal glands and production of autoantibodies against a variety of cellular proteins. The aberrant immune response against these autoantigens may begin or extend to other proteins that are not yet defined. Several studies have shown that autoantibody production is taking place in the affected salivary glands. In the present study, using proteomic approaches, we aimed to: (a) identify new autoantigens in the salivary glands of primary SS (pSS) patients and (b) evaluate the epigenetic changes of known autoantigens. Total parotid gland extracts of pSS patients were analysed using two-dimensional gel electrophoresis, sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblot with pSS patients' sera or purified autoantibodies and immunoprecipitation using homologous IgG. Identification of the unknown proteins was performed using mass spectrometry (MS). Immunoblot analysis on two-dimensional gels using purified anti-La/SSB antibodies revealed that pSS salivary glands contain high levels of post-translationally modified La/SSB autoantigen, while the native form of the protein is recognized faintly, in contrast to normal controls. Moreover, salivary glands of pSS patients contain post-translationally modified actin that becomes immunogenic in the microenviroment of the affected tissue. The alteration of the physicochemical properties of self-proteins could thus contribute to the break of immune tolerance against them. PMID:17177966

  9. Recurrent malignant salivary gland neoplasms.

    PubMed

    Rodriguez-Bigas, M A; Sako, K; Razack, M S; Shedd, D P; Bakamjian, V Y; Castillo, N B; Rao, U

    1989-10-01

    Recurrent salivary gland malignancies present difficult therapeutic decisions and poor prognosis in many instances, and treatment becomes of a palliative nature only. As many of the salivary gland malignancies we see are of the recurrent type, the following study was done to determine the efficacy of a vigorous attempt at retreatment. During the period January 1, 1960, through December 31, 1984, 352 patients with major and minor salivary gland tumors were evaluated at our institution. There were 149 benign lesions and 203 patients with malignant tumors. Of these, 99 patients had recurrent and metastatic tumors that had been treated initially elsewhere. Thirty-three of these patients were able to be treated with curative intent: surgery, 21; surgery plus radiation, 9; radiation therapy alone, 2; and radiation plus chemotherapy, 1. The 5 year survival with no evidence of disease was achieved in three patients with surgery alone and two patients with surgery plus radiation therapy. The group of five patients was comprised of two patients with adenoid cystic carcinomas of the parotid, one with intermediate grade mucoepidermoid carcinoma of the parotid, one, sebaceous cell carcinoma of the parotid, and one, adenoid cystic carcinoma of an accessory salivary gland. The results of this study serve to re-emphasize the relative poor yield of attempts at retreatment of loco-regional recurrence of salivary gland tumors.

  10. Efficacy and treatment-related toxicity of radiotherapy for early-stage primary non-Hodgkin lymphoma of the parotid gland

    SciTech Connect

    Olivier, Kenneth R. . E-mail: kolivier@ufl.edu; Brown, Paul D.; Stafford, Scott L.; Ansell, Stephen M.; Martenson, James A.

    2004-12-01

    Purpose: To assess the efficacy of radiotherapy (RT) in the treatment of primary non-Hodgkin lymphoma (NHL) of the parotid gland. Methods and materials: Data on 35 consecutive patients seen at Mayo Clinic between 1974 and 2000 with Ann Arbor Stage I and II NHL of the parotid gland were reviewed retrospectively. Radiotherapy was given to 23 patients, and 12 patients were observed. Eight patients received RT to local fields only. In addition to local fields, 9 patients received ipsilateral neck irradiation, and 6 patients received both ipsilateral and contralateral neck irradiation. Results: Median follow-up was 6.5 years (range, 2 months-24 years). Local control was significantly improved in the RT group compared with the observation group (p = 0.03). Both overall survival and disease-specific survival were 90% at 5 years and 71% at 10 years. There was no significant difference in disease-specific survival or overall survival between the RT and observation groups. Conclusions: The overall prognosis for this rare presentation of NHL is excellent. Radiotherapy provided significant improvement in local control with minimal morbidity and should be considered in the treatment of these patients.

  11. Synchronous extra-parotid Warthin's tumour.

    PubMed

    Nishikawa, H; Kirkham, N; Hogbin, B M

    1989-08-01

    Warthin's tumour (also known as adenolymphoma or papillary cystadenoma lymphomatosum) is benign and accounts for 12 per cent of all neoplasms of the parotid gland. A case of extra-parotid Warthin's tumour occurring synchronously in a peri-parotid lymph node is described. This is not a metastatic phenomenon and occurs as a result of salivary gland inclusions of local lymph nodes during the embryological development of the parotid. Extra-parotid Warthin's tumour should be regarded as a benign incidental finding and the prognosis is excellent.

  12. A Rare Case of an Epidermoid Cyst in the Parotid Gland - which was Diagnosed by Fine Needle Aspiration Cytology.

    PubMed

    Hegde, Panna N; Prasad H L, Kishan; Kumar Y, Sunil; Sajitha, K; Roy, Pooja Sarda; Raju, Mary; Shetty, Vikram

    2013-03-01

    Cystic lesions are common in the head and neck. The most common are the cutaneous cysts, which are referred to as epidermal cysts. These cysts present as nodular and fluctuant subcutaneous lesions and they are seen most commonly in the acne - prone areas like the head, neck and the back. They arise following a localized inflammation of the hair follicle and occasionally after the implantation of the epithelium, following a trauma or surgery. The presence of benign cystic lesions in the salivary glands is rare.We are presenting a rare case of a 55-year-old male who presented with a soft swelling on the left side of the face. A diagnosis of an epidermoid cyst was given on cytology. A superficial parotidectomy was performed and the histopathology confirmed the above diagnosis.

  13. Effect of clinical symptoms on the indication for selective neck dissection for N0 carcinomas of the parotid gland.

    PubMed

    Maruo, Takashi; Fujimoto, Yasushi; Yoshida, Kenji; Hiramatsu, Mariko; Suzuki, Atsushi; Nishio, Naoki; Shimono, Mariko; Nakashima, Tsutomu

    2014-07-01

    Lymph node metastasis is a major prognostic factor in parotid carcinoma, however, the pre-operative diagnosis of occult nodal metastasis is difficult in clinical N0 (cN0) parotid cancer patients. In addition, the indication of neck dissection in T1-3 cN0 patients is controversial. The current study investigated 17 patients with clinical T1-3 cN0 parotid cancer, and analyzed the correlation between patient symptoms/findings and pathological N status/tumor histological grade. In the statistical analysis, pain was found to significantly correlate with neck metastasis. Furthermore, cN0-staged patients without pain exhibited no neck metastasis. However, no significant correlation was identified between patient symptoms or findings and histological grade. These results indicate the possibility that selective neck dissection can be omitted for T1-3 cN0-staged patients without pain.

  14. Right Parotid Fibrolipoma: A Rare Lesion in a Child

    PubMed Central

    Rattan, Kamal Nain; Singh, Sunita

    2016-01-01

    Lipoma rarely involves parotid gland especially in children. An 11-year-old boy presented with right parotid swelling. Preoperative workup including CT scan and FNAC gave suspicion of parotid gland lipoma. The diagnosis was confirmed on histopathology after complete excision of the mass. PMID:27672580

  15. Right Parotid Fibrolipoma: A Rare Lesion in a Child.

    PubMed

    Rattan, Kamal Nain; Singh, Sunita; Bansal, Shruti

    2016-01-01

    Lipoma rarely involves parotid gland especially in children. An 11-year-old boy presented with right parotid swelling. Preoperative workup including CT scan and FNAC gave suspicion of parotid gland lipoma. The diagnosis was confirmed on histopathology after complete excision of the mass.

  16. Right Parotid Fibrolipoma: A Rare Lesion in a Child.

    PubMed

    Rattan, Kamal Nain; Singh, Sunita; Bansal, Shruti

    2016-01-01

    Lipoma rarely involves parotid gland especially in children. An 11-year-old boy presented with right parotid swelling. Preoperative workup including CT scan and FNAC gave suspicion of parotid gland lipoma. The diagnosis was confirmed on histopathology after complete excision of the mass. PMID:27672580

  17. Tumors of the major and minor salivary glands.

    PubMed

    McKenna, R J

    1984-01-01

    Surgery for salivary gland tumors requires technical skill, competence in head and neck anatomy, and a familiarity with a variety of tumors. Benign salivary tumors at all sites should be 100 percent curable, with a local recurrence rate of less than five percent; these local failures should be curable with further surgery. The majority of parotid tumors are benign. Sixty-two percent of patients with malignant parotid tumors will be alive at five years, 54 percent at 10 years, and 47 percent at 15 years. These survival rates for malignant parotid tumors are better than those for malignant tumors in the submaxillary and minor salivary glands and may be explained in part by the presence of a higher percentage of low-grade malignant tumors in the parotid gland. Since most submaxillary gland tumors are malignant, they are more dangerous than parotid tumors. A total of 80 percent of patients with submaxillary gland tumors die as a result of cancer. Almost all minor salivary gland tumors are malignant; curability relates to size, local extension, histology, and nodal metastases. Forty-five percent are alive at five years, and 21 percent at 15 years. Wide-field radical surgical excision is needed for malignant salivary tumors to minimize local recurrences and treatment failures. Future improvement in treatment results will be made possible by increased awareness of this group of tumors, earlier diagnosis when tumors are still small, more radical extirpation, and greater use of postoperative radiation therapy.

  18. A rare malignancy of the parotid gland in a 13-year-old Taiwanese boy: case report of a mammary analogue secretory carcinoma of the salivary gland with molecular study.

    PubMed

    Hwang, Michael J; Wu, Pei Ru; Chen, Chih-Ming; Chen, Chia-Yu; Chen, Chih-Jung

    2014-03-01

    Mammary analogue secretory carcinoma (MASC) is a recently described malignancy of the salivary glands characterized by an ETV6-NTRK3 (EN) fusion gene. Morphologically, MASC is sometimes difficult to distinguish from acinic cell carcinoma. Consequently, identifying the chromosomal translocation is essential for diagnosis. We present a case of parotid gland MASC in a 13-year-old boy. To the best of our knowledge, this is the youngest case reported in the literature. Histologic evaluation showed a tumor composed of microcysts, tubular structures, solid nests, or papillary architecture, with secretions within the lumens of the cysts or tubules. Immunohistochemically, tumor cells showed diffuse positive staining of S-100 protein, cytokeratin 19, and vimentin. ETV6 rearrangement was detected by fluorescence in situ hybridization and EN fusion transcripts were verified by reverse transcription (RT-PCR) assay.

  19. Salivary gland biopsy

    MedlinePlus

    Biopsy - salivary gland ... You have several pairs of salivary glands that drain into your mouth: A major pair in front of the ears (parotid glands) Another major pair beneath your jaw (submandibular ...

  20. [Avoidance and management of hypoparathyroidism after thyroid gland surgery].

    PubMed

    Selberherr, A; Niederle, B

    2015-01-01

    Postoperative hypoparathyroidism after bilateral thyroid gland surgery or after interventions for recurrence is defined as intact parathyroid hormone levels (iPTH) < 15 pg/ml with simultaneous normal, below normal and markedly decreased serum calcium levels. After bilateral thyroid surgery and after reoperations a single iPTH measurement performed 12-24 h postoperatively can be used to predict parathyroid metabolism. Patients with an iPTH level ≥ 15 pg/ml may be discharged safely, patients with an iPTH < 10 pg/ml must be substituted with calcium and vitamin D and patients with an iPTH between 10 and 15 pg/ml (grey zone) may be discharged if a second measurement 48 h after surgery documents an iPTH ≥ 15 pg/ml. This procedure increases the length of hospital stay. Patients in the (grey zone) must be substituted. The iPTH level and its course determine the necessity, dose and length of calcium and vitamin D substitution.

  1. Alpha adrenergic drugs inhibit ( sup 3 H)-QNB binding to muscarinic receptors of rat heart, brain and parotid gland membranes

    SciTech Connect

    Simon, G.; Filep, J.; Zelles, T. )

    1990-01-01

    Alpha adrenergic agonists and antagonists as clonidine, guanfacine, yohimbine, phenylephrine and prazosin inhibited the ({sup 3}H)-QNB binding to rat brain cortex muscarinic acetylcholine receptor (mAChR, M-1 subtype), heart (M-2 subtype) and parotid gland homogenate (M-3 subtype) in a dose-dependent competitive fashion. Ki values were between 10{sup {minus}6} and 10{sup {minus}3} M. Hill coefficients were about 1. No correlation was found between mAChR inhibiting capacity of these drugs and their activity on alpha adrenergic receptors. In contrast, other transmitters, as dopamine, GABA, glutamic acid, histamine, serotonin, isoproterenol and platelet activating factor (PAF) did not affect the QNB binding.

  2. Resolution of HIV-associated cystic benign lymphoepithelial lesion of the parotid gland in a patient undergoing chemotherapy for non-Hodgkin's lymphoma.

    PubMed

    Albrecht, H; Stellbrink, H J; Greten, H

    1996-01-01

    Cystic benign lymphoepithelial lesion, a previously rare lesion of the parotid gland characterized by multiple cysts accompanied by marked lymphoid hyperplasia, is increasingly reported in patients with human immunodeficiency virus infection. The case of a 59-year-old man without identifiable risk factors for the acquired immunodeficiency syndrome is presented, in whom the development of cystic benign lymphoepithelial lesions led to the diagnosis of the underlying human immunodeficiency virus infection. The lymphoepithelial lesion remained unchanged for 8 years. When chemotherapy was instituted for abdominal non-Hodgkin's lymphoma all cystic lesions resolved completely. This previously undescribed phenomenon strongly supports the concept that the development of the cysts is secondary to the mechanical obstruction of salivary ducts caused by lymphoid hyperplasia and not due to true de novo cyst formation.

  3. Gland-preserving robotic surgery for benign submandibular gland tumours: a comparison between robotic and open techniques.

    PubMed

    Yang, Tsung-Lin; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping; Hsiao, Tzu-Yu

    2014-05-01

    Benign tumours of the submandibular gland are usually treated surgically. Gland-preserving techniques, which can be used to completely remove the tumour, preserve the function of the gland and reduce complications, but conventional open operations result in obvious scars on the neck. We aimed to investigate the feasibility and efficacy of gland-preserving robotic surgery using a hairline approach. We compared robotic with open techniques for gland-preserving operations to remove benign tumours of the submandibular gland. Patients were matched for age and sex (4 in each group). All patients in the robotic surgery group had their tumours removed successfully through hairline approaches. No patient had operative complications or postoperative functional nerve deficit, and an aesthetically pleasing outcome was achieved by concealing the scars within the hairline. Robotic operations took longer than open operations. No recurrence was noted during follow-up. Gland-preserving robotic surgery is a feasible alternative to conventional techniques and has potential advantages for safety and aesthetic outcome.

  4. Immunoglobulin-containing plasma cells in chronic parotitis and malignant lymphomas of the parotid gland. Comparing immunocytochemical observations of frequency and localization.

    PubMed

    von Gumberz, C; Seifert, G

    1980-01-01

    IgA-containing plasma cells in the periductal gland tissue are part of the special secretory immune system of the salivary glands. The reaction of Ig-containing plasma cells (localization, frequency, specific Ig-content) was analyzed by the indirect immunoperoxidase method in chronic recurrent parotitis (9 cases), chronic myoepithelial parotitis (benign lymphoepithelial lesion, Sjögren's syndrome; 8 cases), and malignant lymphoma associated with chronic myoepithelial parotitis (11 cases). The following results were obtained: 1. In chronic recurrent parotitis, parallel to the increase in IgA in the salivary secretion, a marked multiplication of IgA-containing plasma cells was found in the inflammatory infiltrate and the remaining non-inflamed periductal parenchyma of the parotid gland. In the marginal zone of inflammation, a slight increase of IgG-containing plasma cells was also observed. 2. In chronic myoepithelial parotitis, the total plasma cellular infiltration was slightly less distinct than in chronic recurrent parotitis. The most remarkable increase in Ig-containing plasma cells developed in the marginal zones--away from the myoepithelial cellular islands--as well as in the area of ductular proliferations, and was characterized by a strong increase of IgG-containing plasma cells. At the same time, a slight increase of IgM-containing plasma cells was observed. No plasma cells were found in the myoepithelial cellular islands. 3. In the malignant lymphomas associated with myoepithelial parotitis, which were mainly highly differentiated lymphomas (immunocytomas, centrocytic-centroblastic lymphomas) and rarely poorly differentiated immunoblastic lymphomas, there was a distinct decrease of IgG-containing plasma cells when compared with the numbers in this group without lymphoma. The differing degrees of prevalence and Ig-content of the plasma cells partly describe the change taking place in the local secretory immune system of the parotid gland. The possible

  5. Squamous carcinoma arising in a parotid Warthin's tumour.

    PubMed

    Allevi, Fabiana; Biglioli, Federico

    2014-01-01

    Warthin's tumour is the second most common benign neoplasm to affect the salivary glands. It virtually affects the sole parotid gland. A sudden increase in a tumour's size is usually due to a malignant transformation of the tumour. The transformation of the lymphoid stroma into malignant lymphoma is relatively common, while an epithelial malignancy is extremely rare. In this paper, the authors present a case of squamous cell carcinoma arising in Warthin's tumour. The patient underwent enucleoresection of the tumour. Intraoperative frozen section revealed the presence of a cystic component associated with the squamous cell carcinoma areas. In consideration of the result of the intraoperative consultation, the surgeons decided to enlarge the previous resection by removal of a 30×25 mm cuff from the surrounding parotid tissue. Close follow-up was carried out and 12 months after surgery there was no evidence of recurrence or metastatic neoplasm.

  6. Malignant fibrohistiocytoma of the parotid region. Report of a case.

    PubMed

    Alba García, Jose Ramon; Armengot Carceller, Miguel; Zapater Latorre, Enrique; Pérez Valles, Ana; Basterra Alegría, Alegria

    2008-02-01

    Most salivary gland tumors are benign, malignant lesions accounting for 15-30% of the total. The most frequent site of salivary gland neoplasms is the parotid gland (80% of all cases). We present a case of malignant fibrohistiocytoma with atypical features due to its location (in the parotid region), size and rapid growth. Generally, this type of tumor arises in the lower limbs and in the abdomen. When located in the parotid gland, these lesions appear as a firm, slow growing and painless mass. Due to the low frequency of such lesions and their clinical behavior, the imaging study and fine-needle aspiration biopsy findings tend to diagnose them as pleomorphic adenoma. The definitive diagnosis requires microscopic study of the resection piece using immunohistochemical techniques. The treatment of choice is surgery, occasionally associated to radiotherapy. The success of treatment is dependent upon complete resection of the tumor - long term follow-up being necessary due to the risk of recurrence or distant metastasis.

  7. Parotid lipoblastoma in an infant.

    PubMed

    Calhoun, K H; Clark, W D; Jones, J D

    1987-11-01

    We report a case of 'matured' lipoblastoma occurring within the parotid gland of a 7-month-old male. This benign fatty tumor is considered to represent localized continuation of fetal fat development into the post-birth period. At least 7 cases have been reported in the head and neck region, but this is the first known occurrence within a salivary gland.

  8. Intensity Modulated Radiotherapy Improves Target Coverage and Parotid Gland Sparing When Delivering Total Mucosal Irradiation in Patients With Squamous Cell Carcinoma of Head and Neck of Unknown Primary Site

    SciTech Connect

    Bhide, Shreerang Clark, Catherine; Harrington, Kevin; Nutting, Christopher M.

    2007-10-01

    Head and neck squamous cell carcinoma with occult primary site represents a controversial clinical problem. Conventional total mucosal irradiation (TMI) maximizes local control, but at the expense of xerostomia. IMRT has been shown to spare salivary tissue in head and cancer patients. This study has been performed to investigate the potential of IMRT to perform nodal and TMI and also allow parotid gland sparing in this patient group. Conventional radiotherapy (CRT) and IMRT plans were produced for six patients to treat the ipsilateral (involved) post-operative neck (PTV1) and the un-operated contralateral neck and mucosal axis (PTV2). Plans were produced with and without the inclusion of nasopharynx in the PTV2. The potential to improve target coverage and spare the parotid glands was investigated for the IMRT plans. There was no significant difference in the mean doses to the PTV1 using CRT and IMRT (59.7 and 60.0 respectively, p = 0.5). The maximum doses to PTV1 and PTV2 were lower for the IMRT technique as compared to CRT (P = 0.008 and P < 0.0001), respectively, and the minimum doses to PTV1 and PTV2 were significantly higher for IMRT as compared to CRT (P = 0.001 and P = 0.001), respectively, illustrating better dose homogeneity with IMRT. The mean dose to the parotid gland contralateral to PTV1 was significantly lower for IMRT (23.21 {+-} 0.7) as compared to CRT (50.5 {+-} 5.8) (P < 0.0001). There was a significant difference in parotid dose between plans with and without the inclusion of the nasopharynx. IMRT offers improved dose homogeneity in PTV1 and PTV2 and allows for parotid sparing.

  9. HIV-unrelated benign lymphoepithelial cyst of the parotid glands containing lymphoepithelial lesion--like structures: a report of 3 cases.

