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Sample records for parotid gland surgery

  1. Treatment of complications of parotid gland surgery

    PubMed Central

    Marchese-Ragona, R; De Filippis, C; Marioni, G; Staffieri, A

    2005-01-01

    Summary Although several reports in the literature have documented the surgical technique, and the oncological outcome achieved with parotidectomy, only a few articles have described the complications of parotid gland surgery and their management. Several complications have been reported in parotid surgery. We re-classified the complications of parotidectomy in intra-operative and post-operative (early and late). The commonest complications after parotidectomy are temporary or permanent facial palsy and Frey’s syndrome. PMID:16450773

  2. Do we need a new classification of parotid gland surgery?

    PubMed

    Wierzbicka, Małgorzata; Piwowarczyk, Krzysztof; Nogala, Hanna; Błaszczyńska, Marzena; Kosiedrowski, Michał; Mazurek, Cezary

    2016-06-30

    In February 2016 the European Salivary Gland Society (ESGS) presented and recommended classification of parotidectomies based on the anatomical I-V level division of parotid gland. The main goal of this paper is to present the new classification, and to answer the question if it is more precise compared to classic one. 607 patients (315 man, 292 women) operated on for parotid tumours in a tertiary referral centre, Department of Otolaryngology, Head and Neck Surgery, Medical University of Poznań (502 benign and 105 malignant tumours). Parotid surgery descriptions provided by retrospective analysis of all operating protocols covering the years 2006-2015 were "translated" into the new classification proposed by the ESGS. Analysis of operating protocols and fitting them into the new classification proposed by the ESGS show some discrepancies, in both benign and malignant tumours. Based on the re-evaluation of 607 cases, in 94 procedures for benign tumors the only information available was that "surgery was performed within the superficial lobe". Thus, the new classification forces the surgeon to be much more precise than previously. In 3 cases the whole superficial lobe was removed, together with the upper part of the deep lobe. Because the classification lacked parotidectomy I-II-IV, it indicated that the new classification was insufficient in the aforementioned three cases. In 6 cases of ECD more than one parotid gland tumour was removed. Among malignant tumours, total parotidectomy was the predominant procedure. In 3/13 cases of expanded parotidectomy the temporomandibular joint (TMJ) was additionally removed and it seems that the acronym TMJ should be included among the additional resected structures. It is also necessary to supplement the description of the treatment with casuistically resected anatomical structures for oncological purposes (RT planning) and follow-up imaging. Currently, since 2015 in Poland there has been the National Cancer Registry of benign

  3. An audit of surgery of the parotid gland.

    PubMed Central

    Deans, G. T.; Briggs, K.; Spence, R. A.

    1995-01-01

    The management of patients undergoing 50 surgical procedures to the parotid gland was reviewed. The overall accuracy of fine needle aspiration cytology was 87%, false-positive and false-negative rates for malignant disease both being 4%. The sensitivity, specificity and accuracy of fine needle cytology for malignant parotid tumours was 66%, 95%, and 91%, respectively, that of benign tumours (pleomorphic adenoma or Warthin's tumour) being 88%, 83% and 87%, respectively. Sensitivity, specificity and accuracy for the remaining (principally inflammatory) parotid diseases was 100%, 95% and 96%, respectively. The predictive value of a positive test for malignant tumours, benign tumours and inflammatory conditions was 66%, 94% and 75%, respectively. The negative predictive value for these conditions was 95%, 71% and 100%, respectively. Facial nerve weakness after parotidectomy occurred in three patients (8.8%), being permanent in two cases (both malignant). Although Frey's syndrome was not recorded in any of the notes, careful follow-up revealed two cases (6%). To date there have been no local recurrences after excision of either benign or primary malignant parotid masses. One patient with squamous cell carcinoma metastatic to the parotid gland died, despite block dissection of the neck and radiotherapy. This small series with a limited follow-up suggests that diseases of the parotid gland can be managed by general surgeons with an interest in this field. Although fine needle aspiration and ultrasonic scan may be helpful, the decision to operate should be made on clinical grounds. PMID:7598416

  4. Rare Parotid Gland Diseases.

    PubMed

    Sanan, Akshay; Cognetti, David M

    2016-04-01

    The differential diagnosis for "rare" parotid gland diseases is broad and encompasses infectious, neoplastic, autoimmune, metabolic, and iatrogenic etiologies. The body of knowledge of parotid gland diseases has grown owing to advances in imaging and pathologic analysis and molecular technology. This article reviews rare parotid diseases, discussing the respective disease's clinical presentation, diagnosis, imaging, pathogenesis, treatment, and prognosis.

  5. Fluorescein sodium-guided surgery of parotid gland tumors as a technical advance.

    PubMed

    Haubner, Frank; Gassner, Holger G; Brawanski, Alexander; Schebesch, Karl-Michael

    2017-01-01

    Complete tumor removal and preservation of the facial nerve are essential in parotid gland surgery. A technical adjunct that potentially enhances the contrast between the facial nerve and the adherent tumor tissue and allows to identify residual tumor tissue could be Fluorescein Sodium. Retrospective chart analysis on 7 patients with benign parotid gland lesions that were operated using Fluorescein Sodium intravenously and the application of the YELLOW 560 nm filter of the operating microscope. Safety and feasibility were evaluated. All tumors showed fluorescence and the rating ´contrast-enhancing´ was assigned in all cases. In 2 patients, satellite nodules were identified and resected meaning that the fluorescence staining of the tumor margins was significantly better than under white light. The use of Fluorescein Sodium in parotidectomy is promising. In two cases residual tumor was detected that would have been left behind under white light. Further research in parotid gland surgery and other head and neck tumor procedures is warranted.

  6. Accessory parotid gland tumors.

    PubMed

    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.

  7. 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

  8. Telocytes in parotid glands.

    PubMed

    Nicolescu, Mihnea I; Bucur, Alexandru; Dinca, Octavian; Rusu, Mugurel C; Popescu, Laurentiu M

    2012-03-01

    The parotid histological structure includes acinar, ductal, and myoepithelial cells, surrounded by a connective stromal component. The parotid stroma is mostly regarded as an inert shell, consisting of septa, which divide the parenchyma. Telocytes were recently identified as a new stromal cell type in various organs, including exocrine pancreas. We aimed to evaluate telocytes presence in parotid stroma and whether their topographical features might support an involvement in parotid function modulation. Serial ultrathin sections of human and rat parotid glands were studied and compared by transmission electron microscopy. Two-dimensional concatenation of sequenced micrographs allowed the ultrastructural identification of parotid telocytes, with their specific long, thin, and moniliform prolongations (telopodes). Telocyte location appeared frequently as a strategic one, in close contact or vicinity of both secretory (acini and ducts) and regulatory (nerves and blood vessels) apparatuses. They were also found in the interacinar and the subductal stroma. Two previously reported telocyte markers (c-kit/CD117 and vimentin) were assayed by immunohistochemistry. Actin expression was also evaluated. Telocytes are making a network, especially by branching of their long telopodes. Elements of this telocyte network are interacting with each other (homocellular connections) as well as with other cell types (heterocellular connections). These interactions are achieved either by direct contact (stromal synapse), or mediated via shed microvesicles/exosomes. Since telocyte connections include both neurovascular and exocrine elements (e.g., acini and ducts), it is attractive to think that telocytes might mediate and integrate neural and/or vascular input with parotid function.

  9. [Clinical features of accessory parotid gland tumors].

    PubMed

    Iguchi, Hiroyoshi; Wada, Tadashi; Yamamoto, Hidefumi; Yamada, Kei; Matsushita, Naoki; Okamoto, Sachimi; Teranishi, Yuichi; Koda, Yuki; Kosugi, Yuki; Yamane, Hideo

    2013-12-01

    Accessory parotid gland tumors are relatively rare; hence, adequately detailed clinical analyses of these tumors are difficult to perform at a single institution. In this report, we describe the findings for 65 patients [29 men, 36 women; median age, 51 (9-81) years] with accessory parotid gland tumors, consisting of 4 cases documented by us and 61 cases previously reported by other Japanese authors. Approximately 50% of the patients were treated in an otolaryngology department, while the remaining patients were treated in plastic surgery, oral surgery, or dermatology departments. In 4 patients, the results of preoperative fine-needle aspiration cytology indicated that the tumor was benign; however, the postoperative histopathology results revealed malignant tumors. The frequencies of malignant and benign tumors were 44.6% (n = 29) and 55.4% (n = 36), respectively. Mucoepidermoid carcinoma and pleomorphic adenoma were the most frequent types of malignant and benign accessory parotid gland tumors, respectively. Among the various surgical methods that were used, such as direct cheek and intraoral incisions, a standard parotidectomy incision was the most preferred treatment approach for these tumors. Recently, an endoscopic approach has also been found to yield satisfactory results. An optimal approach should be selected after evaluating the advantages and disadvantages of these methods. No definite guidelines are available regarding the choice of elective neck dissection and postoperative radiation therapy for malignant accessory parotid gland tumors. Although tumor resection (plus elective neck dissection) and postoperative radiation therapy have been frequently performed for various kinds of malignant accessory parotid gland tumors to date, additional studies are needed regarding the criteria for selecting elective neck dissection and postoperative radiation therapy. Since the malignancy rate for accessory parotid gland tumors is higher than that for parotid gland

  10. Parotid Gland Imaging.

    PubMed

    Prasad, Ravi S

    2016-04-01

    In this article, various imaging modalities are discussed for evaluation of parotid disease, from congenital to inflammatory to neoplastic etiologies. Key imaging characteristics are outlined using case examples. Introduction to biological imaging is highlighted. Additionally, image-guided biopsy techniques are illustrated for sampling parotid and parapharyngeal space lesions in a minimally invasive manner.

  11. 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.

  12. [Comparative ultrastructural study of parotid gland, lacrimal gland and pituitary gland between miniature pig and mouse].

    PubMed

    Yan, Xing; Hai, Bo; Sun, Yi-lin; Zhang, Chun-mei; Wang, Song-ling

    2009-02-01

    To study the ultrastructure of parotid glands, lacrimal glands and pituitary glands between miniature pig and mouse. Five adult miniature pigs and 5 mice were studied. Ultrastructure of their parotid glands, lacrimal glands, and pituitary glands was observed. The secretary granules in acinar cell of miniature pig parotid glands showed higher density and more aequalis than those of mice. The cell apparatus in acinar cell of mouse parotid glands were more plentiful than those of miniature pigs. The secretary granules on blood vessel wall were richer in parotid gland of miniature pigs compared with mouse parotid gland. Lacrimal gland had the similar ultrastructure to parotid gland in these two animals. Many blood vessel antrum were found in pituitary glands of these two animals. Compared with mouse parotid glands, there are more secretary granules in acinar cells and vascular endothelial cells in miniature pig parotid glands, which might enter blood stream and have function of endocrine secretion.