    PubMed

    Kojima, Masaru; Nakamura, Naoya; Matsuda, Hazuki; Kaba, Sadayuki; Itoh, Hideaki; Masawa, Nobuhide

    2009-12-01

    Benign lymphoepithelial cyst (BLC) of the salivary gland is uncommon. Among report of these lesions, there were no previous cases of lymphoepithelial lesion (LeL) in human immunodeficiency virus type-1 (HIV-1) unrelated BLC. This study reports 3 cases of HIV-unrelated BLC containing LeL-like structures. Pathologically, 3 lesions were characterized by cuboidal epithelial-lined, cystic spaces, numerous lymphoid follicles, and dense lymphoplasmacytoid infiltrate. Moreover, small lymphocytes invaded the epithelial clusters forming LeL-like structures. Histological findings of 3 lesions resembled marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. However, staining with CD3, CD5, and CD20 demonstrated the mixed nature of small lymphocytes invading the epithelial clusters (LeLlike structures). Moreover, there were no CD43+ B-lymphocytes in any of the cases. The polytypic nature of B-lymphocytes was demonstrated by immunohistochemistry and polymerase chain reaction. The 3 cases indicate that HIV-unrelated BLC should be added to the differential diagnosis of MALT-type lymphoma involving the parotid glands.

  10. B-cell monoclonality, Epstein Barr virus, and t(14;18) in myoepithelial sialadenitis and low-grade B-cell MALT lymphoma of the parotid gland.

    PubMed

    Diss, T C; Wotherspoon, A C; Speight, P; Pan, L; Isaacson, P G

    1995-05-01

    Low-grade mucosa-associated lymphoid tissue (MALT) type B-cell lymphomas of the salivary gland arise in a background of myoepithelial sialadenitis (MESA), usually in association with Sjögren's syndrome. The distinction between benign MESA and early lymphoma has proved difficult using histological criteria alone and the significance of B-cell monoclonality in this respect is controversial. We have used immunohistochemistry and polymerase chain reaction (PCR) amplification of immunoglobulin heavy-chain VDJ regions to assess clonality in biopsies from 45 patients with lymphoid infiltration of the parotid. Sequential biopsies spanning 3-18 years were available from seven patients, three of whom had developed disseminated nodal B-cell lymphoma. In light of previous studies, each biopsy was additionally analyzed for the presence of t(14;18) and Epstein Barr Virus (EBV) DNA using PCR. Monoclonality was detected in 34/45 cases. Comparison of histology with clonality confirmed earlier suggestions that the emergence of an identifiable population of centrocyte-like B cells around ducts or epithelial islands correlated with monoclonality. In six of seven patients with sequential biopsies PCR fragments of identical size were amplified from each biopsy, suggesting that demonstrable monoclonality in "lymphoepithelial" lymphoproliferative lesions of the salivary gland is indicative of lymphoma. No t(14;18) chromosome translocations were identified; EBV sequences were detected in three of 45 cases.

  11. Primary osteoclast-like giant cell tumor of parotid gland: A rare extraskeletal presentation with diagnostic challenges

    PubMed Central

    Singh, Ritika; Zaheer, Sufian; Mandal, Ashish K

    2016-01-01

    Primary osteoclast-like giant cell tumor (OC-GCT) has been rarely described in extraskeletal sites. The diagnosis primarily hinges on the detection of giant cells. However, these giant cells are also seen in many giant cell lesions, thus creating diagnostic confusion and dilemma. Here, we describe a rare case of a 24-year-old male with primary extraskeletal, OC-GCT presenting as a swelling in the right parotid region and highlight its cytological, histological and immunohistochemical characteristics with diagnostic challenges. PMID:27601838

  12. Primary osteoclast-like giant cell tumor of parotid gland: A rare extraskeletal presentation with diagnostic challenges.

    PubMed

    Singh, Ritika; Zaheer, Sufian; Mandal, Ashish K

    2016-01-01

    Primary osteoclast-like giant cell tumor (OC-GCT) has been rarely described in extraskeletal sites. The diagnosis primarily hinges on the detection of giant cells. However, these giant cells are also seen in many giant cell lesions, thus creating diagnostic confusion and dilemma. Here, we describe a rare case of a 24-year-old male with primary extraskeletal, OC-GCT presenting as a swelling in the right parotid region and highlight its cytological, histological and immunohistochemical characteristics with diagnostic challenges. PMID:27601838

  13. Clinical and oncological outcomes after surgical excision of parotid gland tumours in patients aged over 80 years.

    PubMed

    Fakhry, N; Aldosari, B; Michel, J; Giorgi, R; Collet, C; Santini, L; Giovanni, A; Dessi, P

    2013-11-01

    The objective of this study was to evaluate the surgical and long-term outcomes of a series of patients aged over 80 years, operated on for parotid neoplasms. Among 614 parotidectomies for neoplasms performed between 1998 and 2008, 34 patients (5.5%) aged over 80 years were identified retrospectively. Pathological examination showed a malignant tumour in 24 and a benign tumour in 10 cases. Overall survival (OS) and disease-free survival (DFS) were determined by Kaplan-Meier analysis. A search for parameters that could influence the postoperative complication rate and long-term outcomes was carried out by univariate analysis. There was no postoperative death. Eight patients (24%) had postoperative complications. Malignant histopathology (P=0.05) and radical resection (P=0.033) were found to have a significant negative impact on the postoperative course. Focusing on malignant tumours, only histopathological type (metastasis vs primary tumour) was found to have a negative impact on OS. The 2- and 5-year OS rates were 86% and 86%, respectively, for primary tumours, and 67% and 29%, respectively, for metastasis (P=0.05). Malignant or benign histopathology had no impact on OS. Our results showed acceptable clinical and long-term oncological outcomes in very elderly patients operated on for parotid tumours, including malignant tumours.

  14. Sclerosing polycystic adenosis of the parotid gland: report of one case diagnosed by fine-needle cytology with in situ malignant transformation.

    PubMed

    Fulciniti, Franco; Losito, Nunzia Simona; Ionna, Franco; Longo, Francesco; Aversa, Corrado; Botti, Gerardo; Foschini, Maria Pia

    2010-05-01

    Sclerosing polycystic adenosis (SPA) is a rare pathological condition affecting the salivary glands, first described by Smith etal. in 1996. Even though this lesion is being increasingly diagnosed, less than 50 cases have been published in the world literature to date. In line with numerous other pathological analogies between breast and salivary gland lesions, SPA shares with fibrocystic disease of the breast many histopathological features, i.e., fibrosis, oncocytic (apocrine) changes, hyperplasia of ductal and acinar epithelium, cystic dilation of ducts, and, often, atypical epithelial changes. Most of the described cases have followed a benign clinical course, despite the frequent possibility of atypical hyperplasia in more than 50% of the cases and of the more than occasional in situ malignant transformation. In this article, we introduce a new case occurring in the parotid gland of a 57-year-old male showing atypical epithelial hyperplasia and low-grade in situ mucoepidermoid carcinoma. Fine-needle cytology (FNC) was performed on the lesion and, when a diagnosis of SPA was prospected, the variegated cytological features of the obtained sample posed several differential diagnostic problems. The spectrum of pathological lesions entering differential diagnosis comprised sebaceous adenoma, Warthin's tumors with presence of sebaceous remnants, and low-grade mucoepidermoid carcinoma. Histopathological examination disclosed SCA with intraductal neoplastic transformation resembling noninvasive low-grade mucoepidermoid carcinoma. The cytological diagnosis of SPA should be entertained whenever a polymorphous picture is found on FNC samples comprising oncocytic/apocrine changes, sebaceous cells, cystic background, and epithelial hyperplasia with low-grade cytological atypias.

  15. Effect of photodynamic therapy on a heterotransplanted human parotid tumor.

    PubMed

    Christensen, N R; Charabi, S; Johansen, L S; Rygaard, J; Balle, V H; Tos, M; Thomsen, J

    2000-07-01

    To evaluate the effect of photodynamic therapy on human parotid tumors we used tumor specimens obtained from parotid surgery on a consecutive group of patients. The tumors were transplanted into a subcutaneous pocket of nude mice. The original human tumors were pleomorphic adenoma (four), adenolymphoma (one), acinic cell carcinoma (one), sarcoma (one) and low-grade adenocarcinoma (one). The most aggressive growth was seen in the low-grade adenocarcinoma. We re-implanted this tumor on ten mice bilaterally, and treated the tumors with photodynamic therapy (PDT), resulting in a mean depth of tumor necrosis of 5.4 mm (1-10 mm). In three cases we found vital tumor cells in the periphery of the tumor after treatment, with several new blood vessels in the surrounding tissue, indicating a great potential for neo-angiogenesis in this tumor. In order to evaluate the possible nerve damage subsequent to the photodynamic therapy, the ischiadic nerve in 24 lower limbs of nude mice were investigated. In one case only the macroscopical and histological investigation revealed signs of nerve damage. The current study demonstrates that the nude mice implantation model is excellent to investigate growth in both malignant and benign parotid tumors, and to test new therapeutic modalities. Photodynamic therapy seems to have a possible role in the future management of the malignant lesions of the parotid gland, in cases where radical surgery for some reason is not achievable. PMID:10808112

  16. Benign tumours affecting the deep lobe of the parotid gland: how to select the optimal surgical approach.

    PubMed

    Casani, A P; Cerchiai, N; Dallan, I; Seccia, V; Sellari Franceschini, S

    2015-04-01

    Many types of approaches allow extra-capsular dissection in the deep parotid parenchyma in the treatment of benign tumours. A transcervical approach (TCA), transparotid approach (TPA) and a combined transcervical-transparotid approach (TPTCA) are the three main procedures performed to expose the deep parenchyma. We conducted a retrospective chart review enrolling 24 consecutive patients treated for benign tumours affecting the deep lobe of the parotid. Review of the surgical data was accompanied by careful follow-up to establish surgical morbidity, functional (Frey's Syndrome and first-bite syndrome) and aesthetical outcomes. A TPA was performed in the majority of cases; in 26% superficial parotidectomy was not required (selective deep parotidectomy). Minor's test showed a low rate of Frey's syndrome (3 cases of 23, 13%). No long-lasting first-bite syndrome was reported. Some additional procedures were easily performed in order to improve aesthetical results (rotational flap of sternocleidomastoid muscle, free abdominal fat transfer); these had the same results as selective deep parotidectomy. TCA (or TPTCA) ensures the best control of the facial nerve, providing good exposure and good functional and aesthetical results (without sparing the superficial parenchyma if additional techniques are performed with the aim of reducing skin depression in the treated area). The choice of the approach should have only the aim of safe resection and should not be influenced by aesthetical outcome; the craniocaudal level of the tumour seems to be the best indicator of the feasibility of the procedure also considering the branches of the facial nerve. In our experience, mandibulotomy can always be avoided.

  17. Gland-preserving surgery can effectively preserve gland function without increased recurrence in treatment of benign submandibular gland tumour.

    PubMed

    Min, Ruan; Zun, Zhang; Siyi, Li; Wenjun, Yang; Jian, Sun; Chenping, Zhang

    2013-10-01

    The most widely accepted treatment for neoplasms of the submandibular gland usually involves excision of the entire gland. Our aim was to establish a gland-preserving operation for benign tumours of the submandibular gland and evaluate its efficacy. We treated 40 patients from January 2007 to December 2008 with benign submandibular gland tumours who were listed to have an operation that either preserved the gland or sacrificed it. Duration of operation, extent of injury to the nerve, postoperative function of the gland, aesthetic appearance, and recurrence were assessed. We found no significant difference in baseline characteristics among the 20 patients in each group (19 men; 21 women, mean (SD) age of 34 (33.8 ± 5.72) years. The extent of injury to the lingual nerve and submandibular branch, together with deformities of the facial contour, were significantly less in the group in which the gland was preserved. Postoperative salivary production and overall patients' satisfaction were also better in that group. There was no recurrence in either group during the follow up period of 38 months-5 years. The gland-preserving procedure has advantages over the typical approach in which the gland is sacrificed. There is less risk of injury to the nerve, less deformity of the facial contour, better preservation of function, and patients are more satisfied. The gland-preserving technique should therefore be the first choice for management of benign submandibular tumours.

  18. Pleomorphic adenoma of the accessory parotid gland: case report and reappraisal of intraoral extracapsular dissection for management.

    PubMed

    Tsegga, Tibebu M; Britt, Jennifer D; Ellwanger, Aragon R

    2015-03-01

    Pleomorphic adenoma is the most common tumor of the major and minor salivary glands. Rarely is it found evolving from an ectopic location of major salivary glandular tissue in the mid cheek. A healthy 56-year-old woman presented to our institution with a 20-year duration of a slowly growing right cheek soft tissue mass that was causing facial asymmetry. No significant functional or neurosensory dysfunction was appreciated. Radiologic examination showed a heterogeneous, hyperintense, well-delineated mass within the region of the right buccal fat pad. Fine-needle aspiration biopsy showed benign salivary gland elements consistent with pleomorphic adenoma. The decision was made to perform intraoral extracapsular dissection for removal. Discussion of the clinical assessment and magnetic resonance imaging evaluation with an emphasis on intraoral extracapsular dissection for definitive surgical therapy of longstanding benign salivary gland tumors is emphasized.

  19. H sup + -dependent calcium uptake into an IP sub 3 -sensitive calcium pool from rat parotid gland

    SciTech Connect

    Thevenod, F.; Schulz, I. )

    1988-10-01

    In permeabilized parotid cells and in isolated membrane vesicles from parotid endoplasmic reticulum (ER), Mg-ATP-dependent Ca{sup 2+} uptake was measured using a Ca{sup 2+}-specific macroelectrode and {sup 45}Ca{sup 2+}, respectively. Mg-ATP-dependent Ca{sup 2+} uptake was inhibited by vanadate by {approximately}45% in permeabilized cells and by {approximately}70% in membrane vesicles from ER during the initial 10 min. After this lag phase, Ca{sup 2+} uptake increased. Subsequent addition of inositol 1,4,5-trisphosphate (IP{sub 3}) caused a similar Ca{sup 2+} release compared with control. This indicates that in presence of vanadate an IP{sub 3}-sensitive Ca{sup 2+} pool was filled. However, when protonophores, such as nigericin or carbonyl cyanide-m-chlorophenylhydrazone, were added in addition to vanadate, this low steady-state free (Ca{sup 2+}) was not reached. {sup 45}Ca{sup 2+} uptake was reduced by {approximately}70% within 60 min, and IP{sub 3} did not cause {sup 45}Ca{sup 2+} release when given subsequently, indicating that filling of an IP{sub 3}-sensitive Ca{sup 2+} pool was prevented. Mg-ATP-driven H{sup +} uptake into ER vesicles was abolished by protonophores and by the H{sup +}-ATPase blockers N-ethylmaleimide and Dio 9 but was unaltered by vanadate. Preincubation of ER vesicles in a medium without Ca{sup 2+}, but with vanadate and with Mg-ATP to generate an H{sup +} gradient, allowed demonstration of {sup 45}Ca{sup 2+} uptake from a medium that did not contain ATP. The data indicate that both a Ca{sup 2+} and a H{sup +} pump are located in a compartment of ER that is also sensitive to IP{sub 3}. Ca{sup 2+} uptake is coupled to an H{sup +} gradient that is generated by the H{sup +} pump and most likely occurs via Mg-ATP-driven Ca{sup 2+}-H{sup +} countertransport but to some extent can also operate in absence of ATP at the expense of the H{sup +} gradient.

  20. Two-year longitudinal study of parotid salivary flow rates in head and neck cancer patients receiving unilateral neck parotid-sparing radiotherapy treatment.

    PubMed

    Henson, B S; Eisbruch, A; D'Hondt, E; Ship, J A

    1999-05-01

    Radiotherapy (RT) is a common treatment for head and neck cancers, and frequently causes permanent salivary dysfunction and xerostomia. This 2-year longitudinal study evaluated unstimulated and stimulated parotid flow rates in 11 patients with head and neck cancers who received unilateral neck parotid-sparing RT. The results demonstrated that treated parotid glands had essentially no output up to 2 years post-RT. Alternatively, spared parotid flow rates were indistinguishable from pre-RT values at 1 and 2 years post-RT, and increased slightly over time. Total unstimulated and stimulated parotid flow rates 2 years after completion of RT were similar to pre-RT values, suggesting that spared parotid function may compensate for lost function from treated parotid glands. These results demonstrate that unilateral neck parotid-sparing techniques are effective in preserving contralateral parotid glands up to 2 years after the completion of RT. PMID:10621842

  1. Investigation of Laser Induced Breakdown Spectroscopy (LIBS) for the Differentiation of Nerve and Gland Tissue—A Possible Application for a Laser Surgery Feedback Control Mechanism

    NASA Astrophysics Data System (ADS)

    Mehari, F.; Rohde, M.; Knipfer, C.; Kanawade, R.; Klämpfl, F.; W., Adler; Oetter, N.; Stelzle, F.; Schmidt, M.

    2016-06-01

    Laser surgery provides clean, fast and accurate modeling of tissue. However, the inability to determine what kind of tissue is being ablated at the bottom of the cut may lead to the iatrogenic damage of structures that were meant to be preserved. In this context, nerve preservation is one of the key challenges in any surgical procedure. One example is the treatment of parotid gland pathologies, where the facial nerve (N. VII) and its main branches run through and fan out inside the glands parenchyma. A feedback system that automatically stops the ablation to prevent nerve-tissue damage could greatly increase the applicability and safety of surgical laser systems. In the present study, Laser Induced Breakdown Spectroscopy (LIBS) is used to differentiate between nerve and gland tissue of an ex-vivo pig animal model. The LIBS results obtained in this preliminary experiment suggest that the measured spectra, containing atomic and molecular emissions, can be used to differentiate between the two tissue types. The measurements and differentiation were performed in open air and under normal stray light conditions.

  2. [Acinar cell carcinoma of submaxillary gland].

    PubMed

    Comeche, C; Calabuig, C; Barona, R

    1997-01-01

    Although acine cell neoplasms have for a long time been regarded as benign tumors, they are presently considered to represent the carcinomas. These rare tumors mainly affect the parotid glands, and only exceptionally involve other salivary glands. Clinically, acic cell carcinoma present as isolated tumors simulating a pleomorphic adenoma. The diagnosis is histopathological, and complete surgical removal of the tumor is the treatment of choice, with cervical lymphatic voiding and/or postoperative radiotherapy in selected cases. A prolonged patient follow-up is required, for the tumor may recur many years after surgery. We report a case of acinic cell carcinoma in submaxillary gland.

  3. Mechanisms of fluid and ion secretion by the parotid gland of the kangaroo, Macropus rufus, assessed by administration of transport-inhibiting drugs.

    PubMed

    Beal, A M

    1995-01-01

    Possible mechanisms of primary fluid formation by macropodine parotid glands were investigated in anaesthetized red kangaroos using ion transport inhibitors. Carotid plasma amiloride concentrations of 0.05-0.5 mmol.l-1 progressively reduced a stable acetylcholine-evoked half-maximal flow rate of 2.0 +/- 0.04 to 0.22 +/- 0.024 ml.min-1 (mean +/- SEM). Concurrently, saliva bicarbonate concentration and secretion fell (135 +/- 1.6 to 67 +/- 1.7 mmol.l-1 and 272 +/- 7.6 to 15 +/- 2.6 mumol.min-1, respectively); [phosphate], [chloride] and [sodium] rose and [potassium] and osmolality were unaltered. High-rate cholinergic stimulation did not increase saliva flow beyond 11 +/- 1.0% of that for equivalent pre-amiloride stimulation. Equipotent levels of amiloride and methazolamide given concurrently were no more effective at blocking flow and bicarbonate secretion than when given separately. Furosemide (up to 2 mmol.l-1), bumetanide (up to 0.2 mmol.l-1) and ethacrynate (1 mmol.l-1) in carotid plasma had no effect on salivary flow or ion concentrations. During methazolamide blockade, furosemide did not curtail the concurrent increase in salivary [chloride]. Chlorothiazide at 0.25-1.0 mmol.l-1 caused progressive depression of saliva flow and [bicarbonate], and elevation of [chloride]. 4-acetamido-4'-isothiocyanatostilbene-2,2'disulphonic acid at 0.1 mmol.l-1 was without effect, whereas at 0.5 mmol.l-1 it stimulated fluid secretion and increased saliva [protein], [sodium], [potassium], [bicarbonate] and osmolality. Concurrently, mean arterial blood pressure and pulse pressure fell and heart rate, haematocrit and carotid artery plasma flow rose. These responses were absent if saliva flow was kept constant by reduction in cholinergic stimulation during 4-acetamido-4-isothiocyanatostilbene-2,2'disulphonic acid administration. It is concluded that secretion of primary fluid by the kangaroo parotid is initiated mainly (> 90%) by secretion of bicarbonate which is formed in the

  4. A micropuncture investigation of electrolyte transport in the parotid glands of sodium-replete and sodium-depleted sheep.

    PubMed Central

    Compton, J S; Nelson, J; Wright, R D; Young, J A

    1980-01-01

    1. Parotid secretion has been studied by micropuncture in sodium-replete and sodium-deficient sheep. 2. The osmolality of unstimulated primary saliva was slightly higher than in plasma and fell following cholinergic nerve stimulation. In sodium-depleted animals the osmolality of final saliva was hypotonic and exhibited flow dependency, where as in sodium-replete animals it was always isotonic. 3. In sodium-replete sheep, the primary fluid sodium concentration was about 120-130 mmol l-1 but in final saliva it was about 167 mmol l-1 and showed little or no flow-dependency. In sodium-depleted sheep, the primary sodium concentration averaged only 82.2 mmol l-1 and it was concluded that sodium-depleted primary fluid contained some other unidentified solute that allowed it to remain approximately isotonic; in final saliva the unstimulated sodium concentration was about 40 mmol l-1 and it rose with increasing flow rate to a maximum of 114.9 mmol l-1. 4. The primary fluid potassium concentration in sodium-replete animals did not differ significantly from that seen in sodium-depleted animals and the values were uninfluenced by stimulation; the over-all mean value was 11.2 mmol l-1. In final saliva, in sodium-replete sheep, the potassium concentrations averaged 7.8 mmol l-1 but in sodium-depleted sheep the concentrations were between 5 and 10 times greater than in primary fluid. 5. It was calculated from the equilibrium pH that the primary bicarbonate concentration would have been about 35 mmol l-1. In final saliva, where bicarbonate was measured directly, the concentrations were much greater and increased with stimulation to about 115 mmol l-1. 6. The primary fluid phosphate and chloride concentrations were the same in both sodium-replete and sodium-depleted animals and were unchanged by stimulation; the mean concentration of phosphate was 1.30 mmol l-1 and of chloride, 53.0 mmol l-1. In final saliva the phosphate concentrations were little changed but the chloride

  5. Salivary secretion during selective beta-adrenoreceptor stimulation and blockade in the parotid gland of red kangaroos, Macropus rufus.

    PubMed

    Boys, C A; Beal, A M

    2002-01-01

    Intracarotid infusions of noradrenaline (0.3 nmol.kg(-1) x min(-1)) stimulated salivary fluid secretion and caused increases in salivary concentrations of protein, potassium. magnesium. chloride and phosphate, and decreases in bicarbonate. These effects of intracarotid noradrenaline were not reduced by simultaneous intracarotid infusion of phentolamine (3.0 nmol.kg(-1) x min(-1)) but were significantly greater than the responses accompanying intravenous noradrenaline infusion. Concomitant administration of the beta-antagonist, CGP20712A, were much more effective in blocking the noradrenaline-induced changes in salivary composition than equimolar infusions of the beta2-antagonist, ICI118551, thereby confirming the presence of beta1-adrenoreceptors. Intracarotid infusion of salbutamol at 0.6 nmol x kg(-1) x min(-1) and 6.0 nmol x kg(-1) x min(-1) caused increasing but qualitatively similar changes in salivary composition to intracarotid noradrenaline but was less effective than noradrenaline in augmenting salivary protein release. Equimolar intravenous infusions of salbutamol and noradrenaline were equally potent in altering salivary electrolyte concentrations but salbutamol by this route had less effect on protein release and fluid secretion. Concurrent intravenous and intracarotid infusions of beta1-(CGP) and beta2-(ICI) antagonists with intracarotid salbutamol showed that the beta2-antagonist was more potent than the beta1-antagonist by the intracarotid route thereby demonstrating the presence of glandular beta2-receptors and eliminating the possibility that the response to salbutamol was due totally by reflex increases in general sympathetic tone triggered by lowered blood pressure. It was concluded that the kangaroo parotid has functional beta1- and beta2-adrenoreceptor subtypes in endpieces whereas the data provide little support for either adrenoreceptor subtype being present in the excurrent duct system.

  6. Schwannoma-like pleomorphic adenoma of the parotid.

    PubMed

    Tille, Jean-Christophe; Reychler, Hervé; Hamoir, Marc; Schmitz, Sandra; Weynand, Birgit

    2011-10-21

    Pleomorphic adenoma is the most common benign salivary gland tumour. It can occur in any salivary gland, but is most frequently found in the parotid gland. Chondroid metaplasia is a frequent finding in pleomorphic adenoma. Other forms of metaplasia have been described, but are encountered less frequently. We report a rare case of unusual pleomorphic adenoma of the parotid gland with schwannoma-like feature.

  7. Dystrophic calcification: A rare pediatric parotid mass.

    PubMed

    Chislett, Sean P; Liming, Bryan J; Rogers, Derek J

    2016-02-01

    Dystrophic calcification, the ectopic deposition of calcium in previously damaged or inflamed tissues, is an uncommon finding in the head and neck. Only a few cases have been reported in the parotidomasseteric region, and all of them have been located within and adjacent to the masseter. We present a case of dystrophic calcification occurring entirely within the parotid gland in a 7-year-old girl without apparent inciting inflammation, infection, or trauma. Our patient's presentation highlights the diagnostic challenge associated with parotid masses in the pediatric population. To our knowledge, this is the first reported case of dystrophic calcification occurring entirely within the parotid gland in a child. PMID:26810287

  8. Idiopathic pseudoaneurysm: a rare cause of parotid mass.

    PubMed

    Pennell, David John Laurie; Asimakopoulos, Panagiotis; Vallamkondu, Vamsidhar; Ah-See, Kim

    2015-01-01

    A 77-year-old woman presented with a pulsatile blue-tinged mass over the left parotid, present for 5 years, and slowly enlarging. The size of the mass fluctuated during this period and there was no associated pain. The patient reported no history of surgery or trauma. Vascular lesions are rarely encountered within parotid glands in adults. MRI with contrast demonstrated a soft tissue lesion; despite the presence of feeding vessels it was thought unlikely to be an arterial venous malformation or aneurysmal change. The appearance was thought to be in keeping with an enlarged lymph node or sebaceous cyst. Fine-needle aspiration was obtained using ultrasound guidance and yielded bloody fluid. The lesion was closely related to the superficial temporal artery and a diagnosis of a thrombosed pseudoaneurysm was made. The vessel had thrombosed and the decision was made to enact a watchful waiting policy. The patient will be monitored in the outpatient setting. PMID:26311006

  9. Activation of the interleukin-6/Janus kinase/STAT3 pathway in pleomorphic adenoma of the parotid gland.

    PubMed

    Andreasen, Simon; Therkildsen, Marianne Hamilton; Grauslund, Morten; Friis-Hansen, Lennart; Wessel, Irene; Homøe, Preben

    2015-08-01

    The interleukin-6 (IL-6)/Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) pathway is of crucial importance in promoting tumorigenesis in several malignant tumors but may also be active in benign tumors, e.g., of pleomorphic adenoma (PA). In this study we characterize the expression of the pathway components with immunohistochemistry and selected mRNAs and microRNAs (miRNAs) regulated by this pathway in isolated duct- and myoepithelial cells in PA. 46 PAs were immunostained and 10 of these were used for in situ hybridization (ISH). Six frozen specimens were analyzed using reverse transcription-polymerase chain reaction (RT-PCR). Using immunohistochemistry, IL-6, JAK1, JAK2 and STAT3 were detected significantly more frequently in PA cells than in cells from normal salivary gland tissue. Using RT-PCR cyclin D1, fibroblast growth factor 2, and p21 were found to be overexpressed while matrix metallopeptidase 9 was detected at low levels in PA compared to normal salivary gland. ISH showed significant overexpression of miR-181b in PA, while miR-21 was undetectable in PA and normal tissue. Overexpression of the pathway components and its mRNA and miRNA products provide important clues regarding the growth of PAs. Our findings brings us one step closer to targeted treatment of this tumor entity, although in vitro studies are warranted to confirm this.

  10. A meta-analysis of the efficacy and safety of managing parotid and submandibular sialoliths using sialendoscopy assisted surgery

    PubMed Central

    Jadu, Fatima M.; Jan, Ahmed M.

    2014-01-01

    Objectives: To review the available techniques and procedures for management of parotid and submandibular sialoliths with special emphasis on the efficacy and safety of the most commonly used combination of techniques; namely, sialendoscopy with conservative surgical removal of the stone. Methods: A systematic search of the English literature using MEDLINE, EMBASE, and the Cochrane library databases were conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. Articles between the years 2004 and 2013 were selected on the basis of preset inclusion criteria. Then, they were reviewed against a checklist to assess the evidence of efficacy of therapy or prevention and analyzed for pertinent data. Results: Eleven articles met the inclusion criteria and were reviewed and analyzed. The success rate of sialendoscopy combined with minor surgical removal of parotid and submandibular sialoliths ranges from 69-100%. Conclusion: Sialendoscopy combined with a minor surgical extraction of parotid and submandibular sialoliths is safe and efficacious. PMID:25316462

  11. Mammary Analogue Secretory Carcinoma of the Parotid Gland: A Third World Country Perspective—A Case Series

    PubMed Central

    Salat, Huzaifah; Mumtaz, Ramiz; Ikram, Mubasher; Din, Nasir Ud

    2015-01-01

    Mammary analogue secretory carcinoma (MASC) is a recently described pathological entity in major salivary glands, which was first described by Skálová et al. in 2010. Since then only a limited number of case reports/series have been published describing this tumor with the majority of them discussing the genetic and cytoarchitectural aspect of this tumor. Keeping this in view with the lack of clinical correlation with regard to this tumor, we present our approach to management of two such cases which, according to the best of our knowledge, are the first 2 cases presenting in the South Asian continent. Both patients were diagnosed and managed at Aga Khan University Hospital, Karachi, Pakistan. PMID:26783481

  12. Mammary Analogue Secretory Carcinoma of the Parotid Gland: A Third World Country Perspective-A Case Series.

    PubMed

    Salat, Huzaifah; Mumtaz, Ramiz; Ikram, Mubasher; Din, Nasir Ud

    2015-01-01

    Mammary analogue secretory carcinoma (MASC) is a recently described pathological entity in major salivary glands, which was first described by Skálová et al. in 2010. Since then only a limited number of case reports/series have been published describing this tumor with the majority of them discussing the genetic and cytoarchitectural aspect of this tumor. Keeping this in view with the lack of clinical correlation with regard to this tumor, we present our approach to management of two such cases which, according to the best of our knowledge, are the first 2 cases presenting in the South Asian continent. Both patients were diagnosed and managed at Aga Khan University Hospital, Karachi, Pakistan.

  13. [Predictors of malignancy in the management of parotid tumors: about 76 cases].

    PubMed

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

    2016-01-01

    Salivary gland tumor pathology is complex and poses a diagnostic and therapeutic problem. A good analysis of predictive factors for malignancy in parotid tumors seems currently necessary for better therapeutic planning. The aim of this study was to investigate the predictive factors for malignancy in parotid tumors through a retrospective study of 76 cases of parotid tumor treated in a service of Otorhinolaryngology and Cervico Facial Surgery of Avicenne military hospital of Marrakech between January 2000 and December 2012. The study involved 40 women and 36 men. The average age was 44 years for benign tumours whereas it was 50 years for malignant tumours. The median of consultation time was 24 months for benign tumors and 16 month for malignant tumours. Swelling in the area of the parotid was always a patient detecting sign. Malignancy is clinically suspected based on pain, facial paralysis, surface structure and deeper structure fixity and on the presence of adenopathy. MRI has become the methodology of choice for evaluating parotid tumors due to its good diagnostic value in the assessment of benignity and malignancy. Fine needle aspiration biopsy has no value unless it is positive. Explorative parotidectomy with extemporaneous anatomopathological examination remains the key to positive diagnosis. Parotid benign tumors represent the most frequent entity (80%) and pleomorphic adenoma remains the predominant histologic type (61%). With regard to malignant tumors, they are rare, mainly dominated by mucoepidermoid carcinomas (6,5%). Surgical treatment is the first choice and it is often associated with lymph node dissection and radiation therapy for malignant tumors. Facial paralysis is the most common complication of parotid surgery. PMID:27279939

  14. [Predictors of malignancy in the management of parotid tumors: about 76 cases].

    PubMed

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

    2016-01-01

    Salivary gland tumor pathology is complex and poses a diagnostic and therapeutic problem. A good analysis of predictive factors for malignancy in parotid tumors seems currently necessary for better therapeutic planning. The aim of this study was to investigate the predictive factors for malignancy in parotid tumors through a retrospective study of 76 cases of parotid tumor treated in a service of Otorhinolaryngology and Cervico Facial Surgery of Avicenne military hospital of Marrakech between January 2000 and December 2012. The study involved 40 women and 36 men. The average age was 44 years for benign tumours whereas it was 50 years for malignant tumours. The median of consultation time was 24 months for benign tumors and 16 month for malignant tumours. Swelling in the area of the parotid was always a patient detecting sign. Malignancy is clinically suspected based on pain, facial paralysis, surface structure and deeper structure fixity and on the presence of adenopathy. MRI has become the methodology of choice for evaluating parotid tumors due to its good diagnostic value in the assessment of benignity and malignancy. Fine needle aspiration biopsy has no value unless it is positive. Explorative parotidectomy with extemporaneous anatomopathological examination remains the key to positive diagnosis. Parotid benign tumors represent the most frequent entity (80%) and pleomorphic adenoma remains the predominant histologic type (61%). With regard to malignant tumors, they are rare, mainly dominated by mucoepidermoid carcinomas (6,5%). Surgical treatment is the first choice and it is often associated with lymph node dissection and radiation therapy for malignant tumors. Facial paralysis is the most common complication of parotid surgery.

  15. [Basal cell adenocarcinoma of the parotid gland: a rare tumor entity. Case report and review of the literature].

    PubMed

    Franzen, A; Koegel, K; Knieriem, H J; Pfaltz, M

    1998-09-01

    Basal cell adenocarcinoma is a rare entity that was first defined as a malignant salivary gland tumor in 1991. We present another case report and discuss pathology, pathogenesis, differential diagnosis, therapy and prognosis on the basis of currently available literature. Although histomorphologic features of the tumors are similar to basal cell adenomas, proof of an infiltrative and destructive growth is essential for diagnosis. Adenoid cystic carcinoma and basaloid squamous carcinoma must also be considered in any differential diagnosis. Tumor development within a pre-existing basal cell adenoma and de novo development are discussed. Most of the tumors appear to be benign clinically. Facial pain is rare and facial nerve palsy was noted in only one case. Metastases have occurred in less than 10% of patients, with only one involving the lung. Due to their biologic behavior and prognosis, basal cell adenocarcinomas should be classified as low-grade carcinomas. The therapy of choice is parotidectomy with preservation of the facial nerve. Neck dissection has to be added in cases with cervical metastases. Radiation is advisable in patients with recurrent disease. Since there is a nearly 30% local recurrence rate, intensive follow-up is necessary.

  16. Parotid involvement by desmoplastic melanoma.

    PubMed

    Jennings, T A; Okby, N T; Schroer, K R; Wolf, B C; Mihm, M C

    1996-08-01

    Desmoplastic malignant melanoma often arises in sun damaged skin of the head and neck and shows frequent neurotropism. Although metastatic melanoma frequently involve the parotid, direct spread to the parotid has been rarely reported. We evaluated five cases of desmoplastic malignant melanoma involving the parotid gland with clinical and pathological evidence of precursor cutaneous lesions in four of the five cases. The parotid involvement in four cases was tumoural, and three of these were not clinically suspected to be melanoma. The histological appearance in all five cases was that of a sarcomatoid tumour. Immunohistochemistry and electronmicroscopy performed on three of the cases showed only evidence of schwannian differentiation: the tumour cells were positive for S-100 protein and vimentin, and negative for cytokeratin and HMB-45. Electronmicroscopy showed no evidence of melanogenesis. All five tumours showed histological evidence of prominent neurotropism with one case demonstrating extension from overlying skin along cutaneous nerves to the superficial parotid. Thus, desmoplastic malignant melanoma may involve the parotid by neurotropic spread and can be pathologically indistinguishable from malignant schwannoma, a diagnosis which may be made erroneously in the absence of clinical information. PMID:8872151

  17. Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery

    PubMed Central

    Vidal Fortuny, J.; Belfontali, V.; Sadowski, S. M.; Karenovics, W.; Guigard, S.

    2016-01-01

    Background Postoperative hypoparathyroidism remains the most common complication following thyroidectomy. The aim of this pilot study was to evaluate the use of intraoperative parathyroid gland angiography in predicting normal parathyroid gland function after thyroid surgery. Methods Angiography with the fluorescent dye indocyanine green (ICG) was performed in patients undergoing total thyroidectomy, to visualize vascularization of identified parathyroid glands. Results Some 36 patients underwent ICG angiography during thyroidectomy. All patients received standard calcium and vitamin D supplementation. At least one well vascularized parathyroid gland was demonstrated by ICG angiography in 30 patients. All 30 patients had parathyroid hormone (PTH) levels in the normal range on postoperative day (POD) 1 and 10, and only one patient exhibited asymptomatic hypocalcaemia on POD 1. Mean(s.d.) PTH and calcium levels in these patients were 3·3(1·4) pmol/l and 2·27(0·10) mmol/l respectively on POD 1, and 4·0(1.6) pmol/l and 2·32(0·08) mmol/l on POD 10. Two of the six patients in whom no well vascularized parathyroid gland could be demonstrated developed transient hypoparathyroidism. None of the 36 patients presented symptomatic hypocalcaemia, and none received treatment for hypoparathyroidism. Conclusion PTH levels on POD 1 were normal in all patients who had at least one well vascularized parathyroid gland demonstrated during surgery by ICG angiography, and none required treatment for hypoparathyroidism. PMID:26864909

  18. Intraoperative Radiotherapy for Parotid Cancer: A Single-Institution Experience

    SciTech Connect

    Zeidan, Youssef H.; Shiue, Kevin; Weed, Daniel; Johnstone, Peter A.; Terry, Colin; Freeman, Stephen; Krowiak, Edward; Borrowdale, Robert; Huntley, Tod; Yeh, Alex

    2012-04-01

    Purpose: Our practice policy has been to provide intraoperative radiotherapy (IORT) at resection to patients with head-and-neck malignancies considered to be at high risk of recurrence. The purpose of the present study was to review our experience with the use of IORT for primary or recurrent cancer of the parotid gland. Methods and Materials: Between 1982 and 2007, 96 patients were treated with gross total resection and IORT for primary or recurrent cancer of the parotid gland. The median age was 62.9 years (range, 14.3-88.1). Of the 96 patients, 33 had previously undergone external beam radiotherapy as a component of definitive therapy. Also, 34 patients had positive margins after surgery, and 40 had perineural invasion. IORT was administered as a single fraction of 15 or 20 Gy with 4-6-MeV electrons. The median follow-up period was 5.6 years. Results: Only 1 patient experienced local recurrence, 19 developed regional recurrence, and 12 distant recurrence. The recurrence-free survival rate at 1, 3, and 5 years was 82.0%, 68.5%, and 65.2%, respectively. The 1-, 3-, and 5-year overall survival rate after surgery and IORT was 88.4%, 66.1%, and 56.2%, respectively. No perioperative fatalities occurred. Complications developed in 26 patients and included vascular complications in 7, trismus in 6, fistulas in 4, radiation osteonecrosis in 4, flap necrosis in 2, wound dehiscence in 2, and neuropathy in 1. Of these 26 patients, 12 had recurrent disease, and 8 had undergone external beam radiotherapy before IORT. Conclusions: IORT results in effective local disease control at acceptable levels of toxicity and should be considered for patients with primary or recurrent cancer of the parotid gland.

  19. Parotid duct cyst: a case report.

    PubMed

    Erkan, A N; Hürcan, C; Bal, N; Yilmazer, C; Ozlüoglu, L

    2006-01-01

    Salivary gland cysts can be benign or malignant. Salivary duct cysts are benign tumours that occur mainly in the parotid gland and represent 10% of all salivary gland cysts. We report the case of a 48-year-old man who presented with a painless preauricular mass on the right side. Superficial parotidectomy was performed based on magnetic resonance imaging (MRI). Histopathologic examination of the specimen revealed a parotid duct cyst. Here we report clinical features, diagnosis, and treatment of the case as well as a review of the literature.

  20. Is parotid lymphadenopathy a new disease or part of AIDS?

    PubMed

    Shaha, A; Thelmo, W; Jaffe, B M

    1988-10-01

    This report describes a series of 15 patients who presented with masses in the tail of the parotid gland which proved at biopsy to be benign hyperplastic lymphadenopathy similar to lymphoepithelial hyperplasia. There were 11 male and 4 female patients. All had a history of intravenous drug use. Ten patients complained of pain. Six patients had smaller masses on the contralateral side of the gland, whereas seven patients had minor axillary adenopathy. Needle aspiration was performed in 12 patients; although not conclusively diagnostic, it ruled out primary salivary tumors. Thick purulent material was aspirated in five patients. All 15 patients underwent parotid exploration. It was apparent after raising the flap that the disease was related to intraparotid and periparotid lymph nodes. Lymphadenopathy in the jugular region, which was not appreciated preoperatively, was also noted in all patients. Each patient underwent exposure of the main trunk of the facial nerve and limited superficial parotidectomy. The postoperative course in each patient was uneventful and no patient had a facial nerve deficit. Cerebral toxoplasmosis developed in one patient who died 3 months after surgery; AIDS developed in one other patient. Human immunodeficiency virus (HIV) titers were not performed routinely because none of the patients came for regular follow-up. None of these patients demonstrated lymphoma at the time of this procedure. Parotid lymphadenopathy, which occurs primarily in intravenous drug users, appears to be an early manifestation of pre-AIDS or AIDS-related complex. If patients have no other sizable lymphadenopathy for biopsy, we advocate exploration of the parotid region and excision of periparotid and intraparotid lymph nodes.

  1. Primary muco-epidermoid carcinoma arising in a parotid lymph node.

    PubMed

    Adkins, G F; Hinckley, D M

    1989-05-01

    A case of well-differentiated muco-epidermoid carcinoma in a parotid lymph node is described. This tumour apparently arose within and was confined to the lymph node. Salivary ductal and acinar inclusions are often found in parotid lymph nodes and these may occasionally give rise to salivary gland tumours, both benign and malignant. The finding of a malignant salivary gland tumour within such a site does not necessarily imply a metastasis from a primary neoplasm elsewhere in the parotid gland.

  2. [Perioperative ocular surface evaluation and management in meibomian gland dysfunction patients undergoing cataract surgery].

    PubMed

    Liang, Qingfeng; Dong, Zhe; Wang, Ningli

    2014-04-01

    Meibomian gland dysfunction (MGD) is one of the most common conditions in the elderly. Most of MGD patients undergoing cataract surgery were found to have significant dry eye symptoms and ocular surface disease. The severe cases with ocular surface disease are also at higher risk of postoperative complications, namely infections and corneal ulcers. To improve the operation effect and achieve the best visual outcome and life quality in cataract patients, it is important to evaluate the ocular surface and meibomian glands in MGD patients preoperatively, pay attention to the intraoperative care and detect the postoperative complications carefully and use medicine properly.