  13. Practical imaging of the parotid gland.

    PubMed

    Bag, Asim K; Curé, Joel K; Chapman, Philip R; Pettibon, Keith D; Gaddamanugu, Siddhartha

    2015-01-01

    The parotid gland may be affected by numerous pathologies, and physicians from many different medical and surgical specialties request parotid imaging. Mastering the typical imaging features of various types of parotid pathology is facilitated by understanding how various diseases produce their characteristic imaging findings. In this review article, we present succinct overviews of the normal anatomy and the common pathologies of the parotid gland and recommend a practical approach to differential diagnosis that can be easily implemented in day-to-day radiology practice.

  14. [Distant metastases to the parotid gland--review of the literature and report of own two cases].

    PubMed

    Markowski, Jarosław; Gierek, Tatiana; Zielińska-Pajak, Ewa; Witkowska, Małgorzata; Wodołazski, Anatol; Pajak, Jacek; Paluch, Jarosław

    2005-01-01

    Metastatic tumors to the parotid gland are very uncommon and it accounts for 8% of all cancers of parotid gland. The parotid gland and its lymph nodes are possible sites of metastases from head and neck cancers. However, metastasis from distant primary neoplasm below clavicle is possible, too. The authors presented the two cases of distant metastases to the parotid gland. The women with breast cancer and metastases to the parotid gland 11 years after surgery, radio- and chemotherapy of breast cancer. She died 7 months after parotid surgery of systemically advanced disease. The man with metastasis of malignant melanoma of unknown primary site. He underwent total parotid surgery with the tumor and lymph nodes. He died 7 months after surgery. In spite of intensive exam the primary location of the melanoma was unknown. The authors described pathophysiology of distant metastases to the parotid gland with special attention to possibilities of treatment and survival.

  15. Unilateral parotid agenesis associated with pleomorphic adenoma of ipsilateral accessory parotid gland.

    PubMed

    Seith, Ashu Bhalla; Gadodia, Ankur; Sharma, Raju; Parshad, Rajinder

    2013-01-01

    Congenital agenesis of the parotid gland is rare, and its association with accessory parotid tissue is even rarer. We report an unusual case of unilateral agenesis of the left parotid gland associated with pleomorphic adenoma of the left accessory parotid gland. To best of our knowledge, this is only the second such published case in the literature.

  16. Infantile Hemangioendothelioma of the Parotid Gland

    PubMed Central

    Chaubal, Rajas; Tavri, Om; Sawant, Atul; Singh, Chitrangada

    2017-01-01

    A 4-month-old infant presented with a painless swelling overlying the left angle of mandible. Ultrasound and magnetic resonance imaging (MRI) revealed a large lesion replacing the entire left parotid gland, with multiple enlarged vessels. Homogeneous enhancement of the lesion was seen on the postcontrast MRI scans. Based on the imaging features, a diagnosis of infantile hemangioendothelioma of the parotid gland was offered. This helped in avoiding any further invasive testing. PMID:28217408

  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. The accessory parotid gland and facial process of the parotid gland on computed tomography

    PubMed Central

    Ahn, Dongbin; Yeo, Chang Ki; Han, Soon Yong

    2017-01-01

    The purpose of this study was to determine the incidence of an anterior extension of the parotid gland, such as an accessory parotid gland (APG) or facial process (FP) and to evaluate its characteristics on computed tomography (CT) scans. We reviewed CT scans of 1,600 parotid glands from 800 patients. An APG on CT was defined as a soft-tissue mass of the same density as the main parotid gland, located at the anterior part of the main parotid gland, and completely separate from the main parotid gland. An FP was defined as a lobe of the parotid gland protruding anteriorly over the anterior edge of the ramus of the mandible on CT and showing continuity with the main gland. The overall incidence rates and characteristics of APGs and FPs were evaluated according to age, sex, and side. The incidence rates of APGs and FPs were 10.2% (163/1,600) and 28.3% (452/1,600), respectively. The mean size of an APG was 15.8 mm × 5.0 mm and the mean distance from the main parotid gland was 10.5 mm. The FP reached anteriorly between the anterior edge of the mandibular ramus and the anterior border of the masseter muscle in 405 (89.6%) cases, while it extended over the anterior border of the masseter muscle in 47 (10.4%) cases. The incidence rates of APGs and FPs decreased and increased, respectively, with increasing age, showing significant linear correlations. However, the incidence of an anterior extension of the parotid gland (either an APG or an FP) was similar across all age groups. The present study showed that CT might be helpful in identifying anterior extensions of the parotid gland including APGs and FPs. The anatomical information gained from this study contributes to a better understanding of APGs and FPs and how their incidence changes with age. PMID:28915265

  19. The accessory parotid gland and facial process of the parotid gland on computed tomography.

    PubMed

    Ahn, Dongbin; Yeo, Chang Ki; Han, Soon Yong; Kim, Jeong Kyu

    2017-01-01

    The purpose of this study was to determine the incidence of an anterior extension of the parotid gland, such as an accessory parotid gland (APG) or facial process (FP) and to evaluate its characteristics on computed tomography (CT) scans. We reviewed CT scans of 1,600 parotid glands from 800 patients. An APG on CT was defined as a soft-tissue mass of the same density as the main parotid gland, located at the anterior part of the main parotid gland, and completely separate from the main parotid gland. An FP was defined as a lobe of the parotid gland protruding anteriorly over the anterior edge of the ramus of the mandible on CT and showing continuity with the main gland. The overall incidence rates and characteristics of APGs and FPs were evaluated according to age, sex, and side. The incidence rates of APGs and FPs were 10.2% (163/1,600) and 28.3% (452/1,600), respectively. The mean size of an APG was 15.8 mm × 5.0 mm and the mean distance from the main parotid gland was 10.5 mm. The FP reached anteriorly between the anterior edge of the mandibular ramus and the anterior border of the masseter muscle in 405 (89.6%) cases, while it extended over the anterior border of the masseter muscle in 47 (10.4%) cases. The incidence rates of APGs and FPs decreased and increased, respectively, with increasing age, showing significant linear correlations. However, the incidence of an anterior extension of the parotid gland (either an APG or an FP) was similar across all age groups. The present study showed that CT might be helpful in identifying anterior extensions of the parotid gland including APGs and FPs. The anatomical information gained from this study contributes to a better understanding of APGs and FPs and how their incidence changes with age.

  20. Transcutaneous approach for the removal of parotid gland stones.

    PubMed

    Oh, Hee-Kyun; Park, Hong-Ju; Oh, Je-Seok; Jung, Seunggon; Kook, Min-Suk

    2014-11-01

    Salivary stones in the parotid gland can be treated with a wide range of methods. Stones close to the opening of the duct can be easily removed through the oral cavity, whereas the entire salivary gland may need to be removed if stones are located close to the parotid gland. In such cases, surgical removal of the parotid gland may be lengthy and may produce facial nerve injury. We report a simple extraoral approach used for the removal of parotid gland stones located close to the parotid gland by precisely identifying the location of stones in 2 patients with parotid sialolithiasis.

  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. US in preoperative evaluation of parotid gland neoplasms.

    PubMed

    Gerwel, Agata; Kosik, Krzysztof; Jurkiewicz, Dariusz

    2015-01-01

    Salivary gland neoplasms account for only 3% of all tumors of the head and neck area, but as they represent a wide variety of histological types, they are a big diagnostic challenge. The cornerstone of salivary gland neoplasm treatment, both for the benign and malignant lesions, is surgery. The main goal of the therapy is not only to achieve complete surgical tumor resection, but also to preserve adjacent structures (facial nerve, parapharyngeal space structures). Ultrasonography is an examination commonly used in the preoperative diagnosis of the lesions localized within salivary glands. Very often it is the only diagnostic imaging method used in these cases. The aim of the study was to establish diagnostic value of US examination and its parameters for the assessment of parotid gland tumors. A prospective study was performed on a group of 51 patients with parotid gland neoplasms, who over a period of 3 years underwent surgery in Otolaryngology and Laryngological Oncology Department with Craniomaxillofacial Surgery Department of Central Clinical Hospital of Ministry of Defence in Warsaw. All the included patients underwent US examination in the preoperative period. The parameters selected for the assessment were: ill-defined tumor margins, tumor vascularity and the presence of enlarged regional lymph nodes. The results of imaging examination were compared to the final diagnosis based on pathological examination of the surgical specimen. The parameters of the US examination such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the evaluation of parotid gland tumors were established based on the examination results. An analysis was performed and ill-defined parotid tumor margins turned out to be a US parameter with higher diagnostic value for differentiating benign and malignant lesions than increased tumor vascularity. The presence of enlarged regional lymph nodes with blurred echostructure on the US examination

  3. 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.

  4. 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

  5. Parotitis and Sialendoscopy of the Parotid Gland.

    PubMed

    Hernandez, Stephen; Busso, Carlos; Walvekar, Rohan R

    2016-04-01

    Nonneoplastic disorders of the salivary glands involve inflammatory processes. These disorders have been managed conservatively with antibiotics, warm compresses, massage, sialogogues, and adequate hydration. Up to 40% of patients may have an inadequate response or persistent symptoms. When conservative techniques fail, the next step is operative intervention. Sialendoscopy offers a minimally invasive option for the diagnosis and management of chronic inflammatory disorders of the salivary glands and offers the option of gland and function preservation. In this article, we review some of the more common nonneoplastic disorders of the parotid gland, indications for diagnostic and interventional sialendoscopy, and operative techniques.

  6. Salivary duct carcinoma of the parotid gland

    PubMed Central

    Mlika, Mona; Kourda, Nadia; Zidi, YSH; Aloui, Raoudha; Zneidi, Nadia; Rammeh, Soumaya; Zermani, Rachida; Jilani, Sarah Ben

    2012-01-01

    Salivary duct carcinoma of the parotid gland is an uncommon tumor, highly aggressive. About 200 cases have been reported in the English literature. Pathomorphologically, these tumors showed great similarities to ductal carcinoma of the female breast, which is why they described this tumor as “salivary duct carcinoma.” The authors describe a new case of salivary duct carcinoma of the parotid gland. We present the case of a 50-year-old patient with progressive facial paralysis. The MRI examination of the head showed two ill-defined formations. A malignant tumor was strongly suspected, so that a total left parotidectomy with excision of the adjacent facial nerve and left lymph node dissection was performed. Microscopic examination concluded to a salivary duct carcinoma of the left parotid gland negative with Her2/neu antibody with lymph node metastasis. There were no recurrences or metastases within 3 years of follow-up. Salivary duct carcinoma of the parotid gland is a rare tumor with an aggressive behavior. This is due to its propensity to infiltrate distant organs. The diagnosis is based on microscopic examination. Treatment modalities are non-consensual, but some authors advocate the necessity of aggressive approach, especially in tumors negative with Heur2/neu antibody. This is due to the fact that the overexpression of this antigen was reported to be associated with a poor prognosis. PMID:22434951

  7. [Sialoadenosis of the parotid glands: diagnostic considerations].