  3. [Perioperative ocular surface evaluation and management in meibomian gland dysfunction patients undergoing cataract surgery].

    PubMed

    Liang, Qingfeng; Dong, Zhe; Wang, Ningli

    2014-04-01

    Meibomian gland dysfunction (MGD) is one of the most common conditions in the elderly. Most of MGD patients undergoing cataract surgery were found to have significant dry eye symptoms and ocular surface disease. The severe cases with ocular surface disease are also at higher risk of postoperative complications, namely infections and corneal ulcers. To improve the operation effect and achieve the best visual outcome and life quality in cataract patients, it is important to evaluate the ocular surface and meibomian glands in MGD patients preoperatively, pay attention to the intraoperative care and detect the postoperative complications carefully and use medicine properly. PMID:24931148

  4. Indications for ultrasonography in parotid pathologies.

    PubMed

    Bruneton, J N; Sicart, M; Roux, P; Pastaud, P; Nicolau, A; Delorme, G

    1983-01-01

    In connection with 141 cases of parotid tumours, 21 adenopathies of the parotid region and 22 cases of parotitis, the authors define the role of ultrasonography in the exploration of the salivary glands. Use of simple criteria permits differentiation of benign from malignant tumours with a good degree of sensitivity (79.8% in our series). This score allows ultrasonography to be offered as the first complementary examination when dealing with a tumefaction of the parotid region. When ultrasonographic findings evoke a malignant lesion, a CT scan seems necessary to evaluate any extension in depth. In contrast, ultrasonography does not appear justified in cases of parotitis or lithiasic pathologies.

  5. Imaging of the salivary glands.

    PubMed

    Weissman, J L

    1995-12-01

    CT and MRI have greatly facilitated evaluation of pathology of the three pairs of major salivary glands and the hundreds of minor salivary glands. Imaging can frequently offer a specific histological diagnosis for benign and malignant neoplasms of the parotid, submandibular, and sublingual glands. Obstruction, infection, autoimmune processes, and congenital anomalies also are readily diagnosed. CT and MRI studies assess the anatomic extent of minor salivary gland neoplasms. Sialography continues to provide useful information about intrinsic abnormalities of the parotid and submandibular ducts.

  6. Regression of both oral mucocele and parotid swellings, following antiretroviral therapy.

    PubMed

    Syebele, Kabunda

    2010-01-01

    HIV-salivary gland associated disease is a well accepted concept in the HIV-related literature. Parotid swellings, especially in its cystic benign lymphoepithelial form, have been largely reported. Oral mucoceles (ranulas) were also associated with HIV in some publications. The exact nature of this link between mucoceles and HIV is still to be clarified. The mainstream treatment of most of parotid pathologies and oral mucoceles remains surgical approach. Strong evidences do, however, exist about lymphopithelial lesions of parotid glands that have been successfully treated with antiretroviral drugs. We present a case of intraoral mucocele, coexisting with bilateral parotid gland lymphoepithelial lesions, on a 2-year-old HIV-positive patient. Both parotid gland swellings and the sublingual mucocele have completely regressed following antiretroviral therapy. No surgical intervention was required. Conversely to benign lymphoepithelial lesions of parotid glands, the regression of oral mucocele on HIV-positive patient, following antiretroviral drugs therapy appears to be a rare phenomenon.

  7. Contemporary management of tumors of the salivary glands.

    PubMed

    Scianna, Joseph M; Petruzzelli, Guy J

    2007-03-01

    Management of tumors of the salivary glands requires a detailed understanding of the anatomy and pathologic processes affecting these glands. Salivary glands give rise to benign and malignant neoplasms and are affected by a variety of systemic diseases. CT remains the most common primary imaging study; magnetic resonance imaging and ultrasound have also been explored. Fine-needle aspiration as part of the diagnostic evaluation remains controversial due to varying sensitivities and specificities. Surgical extirpation is the primary modality for management of tumors of the salivary glands. Parotid surgery carries a potentially high morbidity with possible unsightly scarring and facial nerve damage. Nontraditional surgical approaches and instrumentation, as well as facial nerve monitoring, can decrease the morbidity of a parotidectomy. In specific instances, malignant salivary gland tumors warrant cervical lymphadenectomy. Adjuvant therapy is primarily accomplished with radiation. Chemotherapy continues to play a palliative role in salivary gland malignancies; however, newer trials are investigating the therapeutic role of chemotherapy.

  8. A simple, safe, and effective surgical technique for the treatment of post-traumatic parotid sialocoele.

    PubMed

    Asha'ari, Zamzil Amin; Razali, Mohd Sayuti; Leman, Wan Ishlah; Ahmad, Ashri

    2014-01-01

    Post-traumatic parotid sialocoele is a subcutaneous extravasation of saliva from the parotid gland secondary to traumatic disruption of its duct or parenchyma. Currently, there is no consensus regarding the best therapy for parotid sialocoele, as it is resistant to conservative management. The present paper puts forward a relatively simple, safe and effective technique for the treatment of parotid sialocoele, specifically a peroral drainage technique. The results justify our recommendation to use this approach for the treatment of sialocoele.

  9. Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

    SciTech Connect

    Al-Mamgani, Abrahim; Rooij, Peter van; Verduijn, Gerda M.; Meeuwis, Cees A.; Levendag, Peter C.

    2012-09-01

    Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4-172 months), the 5-year Kaplan-Meier estimates for LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade {>=}2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in

  10. Benign lymphoepithelial parotid cyst with sebaceous differentiation--cystic sebaceous lymphadenoma.

    PubMed

    Gnepp, D R; Sporck, F T

    1980-11-01

    A case of benign lymphoepithelial parotid cyst with sebaceous differentiation, or cystic sebaceous lymphadenoma, in a 57-year-old white man is presented. The literature on lymphoepithelial cysts and sebaceous lymphadenomas of the parotid gland is reviewed, and the alternative hypotheses of "branchial cleft origin" and "intranodal salivary gland inclusion origin" are compared. This case lends support to the intranodal glandular inclusion theory for lymphoepithelial cysts of the parotid.

  11. Modifications of transaxillary approach in endoscopic da Vinci-assisted thyroid and parathyroid gland surgery.

    PubMed

    Al Kadah, Basel; Piccoli, Micaela; Mullineris, Barbara; Colli, Giovanni; Janssen, Martin; Siemer, Stephan; Schick, Bernhard

    2015-03-01

    Endoscopic surgery for treatment of thyroid and parathyroid pathologies is increasingly gaining attention. The da Vinci system has already been widely used in different fields of medicine and quite recently in thyroid and parathyroid surgery. Herein, we report about modifications of the transaxillary approach in endoscopic surgery of thyroid and parathyroid gland pathologies using the da Vinci system. 16 patients suffering from struma nodosa in 14 cases and parathyroid adenomas in two cases were treated using the da Vinci system at the ENT Department of Homburg/Saar University and in cooperation with the Department of General Surgery in New Sant'Agostino Hospital, Modena/Italy. Two different retractors, endoscopic preparation of the access and three different incision modalities were used. The endoscopic preparation of the access allowed us to have a better view during preparation and reduced surgical time compared to the use of a headlamp. To introduce the da Vinci instruments at the end of the access preparation, the skin incisions were over the axilla with one incision in eight patients, two incisions in four patients and three incisions in a further four patients. The two and three skin incisions modality allowed introduction of the da Vinci instruments without arm conflicts. The use of a new retractor (Modena retractor) compared to a self-developed retractor made it easier during the endoscopic preparation of the access and the reposition of the retractor. The scar was hidden in the axilla and independent of the incisions selected, the cosmetic findings were judged by the patients to be excellent. The neurovascular structures such as inferior laryngeal nerve, superior laryngeal nerve and vessels, as well as the different pathologies, were clearly 3D visualized in all 16 cases. No paralysis of the vocal cord was observed. All patients had a benign pathology in their histological examination. The endoscopic surgery of the thyroid and parathyroid gland can be

  12. Salivary gland tumours: an analysis of 62 cases.

    PubMed

    Sousa, J; De Sa, O

    2001-03-01

    Salivary gland tumors are rare entities among the patients with head and neck neoplastic lesions. Between January 1987 to August 1997, 62 patients with salivary gland tumors presented to the surgical department of Goa Medical College, which is a tertiary referral center for the region. These patients were analyzed with an aim to study the clinical and histopathological correlation. While no age predisposition for the malignancy was found, the parotid gland was the most common site for both malignant & benign tumors (69.35%), and the minor glands (4.8%) the least common. Apart from the presence of facial nerve involvement, pain and rapid growth were also the indicators of malignancy. Fine needle aspiration cytology (FNAC) proved to be a reliable method for management of these tumors. All the patients underwent surgery with minimal morbidity and no mortality. There was no identifiable association between smoking, alcohol intake and the occurrence of the salivary glands tumors.

  13. [Rhabdomyosarcoma of the salivary glands. Report of 3 cases].

    PubMed

    BenJelloun, H; Jouhadi, H; Maazouzi, A; Benchakroun, N; Acharki, A; Tawfiq, N; Sahraoui, S; Benider, A

    2005-09-01

    Rhabdomyosarcoma of the salivary glands is rare. Tumours develop mostly in children and young patients but can be diagnosed in older people. We report three new cases in women 7, 14 and 75 years old. Tumefaction of the parotid region and facial paralysis were the principle clinical symptoms. Two patients underwent a total parotidectomy and radiotherapy. The third patient had a locally advanced tumour and received chemotherapy followed by radiotherapy. Loco-regional recurrence was observed in all cases and median survival was 12 months. Rhabdomyosarcoma of the salivary glands is locally aggressive. Treatments include surgery and radiotherapy. The role of chemotherapy remains to be discussed. PMID:15953749

  14. Fistulectomy of the Parotid Fistula Secondary to Suppurative Parotitis: A Case Report

    PubMed Central

    Managutti, Anil; Tiwari, Saba; Prakasam, Michael; Puthanakar, Nagaraj

    2015-01-01

    A parotid fistula is a communication between the skin and a parotid duct or gland through which saliva is discharged. The most common cause of the parotid fistula is trauma. The major causes of parotid trauma in a civilian practice are penetrating injury to the parotid gland from an assault weapon or injury due to shattered glass after a motor vehicle accident. Acute suppurative parotitis can rarely produce a parotid fistula, and it will be difficult to manage successfully. In this article we have described diagnosis by fistulography, meticulous dissection, and complete excision of the fistulous tract with layered closure of the parotid fascia followed by application of a post-operative pressure bandage, use of anticholinergic agents and antibiotics contribute significantly to the successful management of this difficult clinical condition. PMID:25709371

  15. Replanning Criteria and Timing Definition for Parotid Protection-Based Adaptive Radiation Therapy in Nasopharyngeal Carcinoma.

    PubMed

    Yao, Wei-Rong; Xu, Shou-Ping; Liu, Bo; Cao, Xiu-Tang; Ren, Gang; Du, Lei; Zhou, Fu-Gen; Feng, Lin-Chun; Qu, Bao-Lin; Xie, Chuan-Bin; Ma, Lin

    2015-01-01

    The goal of this study was to evaluate real-time volumetric and dosimetric changes of the parotid gland so as to determine replanning criteria and timing for parotid protection-based adaptive radiation therapy in nasopharyngeal carcinoma. Fifty NPC patients were treated with helical tomotherapy; volumetric and dosimetric (D mean, V 1, and D 50) changes of the parotid gland at the 1st, 6th, 11th, 16th, 21st, 26th, 31st, and 33rd fractions were evaluated. The clinical parameters affecting these changes were studied by analyses of variance methods for repeated measures. Factors influencing the actual parotid dose were analyzed by a multivariate logistic regression model. The cut-off values predicting parotid overdose were developed from receiver operating characteristic curves and judged by combining them with a diagnostic test consistency check. The median absolute value and percentage of parotid volume reduction were 19.51 cm(3) and 35%, respectively. The interweekly parotid volume varied significantly (p < 0.05). The parotid D mean, V 1, and D 50 increased by 22.13%, 39.42%, and 48.45%, respectively. The actual parotid dose increased by an average of 11.38% at the end of radiation therapy. Initial parotid volume, initial parotid D mean, and weight loss rate are valuable indicators for parotid protection-based replanning.

  16. [The pathology of salivary glands. Tumors of the salivary glands].

    PubMed

    Mahy, P; Reychler, H

    2006-01-01

    The management of benign and malignant neoplasms of the salivary glands requires precise knowledge of tumor histogenesis and classification as well as surgical skills. Pleomorphic adenoma and Whartin's tumor are the most frequent tumors in parotid glands while the probability for malignant tumors is higher in other glands, especially in sublingual and minor salivary glands. Those malignant salivary glands tumors are rare and necessitate multidisciplinar staging and management in close collaboration with the pathologist and the radiation oncologist.

  17. Cerebral radionecrosis following the treatment of parotid tumours: a case report and review of the literature.

    PubMed

    Coghlan, K M; Magennis, P

    1999-02-01

    Radiotherapy is an accepted part of the treatment of malignant tumours of the parotid gland. The use of radiotherapy in benign parotid tumours, where spillage of tumour cells has occurred at operation, is more controversial. Radiotherapy to the parotid bed is not without morbidity. Complications may arise as a result of radiation damage to neighbouring structures and there is also potential to induce malignant disease. A patient, whose postoperative radiotherapy following resection of a pleomorphic salivary gland adenoma was complicated by cerebral necrosis, is discussed. The literature pertaining to morbidity of radiotherapy for parotid tumours is reviewed.

  18. [Benign lymphoepithelial cysts of the parotid in a patient with HIV infection].

    PubMed

    Ficarra, G; Panzoni, E; Piluso, S; Pierleoni, F; Adler-Storthz, K

    1992-03-01

    We report on a HIV-positive patient presenting bilateral enlargement of the parotid gland. The ultrasound examination demonstrated multiple lesions with cystic aspect. A partial surgical excision of the parotid gland was performed, and histologic examination confirmed the diagnosis of a cystic benign lymphoepithelial lesion. The specimens which were tested for Epstein-Barr virus and cytomegalovirus by in situ hybridization proved negative. The clinical and pathologic features of this unusual salivary gland lesion which affects HIV-positive patients are discussed.

  19. Parotid Cystic Lesion in Amelanotic Malignant Melanoma.

    PubMed

    Santos, Vitorino Modesto Dos; Gondim Neto, Manoel da Costa; de Melo, Tereza Rodrigues de Carvalho Vieira; Motta, Iara Machado

    2016-09-01

    A 60-year Brazilian woman, presented with an enlarged lymph node in the neck for one year, and a superficial nonulcerated lesion was observed in the scalp. Fine needle aspiration and biopsy of the lymph node revealed amelanocytic metastasis, and immunohistochemistry study showed Melan-A/ Mart-1 antigen (clone A103 and S-100 protein). The entire suspected area of the scalp was further resected and an amelanotic melanoma without angiolymphatic invasion was diagnosed. Ultrasonography and PET-computed tomography showed hypermetabolic cystic area in the right parotid. Furthermore, aspiration biopsy and surgical samples from parotid cyst confirmed the malignant amelanotic melanoma. Cystic metastases are scarcely reported in parotid gland, and can pose diagnostic challenges. PMID:27671185

  20. Increased salivary gland density on contrast-enhanced CT after head and neck radiation

    SciTech Connect

    Bronstein, A.D.; Nyberg, D.A.; Schwartz, A.N.; Shuman, W.P.; Griffin, B.R.

    1987-12-01

    In an attempt to determine whether radiation therapy leads to an increased density of salivary glands on subsequent contrast-enhanced CT, 109 CT scans from 78 patients with head and neck tumors were reviewed. The density of parotid and submandibular glands was subjectively evaluated (compared with adjacent muscle) and correlated with treatment including surgery, chemotherapy, and radiation. Density of the parotid and/or submandibular glands was found to be significantly associated with previous irradiation on contrast-enhanced scans (p less than .05). One or both glands were denser than normal in seven (44%) of 16 patients who received only radiation therapy and in eight (38%) of 21 who received chemotherapy and radiation therapy, compared with only two (10%) of 20 patients who received chemotherapy alone and two (4%) of 52 patients who received neither. The type or amount of irradiation, type of chemotherapy, or timing of the CT scan after the initiation of treatment was not found to be significant. We conclude that the density of the parotid and/or submandibular glands on contrast-enhanced CT is frequently increased after radiation therapy for tumors of the head and neck.

  1. Needle aspiration biopsy in salivary gland lesions.

    PubMed

    Shaha, A R; Webber, C; DiMaio, T; Jaffe, B M

    1990-10-01

    The value of needle aspiration biopsy in the evaluation and management of salivary gland pathology is controversial. The major reasons for this controversy are the difficulty in cytologic evaluation and the fact that the extent of surgery can be easily defined based on clinical judgement. However, a preoperative diagnosis is helpful in discussions with patients regarding the extent and type of surgery. Apart from the fact that needle biopsy can distinguish benign from malignant conditions, it is also very useful in distinguishing between salivary and other nonsalivary pathology. Over the past 7 1/2 years, we have performed 160 needle aspirations of parotid, submandibular, and submucosal lesions. Adequate specimens for cytologic evaluation were obtained in 155 patients (97%). A total of 84 parotid lesions, 70 submandibular lumps, and 6 submucosal abnormalities were detected. A cytologic diagnosis of benign pathology was made in 120 patients. Twelve patients had lymphoma and the diagnosis was suspected based on needle aspiration. There were 10 patients with tuberculosis and 30 patients with hyperplastic lymph nodes or benign lymphoepithelial disease of the parotid. There were three false-positive and two false-negative reports. No complications such as hematoma, nerve injury, or infection developed. The major difficulty was in distinguishing between malignancy and obstructive sialadenitis in the submandibular region. Needle aspiration was helpful in evaluating lesions in the tail of the parotid and submandibular area. The cytologic distinction between salivary and nonsalivary pathology was useful in planning the appropriate surgery and the extent of surgical resection. From a clinical standpoint, the distinction between benign and malignant salivary and nonsalivary pathology was very helpful. Preoperative diagnosis of Warthin's tumor, lymphoma, or benign lymphoepithelial disease was essential to the correct management of these patients.

  2. Parotid hypertrophy with bulimia: a report of surgical management.

    PubMed

    Berke, G S; Calcaterra, T C

    1985-05-01

    Benign hypertrophy of the salivary glands can occur in patients with anorexia nervosa. This enlargement has been related to nutritional deficiencies and bulimia, which is a form of episodic binge eating followed by vomiting. The surgical management of a patient with bulimia and benign bilateral parotid enlargement secondary to bulimia will be discussed. Superficial parotidectomy may be a useful adjunct in managing the cosmetic and psychological aspects of patients with anorexia nervosa and bulimia complicated by massive parotid hypertrophy intractable to medical management.

  3. Benign lymphoepithelial lesions of the parotid.

    PubMed

    Shaha, A R; DiMaio, T; Webber, C; Thelmo, W; Jaffe, B M

    1993-10-01

    Persistent generalized lymphadenopathy has been well described in patients with seropositivity to the human immunodeficiency virus (HIV). Moreover, isolated enlargement of the parotid gland and parotid lymphadenopathy have been noted much more frequently over the past few years. Histologically, these lesions demonstrate follicular hyperplasia, cystic dilatation of the ducts lined by pseudo-stratified squamous epithelium, and lymphocytic infiltrates. They are generally considered to be benign lymphoepithelial lesions of the parotid or hyperplastic periparotid lymph nodes. The relationship of this entity to the AIDS-related complex (ARC) and the subsequent development of AIDS is not clear. Over the past 7 years, we have seen 50 patients with parotid enlargement in whom the diagnosis of benign lymphoepithelial lesion was made. Fine-needle aspiration was performed in 32 patients. Although not conclusively diagnostic, needle aspirates ruled out primary salivary glandular pathology. Most patients gave a history of intravenous drug abuse. HIV tests have been performed on a routine basis only in the last 2 years, and these were positive in the majority of the patients. Thirty-five patients underwent surgical excision. In the initial 20 patients, we routinely performed parotid exploration, identification of the facial nerve, and superficial parotidectomy. In the last 15 patients, we changed our surgical approach to parotid exploration and excision of the mass in the tail of the parotid. The exposure of the posterior belly of the digastric muscle, with identification and removal of the deep jugular node, has become routine. In each case, we found an enlarged lymph node in the deep jugular region, which was not clinically palpable preoperatively. The rate of surgical complications was minimal, and, after resection of the mass, patients improved symptomatically. If the patient shows obvious signs of AIDS, a nonsurgical approach with repeated aspirations should be considered

  4. Tumours of minor salivary glands--a clinicopathologic study.

    PubMed

    Nag, Dipanwita; Biswas, Pranab Kumar; Mandal, Palash Kumar; Bhattacharyya, Nirmal Kumar; Gautam, Dibyendu; Mukhopadhyay, Subrata

    2012-08-01

    The salivary gland system comprises 3 pairs of major glands ie, parotid, submandibular and sublingual and also thousands of lobules of minor salivary glands dispersed in oral cavity, nasal cavity, maxillary sinuses and upper airways. Most of the studies on salivary gland tumours included both major and minor salivary glands. Objectives of this study were to see the age, sex and site distribution of minor salivary gland tumours as well as cytohistologic correlation during their diagnosis. The study is a retrospective one and done in the pathology department of Medical College, Kolkata taking the cases referred from ENT and Surgery departments in the period from April 2008 to March 2011. There were 123 cases of salivary gland tumours including both major and minor salivary glands in this study. Out of these, 21 cases of minor salivary gland tumours were selected and further analysed. There were 9 cases of benign and 12 cases of malignant tumours. Most benign cases were pleomorphic adenoma and most of malignant were adenoid cystic carcinoma affecting maximally males above 40 years of age. For malignant cases the cytohistologic correlation was 100% whereas in benign it was 70%. We had no need of using immunohistochemistry as histologic diagnosis were clear-cut. Pathologic staging were done in most of malignant cases thus helping the clinicians to adopt better treatment protocol.

  5. Submandibular gland myoepithelioma.

    PubMed

    Testa, D; Galera, F; Insabato, L; Vassallo, A; Mesolella, M; Galli, V

    2005-06-01

    Benign myoepithelioma is a very rare form of salivary gland tumor, composed entirely of myoepithelial cells. It accounts for approximately 1% of all salivary gland tumors and is most frequently located in the parotid gland and in the minor salivary glands of the hard palate. We describe herein the ninth reported case of myoepithelioma of the submandibular gland. Benign myoepithelioma must be differentiated from several benign and malignant epithelial and mesenchymal tumors. Immunohistochemical staining can help differentiate between these conditions, but histopathology remains the gold standard for diagnosing this neoplastic process.

  6. Minor salivary gland neoplasm in children.

    PubMed

    Spuntarelli, Giorgio; Santecchia, Luigino; Urbani, Urbano; Zama, Mario

    2013-03-01

    In this article, we present a review of the literature, and we focus on 2 particular cases of cancer of the salivary glands accessory in pediatric patients The accessory parotid is the site of congenital and acquired lesions. In adults, the acquired lesions are often neoplastic and are usually similar to those seen in the main parotid gland. The disorders in children are less well defined, as only a few cases have been reported.The accessory parotid gland, or accessory parotid, is a nodule of normal salivary tissue separated from the main parotid gland, located on the masseter muscle, to which it is bound by an extension of the masseteric fascia and connected to the Stensen duct at that level. In contrast to the extensive literature on acquired lesions of the accessory parotid in adults, very few cases of malignant or benign lesions of the accessory parotid in children could be found in the literature. A review of several articles reporting lesions of the accessory parotid in adult patients, reporting 3 or more cases each for a total of 71 patients, showed 24 malignant neoplasms, 39 benign neoplasms, and 8 nonneoplastic lesions. Lesions of the accessory parotid are quite rare in children but should be considered when facing mass located in the cheek.

  7. Major and minor salivary gland tumors.

    PubMed

    Guzzo, Marco; Locati, Laura D; Prott, Franz J; Gatta, Gemma; McGurk, Mark; Licitra, Lisa

    2010-05-01

    Malignant salivary gland tumors are rare. The most common tumor site is the parotid. Aetiologic factors are not clear. Nutrition may be a risk factor, as well as irradiation or a long-standing histologically benign tumor that occurs at youth. Painless swelling of a salivary gland should always be considered as suspicious, especially if no sign of inflammation is present. Signs and symptoms related to major salivary gland tumors differ from those concerning minor salivary gland tumors, as they depend on the different location of the salivary gland. Surgical excision represents the standard option in the treatment of resectable tumors of both major and minor salivary glands. Neutron, heavy ions or proton radiotherapy may be a treatment option for inoperable locoregional disease. Surgery, irradiation or re-irradiation are treatment options for local relapse, whereas radical neck dissection is indicated for regional relapses. Metastatic disease may be either treated with radiotherapy or palliative chemotherapy, depending on the site of metastases. For highly selected patients the employment of anti-androgen therapy is indicated.

  8. Influence of parotid-sparing radiotherapy on xerostomia in head and neck cancer patients.

    PubMed

    Malouf, J Gabriel; Aragon, Cecilia; Henson, Brad S; Eisbruch, Avraham; Ship, Jonathan A

    2003-01-01

    Radiotherapy (RT) for head and neck cancers causes permanent salivary gland dysfunction (SGD) and xerostomia. We have previously demonstrated the effectiveness of parotid-sparing RT on salivary function. The aim of this was to characterize the relationship between radiation dosages to parotid glands, SGD, xerostomia, and impaired quality of life (QOL). Ninety-three patients received unilateral (n=38) and bilateral (n=44) neck RT with parotid-sparing techniques, or standard three-field technique RT (n=11). Unstimulated and stimulated parotid saliva was collected pre-RT and 1 year post-RT. Assessment of QOL and xerostomia was conducted with three questionnaires. The results demonstrated that reduced radiation dosages to parotid glands were strongly associated with percentage of baseline parotid flow rates measured at 1 year post-RT. Unilateral and bilateral neck RT with parotid-sparing techniques were successful in preserving salivary output, compared to standard three beam RT techniques. Lower radiation dose to contralateral parotid glands was associated with greater percentage of baseline salivary flow rates at 1 year post-RT, fewer xerostomic complaints, and an enhanced QOL. PMID:12893079

  9. Defects in muscarinic receptor-coupled signal transduction in isolated parotid gland cells after in vivo irradiation: evidence for a non-DNA target of radiation

    PubMed Central

    Coppes, R P; Meter, A; Latumalea, S P; Roffel, A F; Kampinga, H H

    2005-01-01

    Radiation-induced dysfunction of normal tissue, an unwanted side effect of radiotherapeutic treatment of cancer, is usually considered to be caused by impaired loss of cell renewal due to sterilisation of stem cells. This implies that the onset of normal tissue damage is usually determined by tissue turnover rate. Salivary glands are a clear exception to this rule: they have slow turnover rates (>60 days), yet develop radiation-induced dysfunction within hours to days. We showed that this could not be explained by a hypersensitivity to radiation-induced apoptosis or necrosis of the differentiated cells. In fact, salivary cells are still capable of amylase secretion shortly after irradiation while at the same time water secretion seems specifically and severely impaired. Here, we demonstrate that salivary gland cells isolated after in vivo irradiation are impaired in their ability to mobilise calcium from intracellular stores (Ca2+i), the driving force for water secretion, after exposure to muscarinic acetylcholine receptor agonists. Using radioligand-receptor-binding assays it is shown that radiation caused no changes in receptor density, receptor affinity nor in receptor-G-protein coupling. However, muscarinic acetylcholine agonist-induced activation of protein kinase C alpha (PKCα), measured as translocation to the plasma membrane, was severely affected in irradiated cells. Also, the phorbol ester PMA could no longer induce PKCα translocation in irradiated cells. Our data hence indicate that irradiation specifically interferes with PKCα association with membranes, leading to impairment of intracellular signalling. To the best of our knowledge, these data for the first time suggest that, the cells' capacity to respond to a receptor agonist is impaired after irradiation. PMID:15668705

  10. [Giant cells undifferentiated parotid carcinoma. Report of two cases].

    PubMed

    Pino Rivero, V; González Palomino, A; Trinidad Ruiz, G; Pardo Romero, G; Montero García, C; Mogollón Cano-Cortés, T; Pando Pinto, J M; Blasco Huelva, A

    2005-01-01

    Tumours of the salivary glands represent a 5% of all head and neck neoplasms. Their origin is the parotid gland in about 80% of the cases. Most of them are benign. We are reporting two cases of patients diagnosed, by our ENT Department, as undifferentiated giant cells parotid carcinoma with cervical metastasis. They were operated by total parotidectomy and radical neck disection and later recieved treatment with radiotherapy. After two years-follow-up both patients are standing alive. The tumoral size is the most important pronostic factor in this histological type.

  11. [Nasal endoscope surgery of acinic cell carcinoma of salivary gland on nasal septum: a case report].

    PubMed

    Tang, Yuanyuan; Sun, Xiuzhen; Wang, Jizhe

    2016-02-01

    A 67-year-old male patient was admitted because of "the right side nasal obstruction repeatedly for 4 years". He got nasal obstruction 4 years ago, especially for the right side nasal cavity, sometimes got blood in his nasal discharge, then the symptom relieved after accepting treatment in local hospital. During the 4 years, the symptom repeatedly occurrence. Three days before hospitalization, the CT examination indicated abnormal things in his nasal cavity and the bone of his nasal sinus had been destroyed. Some abnormal organism were sent to pathological examination, and the report indicated it is acinic cell carcinoma of salivary gland. During the nasal endoscope surgery, a red goiter was found in his nose with its surface crude and brittle. Then we cut the goiter by nasal endoscope, during the operation we find the bottom of the goiter is on the nasal septum. Two weeks after the operation, the patient received the radiation therapy. One year after the operation he doesn't get the abnormal symptom and the nasal MRI not found recidivation. PMID:27373103

  12. Gastric carcinoma originating from the heterotopic submucosal gastric gland treated by laparoscopy and endoscopy cooperative surgery

    PubMed Central

    Imamura, Taisuke; Komatsu, Shuhei; Ichikawa, Daisuke; Kobayashi, Hiroki; Miyamae, Mahito; Hirajima, Shoji; Kawaguchi, Tsutomu; Kubota, Takeshi; Kosuga, Toshiyuki; Okamoto, Kazuma; Konishi, Hirotaka; Shiozaki, Atsushi; Fujiwara, Hitoshi; Ogiso, Kiyoshi; Yagi, Nobuaki; Yanagisawa, Akio; Ando, Takashi; Otsuji, Eigo

    2015-01-01

    Gastric carcinoma is derived from epithelial cells in the gastric mucosa. We reported an extremely rare case of submucosal gastric carcinoma originating from the heterotopic submucosal gastric gland (HSG) that was safely diagnosed by laparoscopy and endoscopy cooperative surgery (LECS). A 66-year-old man underwent gastrointestinal endoscopy, which detected a submucosal tumor (SMT) of 1.5 cm in diameter on the lesser-anterior wall of the upper gastric body. The tumor could not be diagnosed histologically, even by endoscopic ultrasound-guided fine-needle aspiration biopsy. Local resection by LECS was performed to confirm a diagnosis. Pathologically, the tumor was an intra-submucosal well differentiated adenocarcinoma invading 5000 μm into the submucosal layer. The resected tumor had negative lateral and vertical margins. Based on the Japanese treatment guidelines, additional laparoscopic proximal gastrectomy was curatively performed. LECS is a less invasive and safer approach for the diagnosis of SMT, even in submucosal gastric carcinoma originating from the HSG. PMID:26306144

  13. A comparative study between fine needle aspiration cytology findings and histopathological report of major salivary gland neoplasm in a tertiary hospital of Bangladesh.

    PubMed

    Huq, A H M Z; Aktaruzzaman, M; Habib, M A; Islam, M S; Amin, A S A

    2013-08-01

    Salivary gland tumours are relatively uncommon and most of the tumours arise from parotid gland. Fine needle aspiration cytology (FNAC) is advised preoperatively as diagnostic tool but sometimes found to shown both false positive and false negative results. This study was aimed to find out distribution of neoplasm of major salivary glands and also to explore the sensitivity and specificity of FNAC. The present cross sectional study was done in the Dept. of Otolaryngology Head and Neck Surgery, BSMMU from January 2007 to December 2008. A total number of 60 gender-matched patients with major salivary neoplasm, confirmed by FNAC, were recruited in the study. Operated salivary gland specimens were sent for histopathological examination, histopathological findings were compared. Overall male to female ratio was 1:1. Out of 60 cases, 47 (78.3%) patients had parotid and 13 (21.7%) patients submandibular gland neoplasm. Male to female ratio for parotid tumour was 1:1.1 and for submandibular 1.6:1. Mean age of the patients was 44.5 with range of 14-85 years. Of the total 60 cases 47 (78.3%) were benign and 13 (21.7%) malignant. Out of 47 parotid tumour 85.1% were benign and 14.9% malignant. Among the parotid tumour 97% were superficial lobe and 3.0% deep lobe. In case of submandibular gland 53.84% were benign and 46.15% tumour malignant. According to the sides of involvement, 25 (53.2%) cases of parotid neoplasm tumour were in the left and 22 (46.8%) the right. In submandibular gland the distribution was 7 (53.8%) and 6 (46.16%) respectively. Statistically incidence of parotid tumour was significantly higher than submandibular tumour (p < 0.05). Out of 60 cases in 56 (93.3%) preoperative FNAC and postoperative histopathological findings were same. There was 1.7% false positive and 5% were false negative results. Sensitivity, specificity of FNAC were 80% and 97.8% respectively. Positive predictive value was 92.3% and negative predictive 93.6% for FNAC.FNAC though cheap and

  14. [Total protein and immunoglobulin concentrations in the parotid saliva of pregnant women].

    PubMed

    Donat, H; Tymnik, G; Bernstein, L; Knauthe, H; Kessler, L

    1977-01-01

    The content of total protein and immunglobulins in the parotid saliva and blood serum of pregnant women and healthy test persons has been determined by the biuret method and radial immunofiffusion. It was stated that total protein and IgG in the parotid saliva were higher in pregnant women than in healthy test persons, whereas the IgA-levels don't show any differences. IgM was not measurable in the parotid saliva. There was no relationship between saliva and serum immunglobulins. During the pregnancy show the parotid glands another typ of reaction than nonpregnant women.

  15. Sialendoscopy-assisted transfacial surgical removal of parotid stones.

    PubMed

    Capaccio, Pasquale; Pasquale, Capaccio; Gaffuri, Michelle; Michele, Gaffuri; Pignataro, Lorenzo; Lorenzo, Pignataro

    2014-12-01

    Minimally invasive surgical approaches to parotid stones (such as extra-corporeal shockwave lithotripsy and sialendoscopy) have proved to be effective in a high percentage of cases, although success depends on factors such as the localisation of the stone, its size and its mobility. The failure rate of 10% is largely due to large and impacted stones and, in such cases, a combined external and sialendoscopic approach can be used to avoid morbidity and the risks of more invasive superficial parotidectomy. We treated eight patients with large parotid stones (>7 mm) using a sialendoscopy-assisted transfacial surgical approach that was effective in all but one case, which was successfully solved by combining this procedure with extra-corporeal lithotripsy and operative sialendoscopy. Our results confirm that the combined approach is a valid alternative to parotidectomy for large parotid stones and should be added to other minimally invasive techniques aimed at restoring the function of the affected parotid gland.

  16. Management of chronic parotid fistula with sodium tetradecyl sulfate.

    PubMed

    Singh, Virendra; Kumar, Pradeep; Agrawal, Aviral

    2013-01-01

    A parotid fistula is a rare, extremely unpleasant disease. It may be due to chronic pathologies of the facial soft tissues, trauma (tangential injury to face), infection or congenital. Various treatment modalities including surgical and conservative management are present to treat this disease. Conservative management plays a vital role in patients who are systemically compromised and unfit for surgery. In the present case report an alternative conservative technique of parotid fistula management has been described in a 28-year-old girl who was severe anemic with parotid fistula since last 25 yrs.

  17. Sebaceous lymphadenoma of submandibular gland.

    PubMed

    Pattnaik, Niharika; Parmar, Deepankar; Rao, B Rama Mohan; Rao, Epari Sanjeeva

    2013-01-01

    Sebaceous lymphadenoma is a rare primary tumour of the salivary gland, benign in nature arising from differentiated Sebaceous glands and cells in the salivary gland. Most of the tumours are seen in the parotid gland and very rarely in the submandibular gland. Herein a case of sebaceous lymphadenoma is reported in a 45 years old female with a swelling in the submandibular region. Histopathological study after surgical excision showed islands of sebaceous epithelial cells with dense collections of lymphoid cells in stroma and a diagnosis of sebaceous lymphadenoma of submandibular gland was made.

  18. [A Clinical Study of a Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of Salivary Glands].

    PubMed

    Mada, Yusuke; Koshitsuka, Keiichi; Ihara, Fumie; Ueki, Yuji; Konno, Akiyoshi

    2015-01-01

    Malignant lymphoma involving the salivary glands is a rare entity that accounts for only 1 to 4% of all salivary gland tumors. We have analyzed the clinical features of MALT lymphoma of the salivary glands in 7 patients whom we have treated in the past 10 years, including data from 43 patients in the literature. The most common symptom was persistent or progressive swelling of the salivary glands without pain or facial palsy. The affected glands were the unilateral parotid in 62%, the unilateral submandibular gland in 6.8%, and the bilateral parotid or submandibular gland in 6.8%. The salivary gland swelling as evaluated by MRI or ultrasonography consisted of a localized solitary tumor in 68.9%, multiple tumors in 10.3%, and diffuse swelling of the gland in 26.1%. In 24 out of 50 patients, MALT lymphoma developed on the basis of Sjögren's syndrome. As for diagnosis, malignant lymphoma was suspected only in 4 cases out of 11 (36.7%) based on the fine needle aspiration cytology. In all patients, a definitive diagnosis was obtained based on histopathological study of the localized tumor or the biopsy specimens. When patients with Sjögren's syndrome have developed persistent swelling of the salivary glands, it is necessary to rule out malignant lymphomas, especially MALT lymphoma, by combination of ultrasonography, MRI, FNA, and biopsy or open surgery depending on image findings. The treatment of MALT lymphoma has not yet been standardized because MALT lymphoma is a rare entity. The choice of initial treatment is important because it is related to its prognosis. If MALT lymphoma remains in a local site, we should undertake an operation or radiotherapy. If MALT lymphoma has dissemineated systemically, we should choose chemotherapy. PMID:26333269

  19. Parotid abscess: mini-pictorial essay.

    PubMed

    Viselner, G; van der Byl, G; Maira, A; Merico, V; Draghi, F

    2013-01-01

    Bacterial and viral infection of the intraparotideal and periparotideal lymph nodes, or of the glandular parenchyma, can lead to inflammatory and subsequently suppurative changes, which can result in abscess formation. Sonography allows a detailed morphological evaluation of the gland and has an important value, complementary to clinical examination, in the study of parotid inflammatory diseases. Specifically, sonography defines lesion's characteristics and, in a large number of cases, also its nature and, among the various imaging techniques, it is considered first-line imaging for the evaluation of parotid abscesses, which are characterized by hypo-anechoic lesions, with irregular margins. Color Doppler signals are peripheral to the abscess. If combined with color Doppler, sonography is important not only in diagnosis, but also in the evaluation of therapeutic efficacy and as a guide to the aspiration and drainage of abscesses. The rarity of some of these lesions led us to publish this mini-pictorial essay.

  20. Parasympathetic denervation increases responses to VIP in isolated rat parotid acini

    SciTech Connect

    McMillian, M.K.; Talamo, B.R. )

    1989-07-01

    Vasoactive intestinal peptide (VIP) is a putative neurotransmitter found in the salivary glands of many species, including the rat parotid gland. Parasympathetic denervation has been reported to deplete VIP in the rat parotid gland and to lead to supersensitivity to this peptide in vivo. We have compared the effects of VIP on acini isolated from parasympathetically denervated and unoperated parotid glands to examine possible supersensitivity to the peptide in vitro. VIP normally produced responses similar to those obtained with a low concentration of the beta adrenergic agonist isoproterenol (ISO), but strikingly different from the effects obtained with the muscarinic agonist carbachol (CARB). In parotid membrane preparations, VIP stimulated adenylate cyclase activity. Dissociated acini treated with VIP showed increases in cAMP accumulation and amylase release which were potentiated by forskolin and also by inhibition of phosphodiesterase. After parasympathetic denervation, maximal effects of VIP on adenylate cyclase, cAMP accumulation and amylase release in intact cells were increased two- to five-fold over contralateral control (or unoperated) parotid responses. The increase in adenylate cyclase-mediated responses after denervation was specific to VIP; there was no increased response nor increased sensitivity of any of these responses to ISO. Specific (125I)VIP binding to parotid acini increased two-fold per gland and three-fold per mg of protein after denervation; this probably explains the observed increases in the response to VIP.

  1. Local-regional recurrence after surgery without postoperative irradiation for carcinomas of the major salivary glands: Implications for adjuvant therapy

    SciTech Connect

    Chen, Allen M.; Granchi, Phillip J.; Garcia, Joaquin; Bucci, M. Kara; Fu, Karen K.; Eisele, David W. . E-mail: deisele@ohns.ucsf.edu

    2007-03-15

    Purpose: To determine factors predictive of local-regional recurrence (LRR) after surgery alone for carcinomas of the major salivary glands in an attempt to evaluate the potential role of postoperative radiation therapy. Methods and Materials: Between 1960 and 2004, 207 patients with carcinomas of the major salivary glands were treated with definitive surgery without postoperative radiation therapy. Histology was: 67 mucoepidermoid (32%), 50 adenoid cystic (24%), 34 acinic cell (16%), 23 malignant mixed (11%), 16 adenocarcinoma (8%), 6 oncocytic (3%), 6 myoepithelial (3%), and 5 other (2%). Distribution of pathologic T-stage was: 54 T1 (26%), 83 T2 (40%), 46 T3 (22%), and 24 T4 (12%). Sixty patients (29%) had microscopically positive margins. Median follow-up was 6.1 years (range, 0.5-18.7 years). Results: The 5-year and 10-year estimates of local-regional control were 86% and 74%, respectively. A Cox proportional hazard model identified pathologic lymph node metastasis (hazard ratio [HR], 4.8; p = 0.001), high histologic grade (HR, 4.2; p = 0.003), positive margins (HR, 2.6; p = 0.03), and T3-4 disease (HR, 2.0; p = 0.04) as independent predictors of LRR. The presence of any one of these factors was associated with 10-year local-regional control rates of 37% to 63%. Conclusion: Lymph node metastasis, high tumor grade, positive margins, and T3-4 stage predict for significant rates of LRR after surgery for carcinomas of the major salivary glands. Postoperative radiation therapy should be considered for patients with these disease characteristics.

  2. [Tumors of the salivary glands].