    PubMed

    Bagán Sebastián, J V; Silvestre Donat, F J

    1990-09-01

    We present 3 cases of Sialoadenosis of the parotid glands, one male and two females, who presented associated systemic pathology (liver cirrhosis and diabetes mellitus), detected following clinically suspect syaloadenosis (the patients were unaware of their systemic disease). In all three cases definitive diagnosis was established by needle aspiration of the gland. Which revealed great acinar dilatation. Finally, differential diagnosis was established between sialoadenosis and those conditions with clinical presentations similar to those described for sialoadenosis.

  8. The ultrasound examination in assessment of parotid gland tumours: the novel graphic diagram.

    PubMed

    Luczewski, L; Golusinski, P; Pazdrowski, J; Pienkowski, P; Kordylewska, M; Guntinas-Lichius, O; Golusinski, W

    2013-07-01

    Ultrasound is one of the main diagnostic techniques for parotid gland tumours. It is inexpensive, non-invasive and widely available. However, interpretation of the images is highly subjective and constitutes a major limitation. To overcome this problem, we developed a graphic diagram to provide a standardised template that can be used for more precise identification of the tumour localisation within the parenchyma of the parotid gland. This new diagram may be used to provide surgeons with an improved and more objective localisation of the tumour. The study included 237 patients who underwent surgery for parotid tumours. To obtain the precise spatial location of the tumours, three topographic coordinates of tumour location in the coronal, sagittal and transversal plane were marked preoperatively during sonography within the parenchyma of the parotid gland. The localisation identified ultrasonically was then compared to the postsurgical report: 197 (83 %) tumours were found within the superficial lobe of the parotid gland and 40 (17 %) within the deep lobe of the parotid gland. In 157 (66 %) cases, tumours were found within the lower pole of the parotid gland, and in 64 (27 %) at the level of earlobe and its insertion, 16 (7 %) tumours were located at the level of the tragus and above it. Based on the results obtained, a graphic diagram of parotid gland tumour locations was developed.

  9. A rare case of parotid gland lipoma arising from the deep lobe of the parotid gland

    PubMed Central

    Paparo, Francesco; Massarelli, Mauro; Giuliani, Giorgio

    2016-01-01

    Lipomas are the most commonly encountered benign mesenchymal tumors, but their occurrence in the head and neck is rare, even more at the level of the parotid region where they can be found nearby the parotid capsule, inside the capsule, or within the gland. In addition, lipomas involving the deep parotid lobe are extremely unusual. That is why lipomas are not often considered for differential diagnosis of parotid lumps. Concerning diagnostic tools, magnetic resonance imaging (MRI) is nowadays considered as the main imaging examination for parotid lipomas due to a characteristic signal intensity on T1- and T2-weighted images. Furthermore, even if the cost of MRI is nearly three times that of computed tomography, MRI is accurate, safe, and has few biological costs for the patient. In this reported case, MRI provided all information for either diagnosis or preoperative planning being the best diagnostic tool regarding tumor margin characteristics and surrounding tissues’ involvement. Concerning treatment, surgical excision of parotid masses is always mandatory for definitive diagnosis, but it is challenging because of the facial nerve. For this reason, a well-established surgical technique is mandatory for success. The authors present a rare case of parotid gland lipoma arising from the deep lobe and discuss diagnostic tools and surgical technique. PMID:28299278

  10. A rare case of chronic sialadenitis of accessory parotid gland.

    PubMed

    Sathe, Nilam Uttam; Thakare, Samir; Wadkar, Gaurav; Gaikwad, Ninad

    2014-01-01

    The accessory parotid gland is salivary tissue adjacent to stenson's duct that is separated from the main parotid gland and lying on masseter muscle. It has secondary duct empting into the stenson's duct. The differential diagnosis of mid-cheek masses include pathology arising from normal anatomic structures or from variations of normal accessory parotid gland tissue. Surgical resection is the treatment of choice for the accessory parotid gland tumor. We report a case of accessory parotid gland with chronic sialadenitis in a 26 years old male with the diagnosis and treatment. Accessory parotid gland pathologies should be included in the differential diagnosis of a patient presently with a mid-cheek mass.

  11. Undifferentiated carcinoma of parotid gland.

    PubMed Central

    López, J I; Alfaro, J; Ballestin, C

    1991-01-01

    Two cases of undifferentiated carcinomas of the major salivary glands were studied using immunohistochemical techniques. Results showed that this entity was a high grade malignant neoplasm arising from the excretory duct. Despite the undifferentiated appearance multiple immunophenotypes were evident in both cases. PMID:2045506

  12. HIV-associated cystic lesions of the parotid gland.

    PubMed

    Ogasawara, Noriko; Takano, Ken-Ichi; Kobayashi, Hajime; Kikuchi, Keisuke; Matsumiya, Hiroshi; Yoshioka, Iwao; Himi, Tetsuo

    2017-02-01

    We present two cases of an HIV-associated parotid gland cyst. One case was a 36-year-old HIV infected woman. She was diagnosed with HIV infection and presented with slowly enlarged parotid gland cysts together with elevation of HIV viral RNA copies/mL in her serum. She was performed parotid gland biopsy under the general anesthesia. The histopathologic analysis revealed negative HIV p24-antigen in her parotid gland tissue. The other case was a 43-year-old man found his parotid gland swelling shortly after highly active antiretroviral therapy (HAART). He was diagnosed with HIV infection 2 years previously. He had started HAART several days before. He showed exceeding elevation of IgE in his serum. We treated him with medication using anti-histamic drugs for his cyst. A computed tomography scan revealed a complete response of his parotid gland cyst 4 weeks after the medication. His serum IgE level was decreased to half of the level before the medication. These findings suggested that the parotid gland swelling associated with HIV was due to various factors including immune reconstitution inflammatory syndrome (IRIS). In case such a parotid gland swelling, we could avoid invasive treatments.

  13. [The hemodynamics of the parotid glands in children consuming carbohydrates].

    PubMed

    Sigal, Z M; Redinova, T L

    1989-01-01

    The rate of sweets consumption was shown to determine, to a large extent, the salivary glands function. In children rarely consuming sweets the parotid blood flow and salivation increased after intake of a 10% sucrose solution. In children abusing sweets even crystal sugar failed to change the parotid glands blood filling with salivation virtually unaltered.

  14. Dysgenetic polycystic disease of the parotid gland: Report of a case and review of the literature

    PubMed Central

    Kumar, KR Ashok; Mahadesh, Jyothi; Setty, Suhas

    2013-01-01

    Dysgenetic polycystic disease (DPD) is a rare cystic lesion affecting mainly the parotid salivary glands with only 14 reported cases in English literature. DPD of parotids is more common in females, common in younger age group, mostly bilateral in occurrence and commonly affects the superficial lobe. Surgery is performed for symptomatic relief and cosmosis. We report a case of a unilateral DPD of the parotid gland with distinctive histopathology. Patient was treated by performing total parotidectomy with preservation of the facial nerve. PMID:24250087

  15. Accessory parotid gland lesions: case report and review of literature.

    PubMed

    Stenner, M; Preuss, S F; Hüttenbrink, K-B; Klussmann, J P

    2008-09-01

    There are numerous causes for chronic cheek swelling, including masseteric hypertrophy, lymphadenopathy, diffuse inflammatory changes and neoplasia. We report an unusual case of a recurrent swelling as the result of sialolithiasis of an accessory parotid gland, which lay isolated from the main parotid gland along the Stensen's duct. The calculi developed in the accessory salivary tissue whereas all major salivary glands presented without sialolithiasis. Clinical findings as well as imaging results are shown and surgical management and histopathology are discussed. Hereby, for the first time we report a case with multiple calculi in an accessory parotid gland removed via a standard parotid incision. Further to this, we give a comprehensive review of literature on accessory parotid gland lesions.

  16. Congenital salivary fistula of accessory parotid gland: imaging findings.

    PubMed

    Gadodia, A; Seith, A; Sharma, R; Thakar, A

    2008-03-01

    We report the imaging findings in a rare case of an accessory parotid gland fistula. An eight-year-old boy was presented with complaints of serous discharge from his left cheek since birth. As part of the radiological investigation, magnetic resonance imaging, computed tomography sialography with fistulography, and digital sialography with fistulography were performed. Magnetic resonance imaging demonstrated the exact location of an accessory parotid gland but failed to demonstrate the accessory duct. The presence of an accessory gland was well delineated on computed tomography fistulography and computed tomography sialography. Fistulography revealed a small accessory parotid duct and gland. No communication between the ductal systems of both glands was demonstrated. In such cases, pre-operative imaging (with sialography, magnetic resonance sialography and computed tomography sialography with fistulography) is helpful for exact delineation of the ductal anatomy. To the best of our knowledge, only four previous cases of congenital accessory parotid gland fistula have been reported in the English literature.

  17. Extracapsular dissection for Warthin tumor in the tail of parotid gland.

    PubMed

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

    2017-09-01

    Extracapsular dissection conferred the advantage of reduced operation time and morbidity without any recurrence, and it could be considered as the treatment of choice for Warthin tumors in the tail of the parotid gland. The purpose of this study is to confirm the appropriate surgical procedure for Warthin tumor in the tail of the parotid gland, by comparing the results of extracapsular dissection and superficial parotidectomy. The medical records of 72 patients with Warthin tumor in the tail of the parotid gland who underwent surgery between January 2006 and December 2016 were retrospectively reviewed. In the extracapsular dissection group, a total of 44 parotid gland operations were performed in 40 patients. In the superficial parotidectomy group, a total of 34 parotid gland operations were performed in 32 patients. The operation time was significantly shorter in the extracapsular dissection group than in the superficial parotidectomy group (p<.001, Table 1). One patient in the extracapsular dissection group and five patients in the superficial parotidectomy group had postoperative facial nerve palsy. Recurrence of Warthin tumor in the tail portion of the parotid gland was identified in one patient who underwent superficial parotidectomy.

  18. Sebaceous lymphadenoma of parotid gland in a child.

    PubMed

    Sun, Guowen; Hu, Qingang; Huang, Xiaofeng; Tang, Enyi

    2009-02-01

    Sebaceous lymphadenoma is a rare tumor presenting predominantly in the parotid gland. Most sebaceous lymphadenomas are composed of variably sized sebaceous glands admixed with salivary ducts in a diffuse lymphoid background. The treatment is complete surgical excision, and this tumor is rarely recurrent. Reported here is a case of sebaceous lymphadenoma of the left parotid gland in a 16-year-old boy. A left superficial parotidectomy was performed.