    PubMed

    Halimi, P; Gardner, M; Petit, F

    2005-06-01

    Tumors of salivary glands arise mainly from the parotid gland. Magnetic Resonance Imaging (MRI) is mandatory not only to localize precisely the tumor within the gland but also to differentiate between benign and malignant neoplasms, in competition with cytology in fine-needle aspiration biopsy. Tumors without risk of transformation, such as adenolymphoma, are not systematically operated on. Indications of roentgenotherapy and irradiation volumes depend on histologic type, localisation and size of the tumor.

  3. Partial sialoadenectomy for the treatment of benign tumours in the submandibular gland.

    PubMed

    Ge, N; Peng, X; Zhang, L; Cai, Z-G; Guo, C-B; Yu, G-Y

    2016-06-01

    The conventional treatment for benign tumours arising in the submandibular gland (SMG) has always involved whole gland excision with the tumour. In light of developments in parotid gland functional surgery, this prospective study was performed to evaluate the effectiveness and safety of partial sialoadenectomy (PS) for benign tumours in comparison with conventional total sialoadenectomy (TS). Thirty-one consecutive patients with a preoperative diagnosis of benign tumour in the SMG were included in the study from December 2008 to December 2010. Eleven patients were treated with PS and 20 patients underwent conventional TS. Salivary gland function and surgery-related complications were assessed. No difference in resting saliva flow was found between the two groups before the operation, while this was significantly higher in the PS group than in the TS group at 1 year after surgery (P=0.009). With regard to complications, there was less deformity in facial appearance in the PS group. There was no recurrence in any of the 31 patients during the follow-up period (range 41-82 months). It is believed that this modification to SMG surgery is consistent with the idea of functional and minimal invasive salivary gland surgery. This technique represents a good choice for the management of benign tumours of the SMG for appropriately selected cases.

  4. Radiotherapy Dose-Volume Effects on Salivary Gland Function

    SciTech Connect

    Deasy, Joseph O.; Moiseenko, Vitali; Marks, Lawrence; Chao, K.S. Clifford; Nam, Jiho; Eisbruch, Avraham

    2010-03-01

    Publications relating parotid dose-volume characteristics to radiotherapy-induced salivary toxicity were reviewed. Late salivary dysfunction has been correlated to the mean parotid gland dose, with recovery occurring with time. Severe xerostomia (defined as long-term salivary function of <25% of baseline) is usually avoided if at least one parotid gland is spared to a mean dose of less than {approx}20 Gy or if both glands are spared to less than {approx}25 Gy (mean dose). For complex, partial-volume RT patterns (e.g., intensity-modulated radiotherapy), each parotid mean dose should be kept as low as possible, consistent with the desired clinical target volume coverage. A lower parotid mean dose usually results in better function. Submandibular gland sparing also significantly decreases the risk of xerostomia. The currently available predictive models are imprecise, and additional study is required to identify more accurate models of xerostomia risk.

  5. Radiotherapy Dose-Volume Effects on Salivary Gland Function

    PubMed Central

    Deasy, Joseph O.; Moiseenko, Vitali; Marks, Lawrence; Chao, K. S. Clifford; Nam, Jiho; Eilsbruch, Avraham

    2013-01-01

    Publications relating parotid dose-volume characteristics to radiotherapy-induced salivary toxicity were reviewed. Late salivary dysfunction has been correlated to the mean parotid gland dose, with recovery occurring with time. Severe xerostomia (defined as long-term salivary function of <25% of baseline) is usually avoided if at least one parotid gland is spared to a mean dose of less than ≈20 Gy or if both glands are spared to less than ≈25 Gy (mean dose). For complex, partial-volume RT patterns (e.g., intensity-modulated radiotherapy), each parotid mean dose should be kept as low as possible, consistent with the desired clinical target volume coverage. A lower parotid mean dose usually results in better function. Submandibular gland sparing also significantly decreases the risk of xerostomia. The currently available predictive models are imprecise, and additional study is required to identify more accurate models of xerostomia risk. PMID:20171519

  6. Nicotine induces DNA damage in human salivary glands.

    PubMed

    Ginzkey, Christian; Kampfinger, Katja; Friehs, Gudrun; Köhler, Christian; Hagen, Rudolf; Richter, Elmar; Kleinsasser, Norbert H

    2009-01-10

    The tobacco alkaloid nicotine is responsible for addiction to tobacco and supposed to contribute to tobacco carcinogensis, too. Recently, genotoxic effects of nicotine have been reported in human cells from blood and upper aerodigestive tract. Because of nicotine accumulation in saliva, the study of possible in vitro genotoxic effects of nicotine have been extended to human salivary gland cells. Specimens of parotid glands of 10 tumor patients were obtained from tumor-free tissue. Single cells were prepared by enzymatic digestion immediately after surgery and exposed for 1h to 0.125-4.0mM of nicotine. Possible genotoxic effects were determined by the Comet assay using the % DNA in tail (DT) as a reliable indicator of DNA damage. Nicotine induced a significant dose-dependent increase of DNA migration in parotid gland single-cells. The mean DT was 1.12-fold (0.125mM) to 2.24-fold (4.0mM) higher compared to control. The lowest concentration eliciting significant DNA damage within 1h, 0.25mM nicotine, is only 10-fold higher than maximal concentrations of nicotine reported in saliva after unrestricted smoking. Although conclusive evidence for a carcinogenic potential of nicotine is still lacking, the safety of long-term nicotine replacement therapy should be carefully monitored. PMID:18852035

  7. Basal cell adenoma of the sublingual gland.

    PubMed

    Lin, Hsin-Ching; Chien, Chih-Yen; Huang, Shun-Chen; Su, Chih-Ying

    2003-12-01

    Salivary gland tumors constitute about 3% to 4% of all head and neck neoplasms. Approximately 80% originate in the parotid gland, and they rarely present in the sublingual gland; however, a disproportionately large majority of sublingual gland tumors are malignant. Basal cell adenoma is a benign epithelial salivary gland tumor that appears to have unique histologic characteristics, different from those of mixed tumors, and has a predilection for development in the parotid and minor salivary glands. No case has ever been reported as arising from the sublingual gland in the otolaryngology literature. We report here a case of a middle-aged woman with basal cell adenoma of the sublingual gland. The clinical presentation, pathological features, differential diagnosis, and treatment options for this relatively rare tumor are discussed.

  8. Botulinum Neurotoxin A for Parotid Enlargement in Cystic Fibrosis: The First Case Report.

    PubMed

    El Khoury, Joseph; Habre, Samer; Nasr, Marwan; Hokayem, Nabil

    2016-09-01

    Cystic fibrosis (CF) is the most common lethal autosomal recessive genetic disease associated with exocrine gland dysfunction. Salivary gland involvement is a common finding. The literature on submaxillary gland involvement has failed to address the parotid gland and any specific treatment of salivary gland manifestations of CF. Treatment is mainly symptomatic, consisting of analgesics, gustatory stimulation, and massage. Salivary secretion has clearly been linked to parasympathetic and sympathetic signals through intracellular calcium release. CF alters salivary composition with increased calcium and phosphorus concentrations and causes histologic changes (duct enlargement, dilation of acini, and abnormal mucous plugs). This study investigated whether botulinum toxin injected into the parotid gland during an acute exacerbation of CF-associated salivary gland disease could alleviate pain and control future exacerbations. PMID:27131031

  9. Botulinum Neurotoxin A for Parotid Enlargement in Cystic Fibrosis: The First Case Report.

    PubMed

    El Khoury, Joseph; Habre, Samer; Nasr, Marwan; Hokayem, Nabil

    2016-09-01

    Cystic fibrosis (CF) is the most common lethal autosomal recessive genetic disease associated with exocrine gland dysfunction. Salivary gland involvement is a common finding. The literature on submaxillary gland involvement has failed to address the parotid gland and any specific treatment of salivary gland manifestations of CF. Treatment is mainly symptomatic, consisting of analgesics, gustatory stimulation, and massage. Salivary secretion has clearly been linked to parasympathetic and sympathetic signals through intracellular calcium release. CF alters salivary composition with increased calcium and phosphorus concentrations and causes histologic changes (duct enlargement, dilation of acini, and abnormal mucous plugs). This study investigated whether botulinum toxin injected into the parotid gland during an acute exacerbation of CF-associated salivary gland disease could alleviate pain and control future exacerbations.

  10. Parotidectomy for Parotid Cancer.

    PubMed

    Cracchiolo, Jennifer R; Shaha, Ashok R

    2016-04-01

    Parotidectomy for parotid cancer includes management of primary salivary cancer, metastatic cancer to lymph nodes, and direct extension from surrounding structures or cutaneous malignancies. Preoperative evaluation should provide surgeons with enough information to plan a sound operation and adequately counsel patients. Facial nerve sacrifice is sometimes required; but in preoperative functioning nerves, function should be preserved. Although nerve involvement predicts poor outcome, survival of around 50% has been reported for primary parotid malignancy. Metastatic cutaneous squamous cell carcinoma is a high-grade aggressive histology whereby local control for palliation with extended parotidectomy can be achieved; however, overall survival remains poor. PMID:26895698

  11. Sclerosing Polycystic Adenosis: A Rare Tumor of the Salivary Glands

    PubMed Central

    Tang, Christopher G; Fong, Justin B; Axelsson, Karen L; Gurushanthaiah, Deepak

    2016-01-01

    Case Presentation: A 74-year-old woman presented to the Head and Neck Surgery clinic with a 4-year history of a slowly growing, painful, left-sided neck mass in the tail of the parotid gland. Fine-needle aspiration suggested well-differentiated adenocarcinoma. Discussion and Results: The patient underwent a superficial parotidectomy and super-selective neck dissection (level 2). Pathology revealed a tumor consistent with sclerosing polycystic adenosis. Conclusion: Sclerosing polycystic adenosis is a rare inflammatory process that causes fibrocystic changes in the salivary gland. Apocrine-like metaplasia and epithelial atypia are common pathologic features. To our knowledge, a total of 51 cases have been described in the English-language literature. PMID:27043832

  12. Postoperative irradiation in malignant epithelial tumors of the parotid

    SciTech Connect

    McNaney, D.; McNeese, M.D.; Guillamondegui, O.M.; Fletcher, G.H.; Oswald, M.J.

    1983-09-01

    From 1954 through 1979, 77 patients with malignant tumors of the parotid gland were referred from the Department of Head and Neck Surgery for postoperative irradiation. The analysis has been made by grouping the patients according to the estimated amount of disease left after the surgical procedure and by the histological types. There were no local failures in the low-grade tumors, and there were 6 in the 63 patients with high-grade tumors. With gross residual disease or potential residual disease the patients received slightly higher doses than those without. Although there were only 6 failures in the various histological types, there was perhaps a trend to more failures in the adenocarcinomas. There was no difference in the failure rates in patients having had a total resection of the facial nerve or partial resection or no resection. The preferred treatment has been a combination of 20 MeV photons and 18 MeV electrons. Five neck failures were essentially a result of lack of electrive irradiation of the neck. Severe complications appeared only in the patients irradiated either for gross residual disease or excision of a recurrence with a high risk of widespread microscopic residual disease.

  13. Papillary cystic variant of acinic cell carcinoma presenting as parotid tail tumor.

    PubMed

    Khan, Sabina; Pujani, Mukta; Hassan, Mohd Jaseem; Jetley, Sujata

    2015-01-01

    Acinic cell carcinoma (ACC) is an uncommon low-grade tumor of the salivary glands that constitutes 2.5-4% of parotid gland tumors. Papillary cystic variant (PCV) of ACC is even rarer and can be diagnosed on histopathological examination only. It is important to diagnose this variant as it carries a poor prognosis when compared with other variants of ACC and is known to be universally fatal in 10 years. The present case describes ACC-PCV in a 20-year-old male, which presented as a slow growing parotid tail tumor and was misdiagnosed as a benign lesion both cytologically and radiologically. This case emphasizes the importance of histopathological examination in parotid masses as well as the need to consider malignant lesion in the differential diagnosis of a parotid tail tumor.

  14. Pictorial essay: Salivary gland imaging

    PubMed Central

    Rastogi, Rajul; Bhargava, Sumeet; Mallarajapatna, Govindarajan Janardan; Singh, Sudhir Kumar

    2012-01-01

    Salivary glands are the first organs of digestion secreting their digestive juices into the oral cavity. Parotid, submandibular, and sublingual glands are the major paired salivary glands in the decreasing order of their size. In addition, multiple small minor salivary glands are noted randomly distributed in the upper aerodigestive tract, including paranasal sinuses and parapharyngeal spaces. The imaging is directed to the major salivary glands. Commonly used imaging methods include plain radiography and conventional sialography. Recently, high-resolution ultrasonography (HRUS) is being increasingly used for targeted salivary gland imaging. However, the advent of cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the imaging of salivary glands. This article illustrates the role of imaging in evaluating the variegated disease pattern of the major salivary glands. PMID:23833425

  15. Diffusion-Weighted Magnetic Resonance Imaging to Evaluate Major Salivary Gland Function Before and After Radiotherapy

    SciTech Connect

    Dirix, Piet Keyzer, Frederik de; Vandecaveye, Vincent; Stroobants, Sigrid; Hermans, Robert; Nuyts, Sandra

    2008-08-01

    Purpose: To evaluate diffusion-weighted (DW)-MRI as a noninvasive tool to investigate major salivary gland function before and after radiotherapy (RT) for head and neck cancer (HNC). Methods and Materials: DW-MRI was performed in 8 HNC patients before and after parotid-sparing RT (mean dose to the contralateral parotid gland <26 Gy). A DW sequence was performed once at rest and then repeated continuously during salivary stimulation. Apparent diffusion coefficient (ADC) maps for both parotid and submandibular glands were calculated. Findings were compared with salivary gland scintigraphy. Results: Before RT, the mean ADC value at rest was significantly lower in the parotid than in the submandibular glands. During the first 5 min of stimulation, the ADC value of the salivary glands showed a decrease, followed by a steady increase until a peak ADC, significantly higher than the baseline value, was reached after a median of 17 min. The baseline ADC value at rest was significantly higher after RT than before RT in the nonspared salivary glands but not in the spared parotid glands. In the contralateral parotid glands, the same response was seen as before RT. This pattern was completely lost in the nonspared glands. These results corresponded with remaining or loss of salivary function, respectively, as confirmed by salivary gland scintigraphy. Conclusions: Diffusion-weighted-MRI allows noninvasive evaluation of functional changes in the major salivary glands after RT and is a promising tool for investigating radiation-induced xerostomia.

  16. Tumors of the major salivary glands.

    PubMed

    Skolnik, E M; Friedman, M; Becker, S; Sisson, G A; Keyes, G A

    1977-06-01

    Tumors of the major salivary glands are reviewed according to classification, location, surgical procedure and end results. Our data of the incidence of benign and malignant tumors show that the most commonly involved area is the parotid gland and the most frequent is of the mixed variety. In the parotid region 80 percent are benign and 20 percent are malignant; whereas, in the submandibular gland, the malignant and benign tumors are equally distributed. The need for an extensive surgical attack and inclusion of contiguous structure is dictated by the nature of the malignant disease. The role of postoperative irradiation is discussed as is the indication for neck dissection. Management of the facial nerve, relative to malignant tumors of the parotid gland, is considered in detail.

  17. Sebaceous lymphadenocarcinoma of salivary glands.

    PubMed

    Croitoru, Claudia M; Mooney, Julia E; Luna, Mario A

    2003-08-01

    Primary sebaceous neoplasms of the salivary glands are extremely rare occurrences; furthermore, sebaceous lymphadenocarcinoma has only been reported in three patients. We report a case of sebaceous lymphadenocarcinoma arising in a lymphadenoma of the parotid gland. The patient was a 55-year-old man who presented with a parotid mass of 3 years' duration. Histologically, the lesion consisted of a sebaceous lymphadenoma with transition to a sebaceous carcinoma. The cytologic touch-preparation at the time of frozen section showed clusters of benign sebaceous cells in a rich lymphocytic background together with tridimensional clusters of malignant epithelial cells, strongly raising the suspicion of a malignant neoplasm arising in a benign sebaceous lesion. Malignant transformation of the sebaceous lymphadenoma, although rare, should be considered in enlarging, locally invasive parotid lesions, considering that clinical behavior and prognosis will be determined by the nature of the malignant component.

  18. Outcome after endoscopically assisted surgical retrieval of symptomatic parotid stones.

    PubMed

    Overton, A; Combes, J; McGurk, M

    2012-02-01

    10% of symptomatic parotid stones cannot be removed by minimally invasive radiological or endoscopic techniques alone. In these cases endoscopically assisted surgical parotid sialolithectomy can be performed via an extraoral approach, reconstituting the duct and preserving functioning glandular tissue. Between 2003 and 2010, 55 consecutive patients underwent endoscopically assisted surgical removal of parotid stones from 57 glands, two having bilateral procedures. Outcome was assessed using a structured questionnaire. 39/55 patients (71%) patients were successfully contacted (40 procedures; one bilateral case). At median follow-up of 3.1 years 28 glands (70%) were symptomless, whilst 11 (28%) were much improved but causing mild or occasional residual symptoms. One patient required postoperative lithotripsy and basket retrieval of a retained stone, but was subsequently symptom free. A further patient was initially symptom free then relapsed, did not respond to lithotripsy and is awaiting further assessment. In 10% of cases a short-lived sialocoele developed postoperatively. No individual reported facial weakness and one had a scar of concern. 37/39 (95%) patients were pleased to have had the operation and would have the procedure contralaterally in similar circumstances. Endoscopically assisted surgical removal of parotid stones is a successful technique with low morbidity that is well received by patients. PMID:22018956

  19. Parotid tail pleomorphic adenoma extending to the parapharyngeal space.

    PubMed

    Polat, Kerem; Doğan, Mansur; Yüce, Salim; Uysal, Ismail Önder; Müderris, Suphi

    2013-03-01

    Parapharyngeal space tumors are rare, accounting for 0.5% of head and neck neoplasms. Most of them are benign and originate in the salivary glands, especially the pleomorphic adenoma. We presented a 47-year-old man with parotid tail pleomorphic adenoma extending to the parapharyngeal space. The patient applied to our clinic with the complaints of a painless mass on his neck and in his mouth for 3 months. After fine needle aspiration biopsy, the mass was diagnosed as pleomorphic adenoma. The patient was hospitalized and operated in our clinic. As we see in literature review, parapharyngeal space tumors are rare, and most of them are pleomorphic adenomas arising from the deep lobe of the parotid gland and extend into the PPS.

  20. Rhinosporidiosis of parotid duct.

    PubMed

    Sivapathasundharam, B; Saraswathi, T R; Manjunath, K; Sriram, G

    2009-01-01

    Rhinosporidiosis is a benign chronic granulomatous infection caused by Rhinosporidium seeberi. Rhinosporidiosis is endemic in south Asia, notably in southern India and Sri Lanka. Majority of the cases have been reported to occur in upper respiratory sites, notably anterior nares, nasal cavity, nasopharynx, larynx and soft palate. Only two rare cases of involvement of parotid duct, have been reported in literature. Hence, this case will probably be the third to be reported.

  1. Effect of low-level laser therapy on irradiated parotid glands—study in mice

    NASA Astrophysics Data System (ADS)

    Acauan, Monique Dossena; Gomes, Ana Paula Neutziling; Braga-Filho, Aroldo; de Figueiredo, Maria Antonia Zancanaro; Cherubini, Karen; Salum, Fernanda Gonçalves

    2015-10-01

    The objective of this study was to evaluate the effect of low-level laser therapy (LLLT) on radiotherapy-induced morphological changes and caspase-3 immunodetection in parotids of mice. Forty-one Swiss mice were divided into control, radiotherapy, 2- and 4-J laser groups. The experimental groups were exposed to ionizing radiation in a single session of 10 Gy. In the laser groups, a GaAlAs laser (830 nm, 100 mW, 0.028 cm2, 3.57 W/cm2) was used on the region corresponding to the parotid glands, with 2-J energy (20 s, 71 J/cm2) or 4 J (40 s, 135 J/cm2) per point. LLLT was performed immediately before and 24 h after radiotherapy. One point was applied in each parotid gland. The animals were euthanized 48 h or 7 days after radiotherapy and parotid glands were dissected for morphological analysis and immunodetection of caspase-3. There was no significant difference between groups in the immunodetection of caspase-3, but the laser groups had a lower percentage compared to the radiotherapy group. LLLT promoted the preservation of acinar structure, reduced the occurrence of vacuolation, and stimulated parotid gland vascularization. Of the two LLLT protocols, the one using 4 J of energy showed better results.

  2. Salivary gland tumours: profile and management at a tertiary cancer centre.

    PubMed

    Shukla, Nootan K; Hazarika, Sidhartha; Deo, Suryanarayana; Kar, Madhabananda; Kumar, Sunil; Samaiya, Atul; Sharan, Rajeev; Rath, Goura K

    2011-06-01

    Salivary gland tumours comprise a varied group of benign and malignant neoplastic lesions posing a challenge to surgeon. To review the profile of salivary gland tumours presenting to a referral cancer centre and their overall management, a retrospective analysis of prospective head and neck cancer database of the surgical oncology department of Institute Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS) was performed. Forty patients of salivary gland tumours treated between 1995 and 2003 were analysed. All computations including recurrences and survival were carried out using the statistical package for social sciences (SPSS) for windows software (SPSS Inc, USA). The profile of salivary gland tumours presenting to a cancer centre setting was found to be different - 77.5% being malignant tumours and the remaining 22.5% werebenign tumours. Most common site of involvement was the parotid gland (72.5%). Muco-epidermoid carcinoma and adenocarcinomas were the most common histological types. Conservative resection was adequate for benign tumours. For primary malignant tumours, radical surgery with or without neck dissection and appropriate reconstruction, combined with postoperative radiotherapy was effective in achieving good locoregional control. Optimal management of primary tumour along with appropriate neck dissection including resection of the involved salivary gland is necessary for the management of metastatic salivary gland tumours.