  19. 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.

  20. 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.

  1. Recurrent inflammation of accessory parotid tissue associated with unilateral parotid gland aplasia: diagnostic and therapeutic implications.

    PubMed

    Capaccio, Pasquale; Luca, Nicola; Sigismund, Paolo Enrico; Pignataro, Lorenzo

    2012-05-01

    Aplasia of the major salivary glands is a rare condition due to an alteration in the development of the ectodermal tissue of the oral cavity often related to other craniofacial abnormalities or alteration of structures deriving from the first or second archial branch, in particular the lacrimal glands; it can be total or partial and determine clinical states ranging from an asymptomatic condition to a severe xerostomia. The accessory parotid tissue is similar to normal parotid tissue, completely independent from the main gland and susceptible to the same pathological disorders. We describe a very unusual case of an inflammatory disorder of accessory parotid tissue in a 44-year-old male patient with concomitant, and previously unknown, aplasia of the main ipsilateral parotid gland. We also discuss the role of imaging and conservative therapeutic modalities such as botulinum toxin therapy and, in the future, minimally invasive endoscopic-assisted resection in the management of such salivary disorder.

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

    PubMed Central

    Sousa, Alexandre A.; Souto, Giovanna R.; Sousa, Isabela A.; Mesquita, Ricardo A.; Gomez, Ricardo S.

    2013-01-01

    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. PMID:24455083

  3. 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.

  4. [Mammary analog secretory carcinoma of the parotid gland].

    PubMed

    Guérin, Maxime; Diedhiou, Abdoulaye; Nallet, Emmanuel; Duflo, Suzy; Laé, Marick; Wassef, Michel

    2014-10-01

    Mammary analog secretory carcinoma (MASC) of the parotid gland is a rare and recently described lesion. We report the case of a 46-year-old man with a tumor of the parotid gland which was carried to the diagnosis of MASC. Diagnostic was confirmed by highlighting the ETV6-NTRK3 gene translocation. However, some morphologic and immunohistochemical features are suggestive of this entity. This carcinoma should be distinguished from its main differential diagnoses: acinic cell carcinoma and low grade cribriform cystadenocarcinoma.

  5. 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

  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. Extracapsular dissection as sole therapy for small low-grade malignant tumors of the parotid gland.

    PubMed

    Mantsopoulos, Konstantinos; Koch, Michael; Iro, Heinrich

    2017-08-01

    The aim of the study was to investigate whether extracapsular dissection of a primarily unsuspected lesion in the parotid gland could be oncologically sufficient for carefully selected cases of parotid gland malignomas. Retrospective clinical study. The records of all patients treated for primary malignant tumors of the parotid gland solely by means of extracapsular dissection between 2006 and 2013 were studied retrospectively. Patients with manifestation of malignant tumors in the parotid gland that were not of primary salivary gland origin (squamous cell carcinomas, lymphomas, melanomas) or who had had revision surgery or other malignant tumors in their history, as well as patients with insufficient data, were excluded from our study sample. Nine patients, all with low-grade parotid malignancies, were detected. Our study showed acceptable oncologic and functional outcomes throughout. Our study was able to show very encouraging preliminary results following primary extracapsular dissection as sole surgical therapy for carefully selected low-stage, low-grade, inferiorly located lesions in patients with high compliance. 4. Laryngoscope, 127:1804-1807, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Adenoid Cystic Carcinoma of Accessory Parotid Gland: A Case Report.

    PubMed

    Das, Somdipto; Nayak, Umanath K; Buggavetti, Rahul; Sekhar, Shobana

    2016-05-01

    The accessory parotid gland is salivary gland tissue separated from the main gland at a variable distance. This gland is histologically similar to the main gland, but has a higher incidence of malignant neoplasms than the main gland. Regarding the various malignant neoplasms, studies have shown higher incidences of mucoepidermoid carcinoma, with less than 2% being adenoid cystic carcinoma. We present a case of swelling in the midcheek region that, after clinical examination, was diagnosed as a case of neoplasm of the accessory parotid gland. On the basis of auxiliary investigations including intraoperative frozen section, it was concluded that it was adenoid cystic carcinoma, grade I, and after wide surgical resection, the tumor was removed without undergoing superficial parotidectomy. The patient received postoperative radiotherapy (RT) and was followed for 14 months without any recurrence or substantial facial asymmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Diagnostic Accuracy of Fine-Needle Aspiration for Parotid and Submandibular Gland Lesions.

    PubMed

    Feinstein, Aaron J; Alonso, Jose; Yang, Sung-Eun; St John, Maie

    2016-09-01

    To assess the diagnostic accuracy of fine-needle aspiration (FNA) of the parotid and submandibular glands. Case series with chart review. Tertiary referral academic center. Retrospective analysis was performed for all parotid and submandibular gland FNAs from a single center from 2001 to 2014. There were 1283 FNAs performed for 1076 patients. Of these, 343 cases had surgical follow-up (parotid gland, n = 272; submandibular gland, n = 71). Cases were included where the patient had a preoperative FNA, followed by surgical excision. Correlation of preoperative FNA results to final surgical pathology was performed, with measures of diagnostic accuracy computed. Malignancy was identified in 29.0% of parotid tumors and 42.3% of submandibular tumors, based on final pathology. FNA was nondiagnostic due to insufficient cellularity for evaluation in 22 of 343 cases (6.4%) and indeterminate in 39 of 343 cases (11.4%). Diagnostic accuracy in the parotid and submandibular glands for distinguishing benign from malignant pathology was determined as follows, respectively: sensitivity, 75.0% and 91.3%; specificity, 95.1% and 94.1%; positive predictive value, 84.9% and 91.3%; and negative predictive value, 91.2% and 94.4%. FNA has high accuracy in identifying malignancy in parotid and submandibular gland lesions when performed at a high-volume center. Preoperative FNA results provide otolaryngologists with valuable diagnostic information that may influence the surgical management of salivary gland tumors. FNA, in conjunction with cross-sectional imaging, is useful in counseling patients for a complete informed consent. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  10. Poorly differentiated carcinoma arising from adenolymphoma of the parotid gland

    PubMed Central

    Ferrero, Stefano; Cattaneo, Laura; Peri, Andrea; Braidotti, Paola; Cioffi, Ugo; Scaramellini, Gabriele; Ciulla, Michele M; De Simone, Matilde; Arizzi, Carmelo; Pignataro, Lorenzo

    2003-01-01

    Background There is only one previous case report of a poorly differentiated carcinoma arising from an adenolymphoma of the parotid gland (Warthin's tumour). The absence of clinical symptoms, and the aspecificity of the radiological pattern make the diagnosis very difficult. Case presentation We here report the case of a 73-year-old man with Warthin's tumour who was brought to our attention because of a swelling in the parotid region. Conclusions In this case with an atypical clinical presentation, the intra-operative examination of a frozen section of the parotid mass allowed us to diagnose the malignant tumour correctly and consequently undertake its radical excision. PMID:12533195

  11. Sialolipoma of the parotid gland: a rare entity.

    PubMed

    Pandey, Diwakar; Vats, Manu; Akhtar, Azaz; Pathania, Om Prakash

    2015-06-16

    Lipomatous neoplasms of the parotid gland are rare tumours contributing from 0.6% to 4.4% to all parotid neoplasms with most series reporting an incidence of 1%. It is extremely rare in females, being 10 times more common in males, and the most common age of presentation is the five to sixth decade. Numerous histological variants of salivary gland lipoma have been described. Sialolipoma is a rare variant having proliferation of mature adipocytes with secondary entrapment of the normal salivary gland element. We report a rare case of sialolipoma in the right parotid of a 45-year-old woman who was treated with superficial parotidectomy. Postoperative recovery as well as follow-up has been uneventful.

  12. 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

  13. Accessory parotid gland tumors: A series of 4 cases.

    PubMed

    Kakuki, Takuya; Takano, Kenichi; Kurose, Makoto; Kondo, Atsushi; Okuni, Tsuyoshi; Ogasawara, Noriko; Himi, Tetsuo

    2016-07-01

    Accessory parotid gland tumors are clinically rare, and their management remains unclear. In this article, we describe our experience with 4 patients-2 males and 2 females, aged 13 to 66 years-who were diagnosed with an accessory parotid gland tumor. All patients presented with an asymptomatic midcheek swelling, and all underwent fine-needle aspiration biopsy, ultrasonography, computed tomography, and magnetic resonance imaging. A standard parotidectomy was performed on all patients. Postoperatively, 2 patients were found to have a malignant tumor, while the other 2 had a pleomorphic adenoma. No patient experienced any obvious facial nerve injuries postoperatively, and no recurrences were observed. We discuss the preoperative evaluation, treatment, and prognosis of these tumors, and we briefly describe the literature. The first choice of treatment for accessory parotid gland tumors is surgical resection. In our experience, a standard parotidectomy approach is safe and cosmetically appealing.

  14. Dermoid cyst of the parotid gland: first pediatric case.

    PubMed

    Tas, Abdullah; Yagiz, Recep; Altaner, Semsi; Karasalihoğlu, Ahmet R

    2010-02-01

    A dermoid cyst is the result of inclusion of epithelial cells along the lines of embryonic closure. Dermoid cysts of the head neck are uncommon and account for only 7% of all such cysts. They are most often reported as arising in the floor of the mouth. Dermoid cyst is rarely seen in the parotid gland. To our knowledge, there have been only six previous case reports in the English literature. Dermoid cyst of the parotid gland in pediatric patient has not been previously reported in the literature. This is the first case report concerning a dermoid cyst in a pediatric patient. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  15. A case of sebaceous carcinoma of the parotid gland.

    PubMed

    Siriwardena, B S M S; Tilakaratne, W M; Rajapakshe, R M S K

    2003-02-01

    Sebaceous carcinoma of salivary gland origin is an extremely rare malignancy. It occurs mainly in the parotid gland. This is a case report of a sebaceous carcinoma in a 57-year-old woman who had a lump over the right parotid region for 8-9 months. The tumour was composed of small basaloid cells and large foamy cells. Sebaceous differentiation was evident in some tumour islands. This is the first case reported in the Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya.

  16. 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.

  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. [A bilateral epithelial myoepithelial carcinoma of the parotid gland].

    PubMed

    Tauziède-Espariat, Arnault; Raffoul, Johnny; Sun, Shan Rong; Monnin, Christine; Lassabe, Catherine; Costes, Valérie

    2015-12-01

    We report the case of a 52-year-old man, who was admitted in the department of otorhinolaryngology for a mass of the right parotid gland. The radiological and clinical hypothesis was a squamous cell carcinoma. Histopathological examination revealed a biphasic proliferation composed of epithelial cells arranged in a tubular pattern stained with cytokeratins 5-6 and 7 and EMA surrounded by clear myoepithelial cells stained with smooth muscle actin and p63. Ki-67 labeling index was low. The diagnosis of epithelial myoepithelial carcinoma was proposed. One year after, the patient noticed a centimetric mass of the left parotid gland. The radiological hypothesis was the presence of an intraparotidian lymph node. Histopathological examination showed a second epithelial myoepithelial carcinoma. This is an uncommon neoplasm comprising approximately 1% of all salivary gland tumours, affecting mainly the parotid gland. It is occurring preferably in patients older than 60years old. This is a low-grade malignant tumour with tendency to local recurrence and lymph node metastatic potential. We describe an exceptional bilateral epithelial myoepithelial carcinoma of the parotid gland.

  19. 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.

  20. [2 cases of adenolymphoma of the parotid gland].

    PubMed

    Andreini, A; Avogadro, M; Trassini, R

    1979-01-01

    Starting from two cases of adenolymphoma of the parotid gland they had under observation, the Authors underline their doubts regarding the histogenesis, discuss the clinical approach and show their attitude towards the therapy. It consists of an enucleation or nucleoresection of the tumour in case only the superficial part of the gland is affected; a total parotidectomy with facial nerve preservation and without any radiotherapy, in case of a radical operation; with complementary radiotherapy if the operation has not been radical for certain.

  1. Human Parotid Gland Alpha-Amylase Secretion as a Function of Chronic Hyperbaric Exposure

    DTIC Science & Technology

    1979-01-01

    parotid ...Pullman, WA 99163 Gilman, S. C, G. J. Fischer, R. J. Biersner, R. D. Thornton, and D. A. Miller. 1979. Human parotid gland alpha-amylase secretion...as a function of chronic hyperbaric exposure. Undersea Biomed. Res. 6(3):303-307.—Secretion of a-amylase by the human parotid gland increased

  2. Accessory parotid gland tumours: 24 years of clinical experience.

    PubMed

    Lukšić, I; Suton, P; Rogić, M; Dokuzović, S

    2012-12-01

    The accessory parotid gland (APG) is salivary tissue anterior to and anatomically separate from the parotid gland. APG is a common anatomical variation, but APG tumours are extremely rare. The authors report 6 patients with APG tumours emphasizing the diagnosis, clinical features, indications and rationales for different treatment approaches. Patients with primary tumours of the parotid gland or APG tumours who underwent surgical treatment were included. APG tumours comprised 1.23% of overall parotid tumours (6/488) and had a malignancy rate of 33.3% (2/6). There were three male and three female patients with a mean age of 39 years (range 14-70 years). 5 of 6 parotidectomies entailed superficial lobectomy, while one was a total parotidectomy with composite resection of masseter muscle. Concomitant selective lymphadenectomy was carried out in 3 of 6 patients. At 5 years disease-free survival was 83.3%. Mean follow-up was 161 months (range 14-253 months). Although nonsalivary diagnoses frequently occur in the buccal area, APG tumours should be considered in every differential diagnosis in patients presenting with a mid-cheek mass. From oncosurgical, cosmetic and functional standpoints, treatment by facelift parotidectomy or 'S-incision' with concomitant superficial lobectomy is the recommended surgical approach; high-grade malignancies require total parotidectomy with regional lymphadenectomy. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Metachronous bilateral pleomorphic adenoma of the parotid gland.

    PubMed

    Silva, Sindeval José da; Costa Junior, Gabriel Tadeu; Brant Filho, Adalberto Caldeira; Faria, Paulo Rogério; Loyola, Adriano Mota

    2006-03-01

    Bilateral salivary gland tumors are very rare, accounting for 3% of all parotid gland tumors. Although the most common tumor with bilateral development is the Warthin tumor, pleomorphic adenomas (PA) have been diagnosed simultaneously as well, but in a smaller incidence. Because of this, the prevalence, etiology, pathogenesis, and behavior of the PA in this context are poorly understood. We present a case of bilateral metachronous PA affecting the parotid gland in a 63-year-old woman. Clinically, the lesions presented with similar aspects as seen in cases of solitary PA with slow-growing asymptomatic nodule. Both lesions were diagnosed by fine-needle aspiration biopsy at an interval of 2 years between them. A total and superficial parotidectomy for left and right tumors, respectively, was performed. Only on the left side some facial nerve branches were removed that induced partial paralysis in the patient. A review of the pertinent literature is included.

  4. 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.

  5. Charcoal Suspension Tattoo: A New Technique for Intraoperative Detection of Small Tumors of the Parotid Gland.

    PubMed

    Tirelli, Giancarlo; Cova, Maria Assunta; Boscolo-Rizzo, Paolo; Da Mosto, Maria Cristina; Makuc, Elisa; Gardenal, Nicoletta

    2016-07-01

    The current surgical trend in the treatment of pleomorphic adenomas of the parotid gland is to limit the extent of resection. This raises the need to correctly identify the mass within the normal parenchyma so as to avoid dissecting the entire superficial lobe of the gland. We describe ultrasound-guided tattooing as a technique to facilitate identification and excision of parotid pleomorphic adenomas. We reviewed 23 consecutive patients with pleomorphic adenoma of the parotid gland. All patients underwent ultrasound-guided tattooing of the lesions with a charcoal suspension. Baseline tumor and patients' characteristics, major and minor complications, and subjective tolerance to the procedure were recorded. We assessed the number of intralesionally marked masses and the percentage of intraoperatively detected marked lesions. The injection was well tolerated. No major complications were recorded. In 2 cases (9%), a transient increase in lesion size was observed. No other minor complications were encountered. Charcoal was found inside the tumor in 19 cases (83%). In 4 cases (17%), it was found in the tissues above the lesion. Twenty-three lesions were intraoperatively detected (100%) and dissected. Charcoal suspension tattooing is safe and well tolerated for the detection of small pleomorphic adenomas during parotid surgery. © The Author(s) 2016.

  6. Sonoelastography – A Useful Adjunct for Parotid Gland Ultrasound Assessment in Patients Suffering from Chronic Inflammation

    PubMed Central

    Wierzbicka, Małgorzata; Kałużny, Jarosław; Ruchała, Marek; Stajgis, Marek; Kopeć, Tomasz; Szyfter, Witold

    2014-01-01

    Background Shear wave elastography (SWE) is widely used in breast, liver, prostate and thyroid evaluations. Elastography provides additional information if used to assess parotid gland pathology. We assessed parotid glands by means of SWE to compare the parenchyma properties in different types of inflammation. Material/Methods Prospective analysis included 78 consecutive patients with parotid gland pathology: sialolithiasis (33), Stensen’s duct stenosis (15), chronic inflammation (10), and primary Sjögren syndrome (pSS) (20) treated at the Department of Otolaryngology, Head and Neck Surgery of PUMS. The primary predictor variable was type of parotid pathology, and secondary predictor variables were patient age and the duration and intensity of complaints. Ultrasound pictures were compared with elastography values of parotid parenchyma. Results Mean elasticity values for pSS (111 Kilopascals (kPa), Stensen’s duct stenosis (63 kPa), sialolithiasis (82 kPa), and chronic inflammation (77 kPa) were significantly higher than the mean value for healthy patients (24 kPa). Elasticity increased proportionally to the intensity of complaints: mild (51 kPa), moderate (78 kPa), and strong (90 kPa). Increased elasticity did not correspond with ultrasonographic pictures. In pSS the parenchyma was almost twice as stiff as in chronic inflammation (p=0.02), although subjective complaints were mostly mild or moderate, and the ultrasonographic picture did not present features of fibrosis. Conclusions Sonoelastography, by improving routine ultrasonographic assessment, might be a useful tool for parotid evaluations during the course of chronic inflammation. An extraordinarily high degree of stiffness was revealed in pSS despite lack of fibrosis by ultrasonography and moderate subjective complaints, suggesting that sonoelastography could be a valuable diagnostic tool. PMID:25398237

  7. A false-negative sentinel lymph node in the parotid gland of a melanoma patient: a new algorithm for SLN biopsy in the parotid gland.

    PubMed

    Hayashi, Toshihiko; Furukawa, Hiroshi; Tsutsumida, Arata; Yoshida, Tetsunori

    2010-10-01

    The sentinel lymph node (SLN) is the first node in the lymphatic basin to be affected by metastatic tumor cells from a primary lesion. It provides a way to avoid elective neck dissection in a case in which there is no metastasis to the SLN. However, identification and excision of the SLN may be difficult due to the shine-through phenomenon, as the SLN in the parotid gland is either located close to the primary lesion or, in many cases, the lymph node of the parotid gland is small and covered by fibrous capsula. When we conducted an SLN biopsy on a 68-year-old male patient with malignant melanoma of the cheeks, the metastasis to the node of the parotid gland identified as the SLN was negative; however, 1 year later, the melanoma recurred on the lymph node of the parotid gland, or in other words, we experienced a false-negative SLN. SLN biopsy in the parotid gland is difficult because the lymph node is small and covered by fibrous capsula. We may consider a total or partial resection of the superficial lobe of the parotid gland, particularly when identification of an SLN in the parotid gland is difficult. Therefore, we propose a new algorithm for SLN biopsy in the parotid gland.

  8. 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.

  9. Morphometric analysis of the parotid gland affected by alcoholic sialosis.

    PubMed

    Bohl, Luciana; Merlo, Carolina; Carda, Carmen; Gómez de Ferraris, María Elsa; Carranza, Miriam

    2008-09-01

    In alcoholic parotid sialosis, the gland is frequently enlarged due to ductal and/or acinar hypertrophy, ductal hyperplasy and stromal fat infiltration. The aim of this study was to determine acinar and ductal dimensions, the number of striated ducts and the proportion of fat tissue in patients with and without alcoholic parotid sialosis. Twelve parotid biopsy samples from patients with hepatic alcoholic cirrhosis and those from seven controls were used. A morphometrical study with a digital image analyser attached to an optical microscope was carried out. Direct and indirect indicators from acinar and ductal dimensions were recorded. The number of striated ducts and the proportion of fat tissue in stroma were determined. Fifteen records for each variable were taken. Mean values were compared using the Mann-Whitney U-test (P parotides was significantly lower than that in the controls. These results do not corroborate previous qualitative descriptions about acinar and ductal hypertrophy and ductal hyperplasy in alcoholic patients. The main cause of parotid enlargement could not be stromal fat infiltration. The data could be used for differential diagnoses of sialosis.

  10. [Sialadenosis of the parotid gland after chronic nicotine use].