  3. Lack of Preemptive Analgesia by Intravenous Flurbiprofen in Thyroid Gland Surgery: A Randomized, Double-blind and Placebo-controlled Clinical Trial

    PubMed Central

    Zhang, Zhaodi; Zhao, Haifang; Wang, Changsong; Han, Fei; Wang, Guonian

    2011-01-01

    Background Nowadays, increasingly more preemptive analgesia studies focus on postoperative pain; however, the impact of preemptive analgesia on perioperative opioid requirement is not well defined. This study was carried out in order to evaluate whether preoperative intravenous flurbiprofen axetil can reduce perioperative opioid consumption and provide postoperative analgesia in patients undergoing thyroid gland surgery. Methods Ninety patients undergoing elective thyroid gland surgery were randomly assigned to three groups. Group A (Control) was administered Intralipid® 2 ml as a placebo 15 min before the cervical plexus block and at the end of the surgery; Group B (Routine analgesia) was administered a placebo 15 min before the cervical plexus block and flurbiprofen 50 mg at the end of the surgery; Group C (Preemptive analgesia) was administered intravenous flurbiprofen 50 mg 15 min before the cervical plexus block and a placebo at the end of the surgery. Sufentanil administration during the surgery and the 24 h satisfaction score on analgesic therapy were both recorded. The analgesic efficacy was assessed at 1, 2, 4, 6, 8, 12, and 24 hours after the surgery, based on visual analog scales. Results Ninety patients were involved in the study. One patient from Group B did not have their scheduled surgery; eighty-nine patients completed the study. There were no significant differences in the patient demographics between the three groups. Visual analog scales: 1, 2, 4 h for Group A was significantly higher than Groups B and C (P<0.05); Sufentanil administration during surgery: Group C was obviously lower compared to Groups A and B (P<0.05); 24 h satisfaction score: Groups B and C were higher than Group A (P<0.05). Conclusion Preoperative administration of intravenous Flurbiprofen axetil reduced analgesic consumption during surgery, but not postoperative pain scores. PMID:21814477

  4. Oncocytoma of palatal minor salivary gland.

    PubMed

    Motallebnejad, Mina; Seyedmajidi, Maryam; Khakbaz Baboli, Oveis; Yarmand, Fateme

    2015-05-01

    Oncocytoma is a rare benign salivary gland tumor, which mostly occurs in the parotid gland. In this article, we describe an early onset of oncocytoma of minor salivary gland in a 36-year, white male. On clinical examination, we encounter with a painless, granular, sessile mass. After Excisional biopsy, the histopathological features revealed sheets of cells with abundant granular eosinophilic cytoplasm, and large, round nuclei that are known as "Oncocyte".

  5. Lipomatous infiltration of the canine salivary gland.

    PubMed

    Brown, P J; Lucke, V M; Sozmen, M; Whitbread, T J; Wyatt, J M

    1997-06-01

    Benign connective tumours of the canine salivary glands are rare. This report describes lipomatous infiltration of parotid or submandibular salivary glands in seven dogs in which the glands were enlarged as a result of infiltration by fat cells; they appeared to have been successfully treated by local excision. The precise cause of the lipomatous infiltration in the dogs is unclear but different causes of similar lesions in humans are discussed.

  6. Warthin tumor of the upper lip: an unusual location of a benign salivary gland tumor.

    PubMed

    dos Santos Almeida, Aroldo; Costa Hanemann, João Adolfo; Tostes Oliveira, Denise

    2011-06-01

    Warthin tumor (papillary cystadenoma lymphomatosum) is a benign salivary gland tumor involving almost exclusively the parotid gland. The lip is a very unusual location for this type of tumor, which develops only rarely in minor salivary glands. The case of 42-year-old woman with Warthin tumor arising in minor salivary glands of the upper lip is reported.

  7. Three-Dimensional Hand-to-Gland Combat: The Future of Endoscopic Surgery?

    PubMed Central

    Nassimizadeh, A.; Muzaffar, S. J.; Nassimizadeh, M.; Beech, T.; Ahmed, S. K.

    2015-01-01

    Objective To compare two dimensional (2D), three-dimensional (3D) non–high-definition (HD), and 3D HD endoscopic surgical techniques. Methods We describe our initial operative experience with a novel 3D HD endoscopic endonasal approach involving a pituitary adenoma resection, provide a case series, and review the current literature. This is the first case in Europe using the new 3D HD endoscope. Results Although research evidence remains limited, there are no significant negative perioperative or postoperative outcomes when compared with 2D endoscopic techniques. In our experience the narrow operating corridors of endoscopic surgery cannot be addressed with 3D endoscopic techniques. The new 3D HD endoscope creates imaging quality similar to conventional 2D HD systems. Conclusion Three-dimensional endoscopic endonasal techniques provide an exciting new avenue, effectively addressing potential depth perception difficulties with current 2D systems. PMID:26623227

  8. Hydatid cyst of parotid: Report of unusual cytological findings extending the cytomorphological spectrum.

    PubMed

    Arora, Vinod Kumar; Chopra, Neha; Singh, Poorva; Venugopal, Vasantha Kumar; Narang, Salil

    2016-09-01

    Hydatid disease is a zoonotic infestation caused by larval cestode of genus Echinococcus. Cystic form of this infection mostly involves liver and lung. Hydatid disease of the parotid gland is very rare even in endemic areas and is often clinically mistaken for parotid tumors or cysts. The presence of protoscolices, laminated membranes, and isolated hooklets are characteristic cytological features observed on fine-needle aspirate from hydatid cysts. We report unusual cytological features from a hydatid cyst of parotid in a 13-year-old girl. She presented with a slowly enlarging hard mass in left parotid. Fine-needle aspiration yielded slightly turbid fluid. Smears from the sediment revealed naked parasitic micronuclei, fragments of germinative layer (endocyst), and abortive brood capsules (buds from endocyst) seen as spherical structures with multiple parasitic nuclei. Some of these spherical structures were degenerated with recognizable nuclei and others were completely necrotic. Diagn. Cytopathol. 2016;44:770-773. © 2016 Wiley Periodicals, Inc. PMID:27324277

  9. Hydatid cyst of parotid: Report of unusual cytological findings extending the cytomorphological spectrum.

    PubMed

    Arora, Vinod Kumar; Chopra, Neha; Singh, Poorva; Venugopal, Vasantha Kumar; Narang, Salil

    2016-09-01

    Hydatid disease is a zoonotic infestation caused by larval cestode of genus Echinococcus. Cystic form of this infection mostly involves liver and lung. Hydatid disease of the parotid gland is very rare even in endemic areas and is often clinically mistaken for parotid tumors or cysts. The presence of protoscolices, laminated membranes, and isolated hooklets are characteristic cytological features observed on fine-needle aspirate from hydatid cysts. We report unusual cytological features from a hydatid cyst of parotid in a 13-year-old girl. She presented with a slowly enlarging hard mass in left parotid. Fine-needle aspiration yielded slightly turbid fluid. Smears from the sediment revealed naked parasitic micronuclei, fragments of germinative layer (endocyst), and abortive brood capsules (buds from endocyst) seen as spherical structures with multiple parasitic nuclei. Some of these spherical structures were degenerated with recognizable nuclei and others were completely necrotic. Diagn. Cytopathol. 2016;44:770-773. © 2016 Wiley Periodicals, Inc.

  10. [Biological significance of DNA content in parotid carcinoma].

    PubMed

    Yang, B

    1991-09-01

    The DNA content was analysed by flow cytometry in 5 samples of normal salivary tissue, 36 cases of benign salivary gland tumors and 50 cases of parotid carcinoma. It was found that the difference in the DNA index (DI) and proliferative index (PI) in age, sex, tumor size and TNM staging were insignificant (P greater than 0.05). The DI and PI of poorly differentiated parotid carcinoma were much higher than those of well differentiated parotid carcinoma (P less than 0.05). The DI and PI were closely related to the presence of lymph node metastasis (P less than 0.001). The DI and PI of patients with facial nerve paralysis and with disease free period shorter than 5 years were remarkably higher than those with normal facial nerve and disease free survival for more than 5 years (P less than 0.01). The above results indicate that DI and PI, showing cell proliferative kinetic characteristics, can provide reliable and objective parameters for assessing the degree of differentiation, degree of malignancy, biological behavior and prognosis of parotid carcinomas.

  11. Fine-needle aspiration (FNA) and pleural fluid cytology diagnosis of benign metastasizing pleomorphic adenoma of the parotid gland in the lung: a case report and review of literature.

    PubMed

    Zhang, Yaxia; Gomez-Fernandez, Carmen R; Jorda, Merce; Ganjei-Azar, Parvin

    2009-11-01

    Lesions that contain abundant benign myoepithelial cells, including pleomorphic adenomas of salivary gland origin, may present a diagnostic challenge in fine-needle aspiration (FNA) specimens. Benign metastasizing pleomorphic adenoma is a rare neoplasm, in which the benign appearing pleomorphic adenoma, without any histological evidence of malignancy, metastasizes to distant sites including lung. In the absence of clinical history of a pre-existing myoepithelial neoplasm, the presence of myoepithelial cells in the lung or any other organs besides salivary glands may create diagnostic difficulty. Here we present the cytologic findings of such a metastatic tumor found in the lung FNA and pleural fluid specimens from a 64-year-old woman, with a history of local recurrent salivary gland pleomorphic adenomas, who presented with multiple bilateral pulmonary nodules and pleural effusion. The diagnosis of benign metastasizing pleomorphic adenoma was made based on clinical information and cytomorphology, and confirmed by immunocytochemistry.

  12. Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

    PubMed Central

    Kendi, Ayse Tuba Karagulle; Magliocca, Kelly R.; Corey, Amanda; Galt, James R.; Switchenko, Jeffrey; Wadsworth, J. Trad; El-Deiry, Mark W.; Schuster, David M.; Saba, Nabil F.; Hudgins, Patricia A.

    2016-01-01

    OBJECTIVE Assessment of benign and malignant lesions of the parotid gland, including metastatic lesions, is challenging with current imaging methods. Fluorine-18 FDG PET/CT is a noninvasive imaging modality that provides both anatomic and metabolic information. Semiquantitative data obtained from PET/CT, also known as PET/CT parameters, are maximum, mean, or peak standardized uptake values (SUVs); metabolic tumor volume; total lesion glycolysis; standardized added metabolic activity; and normalized standardized added metabolic activity. Our aim was to determine whether FDG PET/CT parameters can differentiate benign, malignant, and metastatic parotid tumors. MATERIALS AND METHODS Thirty-four patients with parotid neoplasms underwent PET/CT before parotidectomy; maximum SUV, mean SUV, peak SUV, total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity were calculated on a dedicated workstation. Univariate analyses were performed. A ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven benign, malignant, and metastatic parotid gland neoplasms. RESULTS Fourteen patients had a benign or malignant primary parotid tumor. Twenty had metastases to the parotid gland. When the specificity was set to at least 85% for each parameter to identify cut points, the corresponding sensitivities ranged from 15% to 40%. Assessment of benign versus malignant lesions of parotid tumors, as well as metastasis from squamous cell carcinoma versus other metastatic causes, revealed that none of the PET/CT parameters has enough power to differentiate among these groups. CONCLUSION PET/CT parameters, including total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity, are not able to differentiate benign from malignant parotid tumors, primary parotid tumors from metastasis, or metastasis

  13. Isolated Langerhans cell histiocytosis of the sublingual gland in an adult

    PubMed Central

    Yang, Shaodong; Chen, Xinming; Zhang, Jiali; Fang, Qiong

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder characterized by the proliferation of pathologic Langerhans cells. Its clinical presentation is highly variable, that range from single-system, limited disease to severe, multi-organ disease with high mortality. LCH usually affects children and young adults. The most frequent sites for LCH are the bone, skin, lung, pituitary gland, and lymph nodes. Salivary gland involvement by LCH is extremely rare, and only a few cases of LHC involving the parotid glands have been reported in the English literature. To our knowledge, the involvement of the sublingual gland as a part of single or multisystem LCH has not been previously described. Herein we reported the first case of primary LCH of the sublingual gland. A 40-year-old woman presented with a 2-month history of a painless mass on the right sublingual area. Excision of the lesion including the right sublingual gland was performed. Histopathological diagnosis of LCH was rendered. The patient remains free of symptoms 17 months after surgery. PMID:26722591

  14. Salivary gland neoplasms in children: a 10-year survey at the Children's Hospital of Philadelphia.

    PubMed

    Kessler, A; Handler, S D

    1994-06-01

    Fifteen salivary gland tumors were treated at The Children's Hospital of Philadelphia between 1982 and 1991. Eight of these lesions were malignant and 7 were benign. All of the benign tumors were pleomorphic adenomas. For these, superficial parotidectomy or excision of the submandibular gland was the treatment of choice. One child had recurrence 2 years after her initial surgery. Among the malignant lesions, mucoepidermoid carcinoma was diagnosed in 5 children, and acinic cell carcinoma in 3. Six malignant tumors involved the parotid gland, while 2 originated in the submandibular salivary gland. Superficial or total parotidectomy, or excision of the submandibular gland was performed, according to the nature and the location of the lesion. The facial nerve was sacrificed in one patient because of extensive involvement of the nerve. A 2-year survival rate of 100% was achieved, and all the patients were free of disease at the end of the follow-up period. Successful management of salivary gland lesions in children requires a high index of suspicion of possible malignancy and complete surgical removal as the initial treatment. Radiation therapy is recommended in the management of those patients with microscopic residual tumor and/or nodal involvement.

  15. Fine needle aspiration biopsy in a diagnostic workup algorithm of salivary gland tumors.

    PubMed

    Ivanová, S; Slobodníková, J; Janská, E; Jozefáková, J

    2003-01-01

    The ultrasonic diagnosis of salivary gland diseases can give a more accurate information than clinical data alone. In diagnosis of the parotid gland diseases, it is necessary to differentiate clearly tumors from other diseases. When a tumor is suspected, its presence should be confirmed, and determined if it is solitary, multiple, unilateral or bilateral, intra or extraglandular, and benign or malignant. In the period of May 1998 to January 2001 ultrasound examinations were performed in 354 patients, FNAB with ultrasound control were performed in 152 patients with a mean age of 49.7 years. The ultrasound and cytologic findings were correlated with surgical and histologic findings. Results indicate that in patients with solid mass of the salivary gland, ultrasound examination confirmed the finding of salivary gland tumor in all patients (100%). In non-solid diseases of salivary glands the diagnostic accuracy was slightly lower. The use of ultrasound techniques in the study of salivary gland pathology is well justified, due to its capacity to provide high resolution and improving clinical diagnosis. FNAB is a simple quick, accurate and virtually complications free investigative modality. The data on its ability to distinguish between lesions requiring surgery or not are encouraging.

  16. Pleomorphic adenoma of the minor salivary gland of the cheek.

    PubMed

    Sharma, Arpit; Deshmukh, Shraddha; Shaikh, Ahmed; Dabholkar, Jyoti

    2013-09-01

    Pleomorphic adenoma is the most common tumour of the salivary gland. While the majority arises from the parotid gland, only a small percentage arises from the minor salivary glands. The cheek, however, is a rarely affected site with respect to pleomorphic adenomas of the minor salivary glands. Herein, we report a case of pleomorphic adenoma of the cheek, which presented with intraoral swelling, and conclude that complete surgical excision can be a curative treatment for this benign tumour.

  17. Bilateral multicystic parotid masses in primary Sjögren syndrome.

    PubMed

    Toh, Alex S; Broomfield, Stephen J; Teh, Lee-Suan; Aslam, Muhammad B; Duncan, Gavin; Morar, Pradeep

    2011-10-01

    We report the case of a 48-year-old woman who presented with bilateral parotid gland enlargement as the initial manifestation of primary Sjögren syndrome. Magnetic resonance imaging demonstrated multiple areas of low-intensity signal mixed with foci of high-intensity signal, a finding suggestive of Sjögren syndrome. Autoimmune blood tests for Sjögren syndrome were positive, and a sublabial biopsy confirmed the diagnosis. Investigations for other conditions, including human immunodeficiency virus infection, were negative. After 5 years of follow-up, the parotid swellings remained essentially unchanged. We discuss the etiology of multicystic parotid gland pathology, its involvement in Sjögren syndrome, and the risk of lymphoma.

  18. Salivary gland myoepithelial carcinoma.

    PubMed

    Vilar-González, S; Bradley, K; Rico-Pérez, J; Vogiatzis, P; Golka, D; Nigam, A; Sivaramalingam, M; Kazmi, S

    2015-11-01

    Salivary gland myoepithelial carcinoma (MC) or malignant myoepithelioma is a rare entity. MC usually presents as a slow-growing painless mass arising in the parotid gland, but may involve other salivary glands. This tumour may be particularly locally aggressive, but its clinical and biological features are not yet fully understood. MC may arise from pre-existing benign lesions, such as pleomorphic adenomas or benign myoepitheliomas, or may arise de novo. It usually affects patients over 50 years old, with no gender preference. Because it is often asymptomatic, the presentation and diagnosis can be delayed by months, even years. The current WHO classification considers MC to be an intermediate- to high-grade malignancy. Other published data suggest it is likely to be a high-grade neoplasm, consistent with its aggressive behaviour. Its epidemiology, histopathological features, immunohistochemical profile, clinical behaviour and optimal management are not well understood. Following review of the current literature we aim to address these.

  19. Malignant lymphoepithelial lesion of the salivary gland.

    PubMed

    Saw, D; Lau, W H; Ho, J H; Chan, J K; Ng, C S

    1986-09-01

    Eight cases of malignant lymphoepithelial lesion (MLEL) of major salivary glands, seven of which occurred in Southern Chinese patients, are reported. All but two of the patients were older than 40 years of age; there were five male and three female patients. The parotid and submandibular glands were the sites of origin in equal numbers of cases. Six patients had elevated titers of serum IgA against Epstein-Barr virus capsid antigen. Seven remained well after surgery and local radiation therapy, and one died of miliary tuberculosis without evidence of residual neoplasm. Histologically, MLELs were characterized by syncytial clumps of large cells with vesicular nuclei and prominent nucleoli, admixed with abundant small lymphocytes and plasma cells. Two features not emphasized previously in the literature were the presence of reactive histiocytes in some epithelial islands, producing a starry sky pattern, and perineural invasion, which was identified in four cases. The tumor cells showed strong immunostaining for cytokeratin. The literature concerning this rare tumor is reviewed, and the differential diagnosis between MLEL and benign lymphoepithelial lesion, metastatic undifferentiated carcinoma, and malignant lymphoma is discussed.

  20. Clinicopathological and Targeted Exome Gene Features of a Patient with Metastatic Acinic Cell Carcinoma of the Parotid Gland Harboring an ARID2 Nonsense Mutation and CDKN2A/B Deletion

    PubMed Central

    Warner, Wayne A.; Wong, Deborah J.; Palma-Diaz, Fernando; Shibuya, Terry Y.; Momand, Jamil

    2015-01-01

    We describe the presentation, treatment, clinical outcome, and targeted genome analysis of a metastatic salivary acinic cell carcinoma (AciCC). A 71-year-old male presented with a 3 cm right tail of a parotid lesion, first detected as a nodule by the patient seven months earlier. He had a right total parotidectomy with cranial nerve VII resection, right facial nerve resection and grafting, resection of the right conchal cartilage, and right modified radical neck dissection. The primary tumor revealed AciCC with two distinct areas: a well-differentiated component with glandular architecture and a dedifferentiated component with infiltrative growth pattern associated with prominent stromal response, necrosis, perineural invasion, and cellular pleomorphism. Tumor staging was pT4 N0 MX. Immunohistochemistry staining showed pankeratin (+), CD56 (−), and a Ki67 proliferation index of 15%. Upon microscopic inspection, 49 local lymph nodes resected during parotidectomy were negative for cancer cells. Targeted sequencing of the primary tumor revealed deletions of CDKN2A and CDKN2B, a nonsense mutation in ARID2, and single missense mutations of unknown significance in nine other genes. Despite postoperative localized radiation treatment, follow-up whole body PET/CT scan showed lung, soft tissue, bone, and liver metastases. The patient expired 9 months after resection of the primary tumor. PMID:26634163

  1. Preoperative treatment of a parotid hemangioma with 100% ethyl alcohol

    PubMed Central

    Emsen, Ilteris Murat

    2008-01-01

    Hemangiomas are one of the most common childhood neoplasms, occurring in approximately 12% of infants younger than one year of age. The lesions typically appear shortly after birth, increase in size over the first year and characteristically regress over the next decade. Because hemangiomas can be visible during an important stage of a child’s social development, numerous authors have pursued alternative treatment strategies to avoid or reduce this lengthy involution process. Unfortunately, no effective medical treatment has been reported for children with large, deforming hemangiomas of the parotid gland and overlying cheek. In the present case, a patient with a large parotid hemangioma was treated preoperatively with an intralesional injection of 100% ethyl alcohol solution to reduce the size of the mass. The mass was removed 28 days later with no major postoperative complications. PMID:19949507

  2. Enlargement of salivary glands in bulimia.

    PubMed

    Vavrina, J; Müller, W; Gebbers, J O

    1994-06-01

    We report a unusual case of bulimia nervosa with bilateral swelling of parotid and submandibular glands as the only symptom of the underlying behavioural disorder. Histologically, sialadenosis was diagnosed in a parotid biopsy. The parotomegaly in bulimia may be a diagnostic primer as these patients often deny their eating disorder. B-scan ultrasonography is an important diagnostic tool to assess the nature of the parotid enlargement. Hyperamylasaemia occurs commonly in bulimic patients and may help to confirm the diagnosis. All patients with suspected bulimia should have a thorough medical history and physical examination to rule out other aetiologies of asymptomatic parotid swelling. As the enlargement is usually transient surgical intervention is only rarely required.