    PubMed

    Maier, H; Mall, G; Born, I A

    1991-04-01

    The effect of chronic nicotine consumption on the morphology of the rat parotid gland was investigated. After nicotine-loading for 90 days with an average serum nicotine concentration of 78 +/- 10 ng/ml a significant increase of acinar cell volume was observed. The acinar cells contained an increased number of enlarged light, immature secretory granules. These findings were confirmed by morphometric analysis. Further an increase of the granular endoplasmatic reticulum, an enlargement of the Golgi complexes and an oedematous swelling of intraglandular autonomous nerves were found. Similar findings have been observed in the parotid gland of animals and also of humans chronically treated with the beta-adrenergic drugs aludrin and isoproterenol, and have been termed "sialadenosis". It seems likely that the observed morphological alterations are caused by a stimulation of glandular beta-adrenoceptors via a nicotine-induced release of catecholamines from the adrenals.

  11. 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

  12. The aflatoxin-detoxifizyme specific expression in mouse parotid gland.

    PubMed

    Guan, Li-zeng; Sun, Yu-ping; Cai, Jin-shun; Wu, Han-dong; Yu, Long-zheng; Zhang, Yong-liang; Xi, Qian-yun

    2015-06-01

    The aflatoxin-detoxifizyme (ADTZ) gene derived from Armillariella tabescens was cloned into parotid gland-specific expression vector (pPSPBGPneo) to construct the parotid gland-specific vector expressing ADTZ (pPSPBGPneo-ADTZ). Transgenic mice were generated by microinjection and identified by using PCR and Southern blotting analysis. PCR and Southern blotting analysis showed that total six transgenic mice carried the ADTZ gene were generated. RT-PCR analysis indicated that the expression of ADTZ mRNA could be detected only in parotid glands of the transgenic mice. The ADTZ activity in the saliva was found to be 3.72 ± 1.64 U/mL. After feeding a diet containing aflatoxin B1 (AFB1) for 14 days, the effect of ADTZ on serum biochemical indexes and AFB1 residues in serum and liver of mice were evaluated. The results showed that total protein and globulin contents in the test treatment (transgenic mice) produced ADTZ were significantly higher than that of the positive control, while alanine aminotransferase and aspartate aminotransferase activity in serum of the test treatment (transgenic mice) were remarkably lower compared to that of the positive control (P < 0.05). Moreover, AFB1 residues in serum and liver of the test treatment (transgenic mice) were significantly lower compared with that of the positive control (P < 0.05). These results in the study confirmed that ADTZ produced in transgenic mice could reduce, even eliminate the negative effects of AFB1 on mice.

  13. 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

  14. Long-term parotid gland function after radiotherapy

    SciTech Connect

    Braam, Petra M. . E-mail: P.M.Braam@azu.nl; Roesink, Judith M.; Moerland, Marinus A.; Raaijmakers, Cornelis P.J.; Schipper, Maria; Terhaard, Chris H.J.

    2005-07-01

    Purpose: Irradiation of the parotid glands causes salivary dysfunction, resulting in reduced salivary flow. Recovery can be seen with time; however, long-term prospective data are lacking. The objective of this study was to analyze the long-term parotid gland function after irradiation for head-and-neck cancer. Methods and Materials: A total of 52 patients with head-and-neck cancer and treated with radiotherapy (RT) were prospectively evaluated. Stimulated bilateral parotid salivary flow rates were measured before RT and 6 weeks, 6 months, 12 months, and at least 3.5 years after RT completion. A complication was defined as a stimulated parotid flow rate of <25% of the pre-RT flow rate. The normal tissue complication probability model proposed by Lyman was fit to the data. Multilevel techniques were used to model the patterns of flow rates with time. Results: The mean stimulated flow rate of the parotid glands before RT was 0.31 mL/min (standard deviation [SD], 0.21). This was reduced to 0.14 mL/min (SD, 0.15) at 6 weeks after RT and recovered to 0.20 mL/min (SD, 0.22) at 6 months and 0.19 mL/min (SD, 0.21) at 12 months after RT. The mean stimulated flow rate was 0.25 mL/min (SD, 0.28) 5 years after RT. The mean dose to the parotid gland resulting in a 50% complication probability increased from 34 Gy at 6 weeks to 40 Gy at 6 months, 42 Gy at 12 months, and 46 Gy at 5 years after RT. Multilevel modeling indicated that both dose and time were significantly associated with the flow ratio. Conclusion: Salivary output can still recover many years after RT. At 5 years after RT, we found an increase in the salivary flow rate of approximately 32% compared with at 12 months after RT.

  15. Unusual Foreign Body of Parotid Gland Presenting as Sialolithiasis: Case Report and Literature Review

    PubMed Central

    Sreetharan, Sivapatha Sundaram; Philip, Rajan

    2012-01-01

    This case report highlights an unusual case where a foreign body in the parotid gland was initially thought to be sialolithiasis based on CT scans. The foreign body was safely retrieved from the parotid gland without formal superficial parotidectomy using methylene blue and an image intensifier to localize the lesion. Diagnosis and management of foreign bodies in the parotid gland are reviewed, and surgical options in removal of such lesions are discussed. PMID:23320231

  16. Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy.

    PubMed

    Bahadir, Osman; Livaoglu, Murat; Ural, Ahmet

    2008-07-01

    Adenoid cystic carcinoma of the parotid gland is a rare and slowly growing, but highly malignant tumor. Surgical resection of a malignant parotid tumor should include resection of the facial nerve when the nerve is involved in the tumor. Facial nerve reconstruction is required after nerve resection. A 14 year-old female presented with complaints of painless enlargement of the right parotid gland and facial asymmetry. Physical examination revealed a firm mass in the region of the parotid gland as well as right facial paralysis. Biopsy obtained from the mass showed an adenoid cystic carcinoma of the parotid gland. A radical parotidectomy with a modified radical neck dissection was carried out. Grafting material for the facial reconstruction was harvested from the great auricular nerve. The proximal main trunk and each distal branch of the facial nerve were coapted with the greater auricular nerve. The patient received radiotherapy after surgery and was seen to achieve grade IV facial function one year after surgery. Thus, the great auricular nerve is appropriate grafting material for coaptation of each distal branch of the facial nerve.

  17. Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy

    PubMed Central

    Bahadir, Osman; Livaoglu, Murat; Ural, Ahmet

    2008-01-01

    Adenoid cystic carcinoma of the parotid gland is a rare and slowly growing, but highly malignant tumor. Surgical resection of a malignant parotid tumor should include resection of the facial nerve when the nerve is involved in the tumor. Facial nerve reconstruction is required after nerve resection. A 14 year-old female presented with complaints of painless enlargement of the right parotid gland and facial asymmetry. Physical examination revealed a firm mass in the region of the parotid gland as well as right facial paralysis. Biopsy obtained from the mass showed an adenoid cystic carcinoma of the parotid gland. A radical parotidectomy with a modified radical neck dissection was carried out. Grafting material for the facial reconstruction was harvested from the great auricular nerve. The proximal main trunk and each distal branch of the facial nerve were coapted with the greater auricular nerve. The patient received radiotherapy after surgery and was seen to achieve grade IV facial function one year after surgery. Thus, the great auricular nerve is appropriate grafting material for coaptation of each distal branch of the facial nerve. PMID:19753265

  18. Histological reclassification of parotid gland carcinomas: importance for clinicians.

    PubMed

    Stodulski, Dominik; Majewska, Hanna; Skálová, Alena; Mikaszewski, Bogusław; Biernat, Wojciech; Stankiewicz, Czesław

    2016-11-01

    Reassessment of histological specimens of salivary gland carcinomas is associated with a change of primary diagnosis in a significant number of patients. The authors evaluated the relation between reclassification/verification of histological diagnosis and the clinical course of parotid gland carcinomas. Histological and immunohistochemical examinations of 111 specimens of parotid gland carcinomas operated on during the years 1992-2010 were revised and in some cases supplemented with cytogenetic tests (FISH), to verify the diagnosis and potentially reclassify the tumours. Analysis of the clinical documentation and follow-up data of patients whose diagnosis was changed was then carried out. The prognostic factors taken into account in the evaluation of the clinical course included the T and N stage, the tumour grade and the extent of resection. The primary diagnosis was changed on review in 28 patients (25.2 %). In 16 patients, the change involved a different histological type of cancer. In six cases, what was thought to be a primary salivary gland cancer was reclassified as a secondary tumour. In four other cases, the change was made from a malignant to a benign tumour and in one case to a non-neoplastic lesion (necrotizing sialometaplasia). Additionally, in two patients with carcinoma ex pleomorphic adenoma, the malignant component was found to be of in situ type. A potentially atypical clinical course was observed in 4 out of 28 patients whose diagnosis was changed. In the case of 2 patients, the course of disease was more aggressive (dissemination, death) than predicted and less aggressive in rest of the patients. Histological reclassification/verification of parotid gland carcinomas can explain the cause of an atypical clinical course in some patients and sometimes enables doctors to implement a change in therapy.

  19. Parotid gland metastases of distant primary tumours: A diagnostic challenge.

    PubMed

    Franzen, Achim M; Günzel, Thomas; Lieder, Anja

    2016-04-01

    Metastatic disease is common among parotid malignancies. The majority of primary tumours are located in the head and neck, but primary tumours below the clavicle must also be considered, especially in histological types not usually found in primary parotid or skin tumours. We performed 644 consecutive parotidectomies between 1980 and 2012. Benign tumours were found in 555 patients (86%) and malignant tumours in 89 patients (14%). Of 89 malignant tumours, 39 were metastases (44%). In 5 cases, the primary tumour was located below the clavicle (6% of malignant tumours). A carcinoma of the bronchus was subsequently diagnosed in three patients: one patient had breast carcinoma and one renal cell carcinoma. The majority of metastases in the parotid gland arise from primary tumours of the head and neck. In 10-20% of metastases, the primary tumour arises below the clavicle. Parotid metastases can be the first clinical manifestation of a malignant tumour, and can also occur years after curative intent treatment. Histopathology and immunohistochemistry will offer clues to a possible metastatic process and to primary tumour location. Parotidectomy with complete excision of the tumour can be a curative measure or form an essential part of symptom control and should be considered in all but the most moribund patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Predicting facial nerve invasion by parotid gland carcinoma and outcome of facial reanimation.

    PubMed

    Preis, M; Soudry, E; Bachar, G; Shufel, H; Feinmesser, R; Shpitzer, T

    2010-01-01

    We sought to define risk factors for facial nerve involvement in parotid gland carcinoma and assess the outcome of facial nerve reanimation. Medical records were reviewed of 66 patients who underwent surgery for parotid carcinoma in 2000–2007 at a tertiary hospital. Patient and tumor characteristics were compared between patients with and without facial nerve involvement and were analyzed on their influence on functional outcome following reanimation. Facial nerve involvement was verified intraoperatively in 24 patients, of whom 16 underwent reanimation during ablative surgery. Deep lobe invasion was significantly associated with intraoperative finding of facial nerve involvement. Tumors larger than 4 cm and salivary duct carcinoma had an obvious trend for facial nerve involvement. House-Brackmann score at 12 months was 3-4 in most patients. Deep lobe involvement and large tumor size may identify patients at risk of facial nerve involvement. Reanimation is associated with good functional outcome regardless of patient's age.

  1. Carcinosarcoma of parotid gland (malignant mixed tumor).

    PubMed

    Feng, Duan; Fidele, Nyimi Bushabu; Agustin, Mansthumba Milolo; Jian, Guan; Bourleyi, Sekele Isouradi; Augustin, Lamwe; Olivier, Ngueji Kakubu

    2015-01-01

    Salivary gland carcinosarcoma is a rare neoplasm; with a poor prognosis. The most common epithelial components are adenocarcinoma or squamous cell carcinoma, whereas the most common mesenchymal components are chondrosarcoma. It should not be confused with the most common carcinoma ex-pleomorphic adenoma, in which the epithelial component alone is malignant. This condition might exhibit with a wide variety of presentation and symptoms along with associated conditions. We present a case of an old patient who presented with a very unusual type clinically with confusing presentation which was eventually diagnosed as carsinosarcoma. In addition, the literature is reviewed, and the possible clinical signs and management of malignant mixed tumor of the salivary gland are briefly discussed.

  2. Clinical management of masses arising from the accessory parotid gland.

    PubMed

    Yang, Xiao; Ji, Tong; Wang, Li-Zhen; Yang, Wen-jun; Hu, Yong-jie; Zhong, Lai-ping; Zhang, Chen-ping; Zhang, Zhi-yuan

    2011-09-01

    Accessory parotid lesions are clinically rare and its management remains poorly understood. The aim of this study was to analyze the clinical management of accessory parotid lesions. From April 1999 to November 2008, a retrospective analysis of 32 patients with accessory parotid lesions was performed. The preoperative examinations, surgical treatment, and prognosis were recorded and analyzed. Among the 32 patients, there were 8 men and 24 women with an overall average age of 45 years. These patients always presented without obvious symptoms, and the masses were moderate to hard in hardness without tenderness, mobile, and with clear boundary. The pathologic diagnoses were 24 benign and 8 malignant lesions. Surgery and surgery plus radiotherapy were performed in the patients with benign and malignant lesions, respectively, with good prognosis. Accessory parotid lesions are rare, and the clinical manifestation is always the same for benign tumors. Surgical resection and surgical resection plus radiotherapy are the primary choices of treatment for benign and malignant lesions, respectively. The prognosis is always good. Copyright © 2011 Mosby, Inc. All rights reserved.

  3. An unusual case of spleen metastasis from carcinoma ex pleomorphic adenoma of the parotid gland.

    PubMed

    Rossi, Luigi; Giordani, Erika; Fontana, Antonella; Di Cristofano, Claudio; Cavallaro, Giuseppe; Bagni, Oreste; Filippi, Luca; Bianchi, Loredana; Rinaldi, Giulia; Congedi, Francesca Perrone; Papa, Anselmo; Caruso, Davide; Verrico, Monica; Silecchia, Gianfranco; Tomao, Silverio

    2014-01-23

    Carcinoma ex pleomorphic adenoma is a rare tumor arising from the salivary glands that spreads through direct extension, through the lymphatic vessels, and, rarely, hematogenously. When distant metastases have been found, they have been reported mainly in the lung. We present an unusual case of carcinoma ex pleomorphic adenoma of the parotid gland with splenic metastases. The patient presented with a primary carcinoma ex pleomorphic adenoma of the parotid gland and he underwent a total parotidectomy with laterocervical lymphadenectomy ipsilateral and adjuvant radiation therapy to the right parotid area. One year later, the patient showed an ipsilateral supraclavicular lymph node recurrence, treated with surgery and radiation therapy. Two more years later, the patient developed lung and splenic lesions, detected through CT and PET. He underwent splenectomy and pathologic assessment of the specimen showed metastatic carcinoma ex pleomorphic adenoma. To our knowledge, there is no reported case of a carcinoma ex pleomorphic adenoma metastasizing to the spleen. Patients treated for carcinoma ex pleomorphic adenoma should be investigated for distant metastases with a long-term follow-up examination for local and distant metastases and new splenic lesions in these patients should be investigated.

  4. Prognostic Factors and Treatment Outcomes of Parotid Gland Cancer: A 10-Year Single-Center Experience.

    PubMed

    Chang, Jae Won; Hong, Hyun Jun; Ban, Myung Jin; Shin, Yoo Seob; Kim, Won Shik; Koh, Yoon Woo; Choi, Eun Chang

    2015-12-01

    To investigate the treatment outcomes of parotid gland cancer at a single center over a 10-year period and to evaluate the prognostic significance of maximum standardized uptake value. Retrospective case series with chart review. Academic care center. Ninety-eight patients with primary parotid gland cancer who were surgically treated at Yonsei University Head & Neck Cancer Clinic between January 1999 and December 2008 were analyzed. Patient data were collected retrospectively from medical charts. The investigators analyzed the association of clinicopathological factors and maximum standardized uptake value on (18)F-fluorodeoxyglucose positron emission tomography-computed tomography scan with disease-specific survival. Mean patient age was 49.7 years. Mean follow-up was 48.8 months. Thirty-three, 40, 30, and 23 patients had stage I, II, III, and IVA disease, respectively. Mucoepidermoid carcinoma was the most common histologic type (34.7%), followed by acinic cell carcinoma (27.6%). Eighteen patients (18.4%) experienced recurrences (mean recurrence gap, 20.6 months; range, 2-87 months). Five- and 10-year disease-specific survival rates were 93.6% and 81.8%, respectively. In the univariate analysis, pathologic T stage, pathologic lymph node status, resection margin, external parenchymal extension, and maximum standardized uptake value were significantly associated with disease-specific survival. Pathologic lymph node status and maximum standardized uptake value were independent prognostic factors in the multivariate analysis. Our single-center experience with parotid gland cancer treatment is consistent with the literature. Cervical lymph node metastasis and high maximum standardized uptake value are associated with poor survival in parotid gland cancer. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  5. Minimally-invasive surgery in the management of symptomatic parotid stones.

    PubMed

    Samani, Meera; Hills, Alexander James; Holden, Adam Matthew; Man, Chang-Bon; McGurk, Mark

    2016-05-01

    Traditionally, large, symptomatic, parotid stones that were refractory to conservative treatment were usually managed by parotidectomy, with the attendant risk to the facial nerve. Microendoscopes have transformed the management of such stones. For large stones that are not amenable to retrieval with a basket the endoscope provides a new dimension to operative surgery. It can guide the surgeon on to the duct and stone without the need to remove the parotid gland. In 2005-2014, 111 consecutive patients underwent endoscopically-assisted operations for the removal of 132 parotid stones at Guy's Hospital. Removal was successful in all but three cases. Long-term follow up (mean (SD) 44 (30) months) was obtained by postal or online survey and telephone, and 92 patients (83%) said that they had no symptoms. Further endoscope-assisted surgery was required in four cases, with preservation of the gland in all patients. Sialocoeles developed postoperatively in 15% (n=17). Transient facial nerve weakness occurred in 4 cases (4%), and there was no case of permanent deficit. Endoscopically-assisted retrieval of parotid stones is a technique to preserve the gland that adds to the current minimally-invasive options for management of parotid calculi.

  6. 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.

  7. 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

  8. Immunochemical relationship between alpha-amylases of rat liver, serum, pancreas and parotid gland.

    PubMed Central

    Messer, M; Dean, R T

    1975-01-01

    1. Rabbit antisera to purified rat parotid alpha-amylase were prepared. 2. The relationships between rat parotid-gland, pancreatic, serum and liver amylase were investigated by using the antisera in immunodiffusion, immunoelectrophoresis and immunoinhibition experiments. 3. Serum and liver amylase were identical, and very similar to parotid-gland amylase; pancreatic amylase was, however, quite distinct, and showed only some of the determinants present on parotid-gland amylase. 4. The data strengthen the suggestion that the liver is the main source of serum amylase. Images PLATE 1 PLATE 2 PLATE 3 PMID:55120

  9. Simultaneous Bilateral Hypertrophies of the Parotid Gland and Masseter Muscle: Case Report.

    PubMed

    Prabhu, Rohan; Mandel, Louis

    2017-01-01

    Increased salivary demand can lead to enlarged parotid salivary glands, and increased activity of the masseter muscles can cause masseter hypertrophy. This report describes a most unusual case of simultaneous bilateral hypertrophies of the parotid gland and masseter muscle originating from the very extensive habit of chewing gum. An extensive literature review uncovered many cases of the independent existence of masseteric or parotid hypertrophy, but no example of the simultaneous occurrence of these 2 conditions.

  10. Parotid gland squamous cell carcinoma invading the temporomandibular joint.

    PubMed

    Klasser, Gary D; Epstein, Joel B; Utsman, Robert; Yao, Mike; Nguyen, Pamela H

    2009-08-01

    Tumor invasion of the temporomandibular joint from the parotid gland is rare. Practitioners should be able to differentiate tumor involvement from temporomandibular disorders (TMDs). . The authors present case reports of two patients with parotid gland masses accompanied by pain, dysfunction and other symptoms not consistent with musculoskeletal disorders. In both cases, clinicians initially reached an incorrect diagnosis and treated the masses as if they were TMDs, which delayed a definitive diagnosis and provision of appropriate treatment. Dentists must take a thorough patient history, perform a detailed clinical examination and request proper radiographic imaging, when necessary, to render an accurate diagnosis and avoid mistreatment. Dentists who treat TMDs must recognize the possibility that a head or neck malignancy may manifest with symptoms and signs that mimic TMDs. If dentists are in doubt about a diagnosis, referral to the appropriate specialist should be considered. A thorough history, a comprehensive clinical examination and an understanding of salivary gland disorders should facilitate an accurate initial diagnosis, allowing delivery of the appropriate and necessary medical treatment.

  11. Use of semiconducting laser in drug-induced chronic bilateral inflammation of parotid glands

    NASA Astrophysics Data System (ADS)

    Grzesiak-Janas, Grazyna

    1997-10-01

    A case of chronic bilateral inflammation of parotid glands in a patient as a results of complication induced by the drug Ospolot in the treatment of epilepsy was presented. Apart from conventional methods a semiconducting laser was used. The laser beam had beneficial effect on elimination of pain and increase in the parotid gland secretion activity.