  3. Preservation of the superficial lobe for deep-lobe parotid tumors: a better aesthetic outcome.

    PubMed

    Hussain, Akhtar; Murray, Daran P

    2005-08-01

    Deep-lobe parotid tumors are relatively uncommon. Most of these tumors present as external masses. They can also present in the oral cavity or oropharynx. Magnetic resonance imaging and ultrasound-guided fine-needle aspiration for biopsy and cytology have made it possible to establish a definitive diagnosis and identify the exact location of the tumor in almost all cases before surgery. Traditionally, deep-lobe tumors have been managed by a formal superficial parotidectomy and identification and preservation of the facial nerve, followed by removal of the deep lobe that contains the tumor Superficialparotidectomy is associated in most cases with periauricular depression secondary to a loss of volume, leading to variable aesthetic deformities. A complete parotidectomy is more likely to be associated with a larger aesthetic deficit secondary to a greater loss of tissue volume. The incidence of gustatory sweating is high after superficial parotidectomy, particularly in the early postoperative period. We hypothesize that if the superficial lobe is preserved, there is less likelihood of gustatory sweating because of the interposition of tissue between the skin and the cut ends of the secretomotor fibers. Approximately 80% of parotid tissue volume is made up of the superficial lobe, and therefore preservation of the superficial lobe should be associated with less postparotidectomy depression. Therefore, we decided to preserve the superficial lobe of the gland for deep-lobe tumors. Nine patients underwent deep-lobe parotidectomy with preservation of the superficial lobe over a 6-year period. Patients were studied prospectively with regard to technical difficulty, complications, and cosmetic outcome. Follow-up ranged from 12 months to 6 years. We did not experience any undue technical difficulty, and there were no cases of facial weakness. One patient developed gustatory sweating, which almost completely resolved over a 2-year period. There were no cases of post

  4. Pleomorphic adenoma of the buccal salivary gland.

    PubMed

    Khandekar, Shubhangi; Dive, Alka; Munde, Prashant; Wankhede, Neena Dongre

    2015-01-01

    Salivary gland swellings can result from tumors, an inflammatory process or cysts. It can sometimes be difficult to establish; whether pathology arises from the salivary gland itself or adjacent structures. Neoplasms of the salivary glands account for less than 1% of all tumors, 3-5% of all head and neck tumors and benign pleomorphic adenoma (PA) of minor salivary glands arising de novo is very rare. PA is the most common tumor of the salivary gland. While the majority arises from the parotid gland, only a small percentage arises from the buccal minor salivary gland. A case of PA of minor salivary glands in the buccal mucosa in a 70-year-old female is discussed. It includes review of literature, clinical features, histopathology, radiological findings and treatment of the tumor; with emphasis on diagnosis.

  5. Rhinosporidiosis of Parotid Duct Presenting as Consecutive Bilateral Facial Swelling: A Rare Case Report and Literature Review.

    PubMed

    Sarkar, Santanu; Panja, Soumyajyoti; Bandyopadhyay, Arghya; Roy, Shreosee; Kumar, Sandeep

    2016-03-01

    Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi. Sporadic cases of rhinosporidiosis has been reported from many countries but is endemic in Southern India (Madurai, Ramnad, Rajapalayam and Sivaganga), Nepal, Bangladesh and Sri Lanka. This disease commonly affects the mucous membrane of the nose or naso-pharynx and presents as a leafy, polypoidal mass. The reported extranasal sites include the oro-pharynx, eye, ear, larynx, trachea, bronchi, skin and genital mucosa. It may also become disseminated to present as a generalized form. In our case a 40-year-old female from rural West Bengal (Eastern India) presented with right sided facial swelling. Our provisional diagnosis was parotid duct cyst on the basis of careful history, scrupulous clinical examination and relevant investigations comprising CECT scan of face. Although Rhinosporidiosis was not taken into consideration in the clinical differential diagnosis, it was eventually diagnosed postoperatively by histopathological examination of surgical specimen. Two months later in follow-up, the same patient presented to us with left sided facial swelling. We managed the left facial swelling successfully with minimally invasive surgery and 100mg twice daily dapsone for 6 months. We present this case firstly because Rhinosporidiosis of parotid duct (stensen's duct) is a rare entity and secondly non-neoplastic cysts of the salivary glands are also uncommon and represent only 2-5% of all salivary gland lesions. Furthermore our case emphasizes that the clinicians should aware of this rare clinical entity specially in endemic areas, because minimally invasive techniques and medications might solve the problem while helping patients to avoid surgical excision. PMID:27134935

  6. Schwannoma of the submandibular gland.

    PubMed

    Diaz, D D; Kennedy, K S; Parker, G S; White, V J

    1991-01-01

    Neurilemmomas (schwannomas) are solitary neurogenic tumors that arise from cells of the neural sheath. They are slow growing and represent a proliferation of Schwann cells. Extracranial neurogenic tumors of the head and neck are uncommon, with benign tumors occurring with greater frequency than malignant tumors. These tumors often mimic primary or metastatic disease in the head and neck. Schwannoma of the salivary gland is a particularly rare form of an extracranial neurogenic tumor, with most presenting in the parotid gland originating from a peripheral branch of the facial nerve. An unusual case of neurilemmoma of the submandibular gland is presented, and the literature concerning this subject is reviewed. We believe this tumor originated in an autonomic nerve of the submandibular gland. The mass was discrete and well demonstrated on CT scan. Total excision of the gland resulted in complete resolution of symptoms with no cranial nerve deficits.

  7. Diagnosis of sarcoidosis by lip biopsy of minor salivary glands

    PubMed Central

    Tannenbaum, Hyman; Anderson, Larry G.; Rosenberg, Earle H.; Sheffer, Albert L.

    1974-01-01

    In two patients with bilateral parotid gland swelling of unknown etiology the diagnosis of sarcoidosis was established by lip biopsy of the minor salivary glands. This simple, innocuous biopsy procedure may prove useful in tissue documentation of sarcoidosis. ImagesFIG. 1 PMID:4442017

  8. Physical, Chemical, and Immunohistochemical Investigation of the Damage to Salivary Glands in a Model of Intoxication with Aluminium Citrate

    PubMed Central

    da Costa, Natacha M. M.; Correa, Russell S.; Júnior, Ismael S. M.; Figueiredo, Adilson J. R.; Vilhena, Kelly F. B.; Farias-Junior, Paulo M. A.; Teixeira, Francisco B.; Ferreira, Nayana M. M.; Pereira-Júnior, João B.; Dantas, Kelly das Graças F.; da Silva, Marcia C. F.; Silva-Junior, Ademir F.; Alves-Junior, Sergio de M.; Pinheiro, João de Jesus V.; Lima, Rafael Rodrigues

    2014-01-01

    Aluminum absorption leads to deposits in several tissues. In this study, we have investigated, to our knowledge for the first time, aluminum deposition in the salivary glands in addition to the resultant cellular changes in the parotid and submandibular salivary glands in a model of chronic intoxication with aluminum citrate in rats. Aluminum deposits were observed in the parotid and submandibular glands. Immunohistochemical evaluation of cytokeratin-18 revealed a decreased expression in the parotid gland with no changes in the submandibular gland. A decreased expression of α-smooth muscle actin was observed in the myoepithelial cells of both glands. The expression of metallothionein I and II (MT-I/II), a group of metal-binding proteins, which are useful indicators for detecting physiological responses to metal exposure, was higher in both glands. In conclusion, we have shown that at a certain time and quantity of dosage, aluminum citrate promotes aluminum deposition in the parotid and submandibular glands, leads to an increased expression of MT-I/II in both the glands, damages the cytoskeleton of the myoepithelial cells in both glands, and damages the cytoskeleton of the acinar/ductal cells of the parotid glands, with the submandibular glands showing resistance to the toxicity of the latter. PMID:25464135

  9. Physical, chemical, and immunohistochemical investigation of the damage to salivary glands in a model of intoxication with aluminium citrate.

    PubMed

    da Costa, Natacha M M; Correa, Russell S; Júnior, Ismael S M; Figueiredo, Adilson J R; Vilhena, Kelly F B; Farias-Junior, Paulo M A; Teixeira, Francisco B; Ferreira, Nayana M M; Pereira-Júnior, João B; Dantas, Kelly das Graças F; da Silva, Marcia C F; Silva-Junior, Ademir F; Alves-Junior, Sergio de M; Pinheiro, João de Jesus V; Lima, Rafael Rodrigues

    2014-12-01

    Aluminum absorption leads to deposits in several tissues. In this study, we have investigated, to our knowledge for the first time, aluminum deposition in the salivary glands in addition to the resultant cellular changes in the parotid and submandibular salivary glands in a model of chronic intoxication with aluminum citrate in rats. Aluminum deposits were observed in the parotid and submandibular glands. Immunohistochemical evaluation of cytokeratin-18 revealed a decreased expression in the parotid gland with no changes in the submandibular gland. A decreased expression of α-smooth muscle actin was observed in the myoepithelial cells of both glands. The expression of metallothionein I and II (MT-I/II), a group of metal-binding proteins, which are useful indicators for detecting physiological responses to metal exposure, was higher in both glands. In conclusion, we have shown that at a certain time and quantity of dosage, aluminum citrate promotes aluminum deposition in the parotid and submandibular glands, leads to an increased expression of MT-I/II in both the glands, damages the cytoskeleton of the myoepithelial cells in both glands, and damages the cytoskeleton of the acinar/ductal cells of the parotid glands, with the submandibular glands showing resistance to the toxicity of the latter.

  10. Oncocytic lipoadenoma of the submandibular gland.

    PubMed

    Hirokawa, M; Shimizu, M; Manabe, T; Ito, J; Ogawa, S

    1998-04-01

    We report a case of oncocytic lipoadenoma of the submandibular gland, previously unrecognized benign tumor of the salivary gland. The patient was a 66-year-old Japanese woman with a left submandibular mass, measuring 11 x 7.5 x 5 cm. Microscopically, the mass was completely surrounded by a thin fibrous connective tissue capsule, and was composed of an intimate admixture of mature fat cells and oncocytes. There have been no English reports of such a neoplasm in the salivary gland with the exception of one recent case report of lipoadenoma of the parotid gland without oncocytic features. We propose the diagnostic term "oncocytic lipoadenoma" for this benign tumor.

  11. Bicarbonate transport in sheep parotid secretory cells.

    PubMed Central

    Steward, M C; Poronnik, P; Cook, D I

    1996-01-01

    1. Intracellular pH (pH1) was measured by microfluorimetry in secretory endpieces isolated from sheep parotid glands and loaded with the pH-sensitive fluoroprobe 2', 7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF). 2. Stimulation with 1 microM acetylcholine (ACh) caused a large, transient decrease in pH1 of 0.37 +/- 0.02 pH units followed by a slower recovery. The transient, which was reduced by 60% in the absence of HCO3-, could be attributed mainly to HCO3- efflux. During sustained stimulation, pH1 increased to a value that exceeded the resting value by 0.083 +/- 0.023 pH units after 20 min. 3. The anion channel blocker NPPB (0.1 mM) reduced the transient acidification in response to ACh by 48% and raised pH1 during sustained stimulation. Simultaneous application of NPPB and ACh accelerated the re-alkalinization following the initial acidification, indicating that NPPB inhibits HCO3- efflux. 4. The stilbene derivative H2DIDS (0.5 mM) reduced the transient acidification in response to ACh by 76% but caused a marked decrease in pH1 during sustained stimulation. Simultaneous application of H2DIDS and ACh slowed the re-alkalinization following the initial acidification, indicating that the main effect of H2DIDS was to inhibit HCO3- accumulation. 5. In the absence of HCO3-, the recovery from an acid load was unaffected by ACh stimulation. Acid extrusion, although dependent on Na+, was not inhibited by amiloride (1 mM), clonidine (1 mM) or H2DIDS (0.5 mM) and was therefore provisionally attributed to a Na(+)-H+ exchanger isoform other than NHE1 or NHE2. 6. In the presence of HCO3-, the rate of recovery from an acid load was reduced during ACh stimulation, probably as a result of the increased efflux of HCO3-. Acid extrusion was dependent on Na+ and was significantly inhibited by H2DIDS. 7. We conclude that ACh-evoked HCO3- secretion in the sheep parotid gland differs from that in many other salivary glands by being driven predominantly by basolateral Na(+)-HCO3

  12. Radionuclide salivary gland imaging

    SciTech Connect

    Mishkin, F.S.

    1981-10-01

    Salivary gland imaging with 99mTc as pertechnetate provides functional information concerning trapping and excretion of the parotid and submandibular glands. Anatomic information gained often adds little to clinical evaluation. On the other hand, functional information may detect subclinical involvement, which correlates well with biopsy of the minor labial salivary glands. Salivary gland abnormalities in systemic disease such as sarcoidosis, rheumatoid arthritis, lupus erythematosus, and other collagenvascular disorders may be detected before they result in the clinical manifestaions of Sjoegren's syndrome. Such glands, after initially demonstrating increased trapping in the acute phase, tend to have decreased trapping and failure to discharge pertechnetate in response to an appropriate physiologic stimulus. Increased uptake of gallium-67 citrate often accompanies these findings. Inflammatory parotitis can be suspected when increased perfusion is evident on radionuclide angiography with any agent. The ability of the salivary gland image to detect and categorize mass lesions, which result in focal areas of diminished activity such as tumors, cysts, and most other masses, is disappointing, while its ability to detect and categorize Warthin's tumor, which concentrates pertechnetate, is much more valuable, although not specific.

  13. Intraductal papillary tumors of the major salivary glands: case reports of benign and malignant variants.

    PubMed

    Nagao, T; Sugano, I; Matsuzaki, O; Hara, H; Kondo, Y; Nagao, K

    2000-02-01

    Intraductal papilloma is an extremely rare benign salivary gland tumor that occurs most commonly in the minor salivary glands. To our knowledge, a malignant counterpart of intraductal papilloma has not been described previously. We report one case each of benign and malignant intraductal papillary tumors. The benign tumor occurred in the sublingual gland and was a typical example of intraductal papilloma, with the exception that we found no previously published reports of this type of tumor in this location. The other patient had a left parotid gland tumor that was architecturally similar to the intraductal papilloma, with the addition of cytologic atypia, intraductal extension, microinvasion, and lymph node metastases. This tumor was diagnosed as intraductal papillary adenocarcinoma with an invasive component. Both patients were alive and well without evidence of recurrence 2 years and 6 months (case 1) and 6 years (case 2) after surgery. Immunohistochemical examination revealed that the tumor cells resembled duct luminal cells in both cases. The 2 tumors had different immunoreactivities for carcinoembryonic antigen, p53, and Ki-67. The malignant counterpart of intraductal papilloma should be considered in the differential diagnosis of salivary gland tumors with a predominantly papillary structure, even though this tumor is extremely rare.

  14. Salivary gland neoplasms in Lagos, Nigeria.

    PubMed

    Arotiba, G T

    1996-01-01

    This 14 year retrospective clinico-statistical analysis of 237 salivary gland neoplasms in Lagos, Nigeria, was undertaken with a view to providing further insights into the presentation of this disease in Africans. These neoplasms constituted 10.0% of all head and neck neoplasms, and were most frequently situated at the parotid gland (32.1%), the palate (24.9%) and the submandibular gland (19.4%). While parotid squamous cell carcinoma affected more males (41.2%) than females (4.7%) (P = 0.03); parotid mucoepidermoid carcinoma affected more females (53.3%) than males (11.8%) (P = 0.0149). Furthermore, labial salivary gland tumours affected more females (6.8%) than males (1.7%) (P = 0.05). At presentation, patients with palatal tumours were relatively more advanced in age (Peak = 6th decade) than those with parotid and submandibular tumours (Peak = 3rd decade). Males presenting with pleomorphic adenoma were relatively younger than their female counterparts. This is especially true of palatal pleomorphic adenoma. The recurrence rate for benign tumours was 4.8%. Majority of patients with malignant tumours (83.9%) had significant local extension, regional or distant metastasis at presentation. In twenty-nine percent of these patients with cancer, the disease was controlled for 1-5 years of follow-ups. However, a quarter of these patients with cancer defaulted the planned treatment regime because they could not afford the cost of treatment or they opted for traditional medical care.

  15. Management algorithm for HIV-associated parotid lymphoepithelial cysts.

    PubMed

    Mourad, Waleed F; Patel, Shyamal; Young, Rebekah; Khorsandi, Azita S; Concert, Catherine; Shourbaji, Rania A; Ciarrocca, Katherine; Bakst, Richard L; Shasha, Daniel; Guha, Chandan; Garg, Madhur K; Hu, Kenneth S; Kalnicki, Shalom; Harrison, Louis B

    2016-10-01

    We report an evidence-based management algorithm for benign lymphoepithelial cysts (BLEC) of the parotid glands in HIV patients based on long-term outcomes after radiation therapy. From 1987 to 2013, 72 HIV-positive patients with BLEC of the parotid glands treated at our institutions were identified and their medical records were reviewed and analyzed. The primary endpoint of our study was to determine a dose response in HIV patients with BLEC. In group A (≤18 Gy), which received a median dose of 10 Gy (8-18), overall response (OvR), complete response (CR), partial response (PR), and local failure (LF) was experienced by 7, 7, 0, and 93 %, respectively. In group B (≥22.5 Gy), which received a median dose of 24 Gy (22.5-30), OvR, CR, PR, and LF was experienced by 88, 65, 23, and 12 %. Logistic regression revealed that higher dose (≥22.5 Gy) predicted for cosmetic control (p = 0.0003). Multiple regression analysis revealed higher dose predicted for cosmetic control (p = 0.0001) after adjusting for confounding variables (age, gender, race, HAART use, BLEC duration, and fractionation size). No patients in either group experienced RTOG grade ≥3 toxicities. A radiation dose of 24 Gy delivered in 12-16 fractions of 1.5-2 Gy per fraction provides long-term cosmetic control in HIV-positive patients with BLEC of the parotid glands.

  16. Endocrine glands

    MedlinePlus

    The endocrine system is primarily composed of glands that produce chemical messengers called hormones. Glands of the endocrine system include the pituitary gland, the thyroid gland, the parathyroid glands, the thymus, ...

  17. Rosai-Dorfman disease presenting as a parotid mass.

    PubMed

    Norman, L; Bateman, A C; Watters, G W; Singh, V; Spedding, A V

    1997-11-01

    Sinus histiocytosis with massive lymphadenopathy (SHML) is a rare, benign disease of unknown aetiology. This disease typically presents with massive, painless cervical lymphadenopathy but may occur in a wide variety of extranodal sites. Our report describes a 71-year-old man who presented with a discrete, unilateral parotid mass which was clinically suggestive of a primary salivary gland tumour. Initial cytological examination of a fine needle aspirate specimen taken from the mass demonstrated a discohesive cell population with nuclear atypia, raising the possibility of malignancy. However, excision of the mass and histological examination enabled a definitive diagnosis to be made.

  18. Oncocytic adenocarcinoma of salivary glands.

    PubMed

    Goode, R K; Corio, R L

    1988-01-01

    Oncocytic adenocarcinoma of salivary gland origin is an extremely rare neoplasm. The diagnosis is established on the basis of oncocytic cellular features in conjunction with dysplastic change. These dysplastic changes may occur in benign oncocytomas or arise de novo. The tumor occurs most commonly in the parotid glands of persons over 60 years of age. Tumors that measure less than 2 cm at the initial surgical procedure appear to have a better prognosis than larger tumors. Aggressive surgical intervention at the initial presentation of the neoplasm, compared to simple enucleation, seems to offer a more favorable prognosis. Recurrence is an ominous feature. Metastasis, when it occurs, is widespread.

  19. Parotid manifestations of HIV infection.

    PubMed

    Zeitlen, S; Shaha, A

    1991-08-01

    A lump in the parotid region is generally a salivary tumor unless proved otherwise. Recently with an epidemic of acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC), a large number of pathologies are noticed in the parotid region. These conditions generally involve the intraparotid and periparotid lymph nodes. Hyperplastic lymphadenopathy and the benign lymphoepithelial lesions are the most common variants. Our knowledge regarding these new conditions is just evolving. There remains a therapeutic dilemma starting from observation only to local excision and superficial or total parotidectomy. These lesions must be kept in mind when we evaluate a patient with risk factors for human immunodeficiency virus (HIV) infection.

  20. Frequency and Histopathology by Site, Major Pathologies, Symptoms and Signs of Salivary Gland Neoplasms.

    PubMed

    Bradley, Patrick J

    2016-01-01

    The frequency distribution of salivary gland neoplasms (SGNs) is, in decreasing order, parotid neoplasms, submandibular gland neoplasms, minor SGNs, and sublingual gland neoplasms. The larger the salivary gland (e.g. parotid), the more likely a neoplasm is benign, and the smaller the gland (e.g. minor salivary gland), the more likely the neoplasm is malignant. The majority of SGNs, benign and/or malignant, irrespective of site, present as a painless swelling or mass. Definitive symptoms and signs of salivary gland malignancy are the presence of named nerve palsy in anatomical proximity to the gland and/or the presence of cervical lymphadenopathy. All discrete major salivary gland masses and non-ulcerated submucosal masses presenting in the head and neck region, irrespective of age, should be investigated, with the aim of excluding an SGN.