  12. Skull Base Involvement by Acinic Cell Carcinoma of the Parotid Gland

    PubMed Central

    Breen, Joseph T.; Carlson, Matthew L.; Link, Michael J.; Moore, Eric J.; Neff, Brian A.; Driscoll, Colin L.W.

    2012-01-01

    Objective Describe the clinical course and outcomes of patients with primary acinic cell carcinoma (ACC) of the parotid gland with skull base invasion or metastasis. Design Retrospective case series (1995–2011) at a single institution. Results Ten patients met study criteria. Mean and median time from initial diagnosis of parotid ACC to development of skull base disease were 14.6 and 10.2 years, respectively. Two patients demonstrated skull base disease on initial presentation. Those who pursued further treatment after developing disease at the skull base underwent surgery (4/7), stereotactic radiosurgery (4/7), or external beam radiation (3/7). The 10-year Kaplan-Meier estimated overall survival after initial diagnosis of parotid ACC was 80%. Once skull base invasion occurred, 2-year estimated overall survival was 50%. Conclusion Although primary ACC of the parotid generally caries an excellent prognosis, tumor control with cranial base disease is difficult and the majority of patients present with late aggressive recurrences. Our observations underscore the importance of long-term follow-up in this patient group. PMID:24294553

  13. Tumors of the accessory lobe of the parotid gland: a 10-year experience.

    PubMed

    Lin, Derrick T; Coppit, George L; Burkey, Brian B; Netterville, James L

    2004-09-01

    The differential diagnosis of midcheek masses include pathology arising from normal anatomic structures or from variations of normal accessory parotid gland tissue. Accessory parotid gland tissue has been described as salivary tissue adjacent to Stenson's duct that is separate from the main body of the parotid gland. We report our 10-year experience with the diagnosis and treatment of eight accessory parotid gland neoplasms that have been followed by the senior authors. This is a retrospective review of our experience with eight accessory parotid gland neoplasms. A literature review and retrospective chart review of our experience with accessory parotid gland tumors over the past 10 years. The presentation, evaluation, management, treatment, and outcome were recorded. Eight cases of accessory lobe parotid tumors were identified, which have been followed since the date of initial treatment. All of the patients presented with a slowly growing cheek mass. There was one case of carcinoma expleomorphic adenoma, one case of undifferentiated carcinoma (small cell carcinoma), one case of basal cell adenocarcinoma, one case of benign salivary cyst, two cases of pleomorphic adenoma, and two cases of monomorphic adenoma. A standard facelift approach or modified Blair incision was used to excise these tumors. Neoplasms of the accessory parotid gland are rare. Management of these tumors include a high index of suspicion, good understanding of the anatomy, and meticulous surgical approach.

  14. Local Rhomboid Flap Reconstruction for Skin Defects After Excising Large Parotid Gland Tumors.

    PubMed

    Hung, Min-Hui; Liao, Chun-Ta; Kang, Chung-Jan; Huang, Shiang-Fu

    2017-01-01

    Most parotid tumors grow slowly, and sometimes these patients do not request surgical treatment until the tumors become large and affect their appearance. The surgical treatment of these large tumors is usually accompanied by large skin defects after excision, and it is challenging for surgeons to close the defect primarily. This report describes the case of a 68-year-old man with a left parotid gland tumor (largest dimension, 110 mm) and the case of a 79-year-old man with a left parotid gland tumor measuring approximately 77 mm that had existed for decades. These patients underwent facial nerve dissection and parotidectomy with skin sacrifice. The large skin defects after the parotidectomy were successfully reconstructed with local rhomboid flaps. No facial palsy, wound disruption, flap edge loss, or major complications occurred after the surgeries. Except for the scars, the color of the cheek flap was not apparent from the periphery. In conclusion, local rhomboid flap reconstruction is a rapid and practical technique for reconstructing medium to large skin defects in the cheek and upper neck regions after tumor excisions. The flap was reliable in blood supply and cosmetic outcome.

  15. 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.

  16. Lateral facial cleft associated with accessory mandible having teeth, absent parotid gland and peripheral facial weakness.

    PubMed

    Ozçelik, D; Toplu, G; Türkseven, A; Senses, D A; Yiğit, B

    2014-07-01

    Transverse facial cleft is a very rare malformation. The Tessier no. 7 cleft is a lateral facial cleft which emanates from oral cavity and extends towards the tragus, involving both soft tissue and skeletal components. Here, we present a case having transverse facial cleft, accessory mandible having teeth, absent parotid gland and ipsilateral peripheral facial nerve weakness. After surgical repair of the cleft in 2-month of age, improvement of the facial nerve function was detected in 3-year of age. Resection of the accessory mandible was planned in 5-6 years of age. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

    PubMed Central

    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. PMID:23798838

  18. 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.

  19. Rat parotid gland amylase: evidence for alterations in an exocrine protein with increased age.

    PubMed

    Baum, B J; Levine, R L; Kuyatt, B L; Sogin, D B

    1982-05-01

    The content of alpha-amylase, the major exocrine secretory protein from rat parotid glands, was studied in young adult and aged rat tissue. alpha-Amylase protein was determined with an enzyme-linked immunosorbent assay. This employed antisera, produced against alpha-amylase purified from young adult rats, but which recognized and precipitated alpha-amylase enzyme activity equally well from both age groups. The parotid gland content of alpha-amylase was reduced about 50% in aged rats. Furthermore, the percentage of total gland protein which was alpha-amylase was decreased about 40% in aged animals. The data suggest that a somewhat specific alteration in alpha-amylase production (synthesis and/or degradation) occurs in parotid glands from aged rats. In addition, alpha-amylase functional activity was followed. The specific enzyme activity (U amylase activity per mg immunoreactive amylase) was about 35% higher in extracts from aged rat parotid glands compared to that of young adult glands.

  20. 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.

  1. 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.

  2. Effects of shock waves on oxidative stress in parotid gland of rat.

    PubMed

    Garca, M Fatih; Kavak, Servet; Gecit, Ilhan; Meral, Ismail; Demir, Halit; Turan, Mahfuz; Çeğin, Bilal; Bektas, Hava; Çankaya, Hakan

    2014-06-01

    This study was designed to investigate whether extracorporeal shock wave lithotripsy (ESWL) exposure to parotid gland produces an oxidative stress in parotid glands of rats. Twelve male Wistar-albino rats, 6 months of age with an average body weight of 250-300 g, were divided randomly into two groups, each consisting of six rats. The animals in the first group did not receive any treatment and served as control. The left parotid glands of animals in group 2 (ESWL treated) received a thousand 18 kV shock waves after anesthetizing the rats with 50 mg/kg of ketamine. The animals in both groups were killed 72 hours after the ESWL treatment, and the parotid glands were harvested for the determination of lipid peroxidation product malondialdehyde (MDA), antioxidant glutathione (GSH) levels and the activities of antioxidant enzymes such as superoxide dismutase (SOD), GSH-Px and catalase (CAT). It was found that MDA level increased in parotid glands of rats after the ESWL treatment. The SOD, GSH-Px and CAT enzyme activities, and the level of antioxidant GSH decreased in parotid gland of rats after the ESWL treatment. It was concluded that short-term ESWL treatment caused an increase in the free radical production and a decrease in the antioxidant enzyme activity in parotid glands of ESWL-treated rats. © The Author(s) 2012.

  3. An intraoperative diagnosis of parotid gland tumors using Raman spectroscopy and support vector machine

    NASA Astrophysics Data System (ADS)

    Yan, Bing; Wen, Zhining; Li, Yi; Li, Longjiang; Xue, Lili

    2014-11-01

    The preoperative and intraoperative diagnosis of parotid gland tumors is difficult, but is important for their surgical management. In order to explore an intraoperative diagnostic method, Raman spectroscopy is applied to detect the normal parotid gland and tumors, including pleomorphic adenoma, Warthin’s tumor and mucoepidermoid carcinoma. In the 600-1800 cm-1 region of the Raman shift, there are numerous spectral differences between the parotid gland and tumors. Compared with Raman spectra of the normal parotid gland, the Raman spectra of parotid tumors show an increase of the peaks assigned to nucleic acids and proteins, but a decrease of the peaks related to lipids. Spectral differences also exist between the spectra of parotid tumors. Based on these differences, a remarkable classification and diagnosis of the parotid gland and tumors are carried out by support vector machine (SVM), with high accuracy (96.7~100%), sensitivity (93.3~100%) and specificity (96.7~100%). Raman spectroscopy combined with SVM has a great potential to aid the intraoperative diagnosis of parotid tumors and could provide an accurate and rapid diagnostic approach.

  4. Benign lymphoepithelial cysts of parotid and submandibular glands in a HIV-positive patient

    PubMed Central

    Shivhare, Peeyush; Shankarnarayan, Lata; Jambunath, Usha; Basavaraju, Sowbhagya Malligere

    2015-01-01

    Patients with human immunodeficiency virus (HIV) infection have been reported to have parotid swellings of various types such as diffuse infiltrative lymphocytosis syndrome, parotitis, intraparotid lymphadenopathy, benign lymphoepithelial cyst (BLEC), as well as salivary gland neoplasms such as adenoid cystic carcinoma, Kaposi sarcoma and lymphoma. LECs in the parotid gland are uncommon benign entities with increased incidence associated with HIV infection. We are presenting a case of 28-year-old HIV-positive patient with BLECs in the parotid and submandibular glands. PMID:26097320

  5. A case of congenital fistula from an accessory parotid gland: diagnosis and treatment.

    PubMed

    Pinto, Fábio Roberto

    2012-01-01

    The author reports a case of congenital fistula from an accessory parotid gland and describes its diagnosis and treatment. The patient was referred to the author's clinic for evaluation of a continuous serous discharge from a small orifice in the left cheek near the angle of the mouth. A left preauricular appendix was also noted. Fistulography detected an aberrant duct leading to an accessory parotid gland. The main parotid gland and its duct were normal. The anomalous duct was dissected in continuity with a small ellipse of skin and sutured to the buccal mucosa. The patient's recovery was uneventful. The author also discusses the embryologic origin of this rare anomaly.

  6. Extracapsular dissection of pleomorphic adenoma of the parotid gland through minimal preauricular and retroauricular incisions in children.

    PubMed

    Li, Jin-Song; Chen, Wei-Liang; Zhang, Da-Ming; Fan, Song; Wang, Lei

    2012-05-01

    We evaluate treatment outcomes in children with benign parotid neoplasms who underwent extracapsular dissection of the tumor using minimal incisions. Nine pediatric patients (4 boys and 5 girls) with pleomorphic adenoma of the parotid gland were treated with extracapsular dissection via preauricular and retroauricular incisions. The mean age of the patients at the time of surgery was 9.4 years. The size of the tumors ranged from 1.5 × 1.4 to 3.5 × 3.0 cm. Seven tumors were located in the superficial lobe of the parotid gland and 2 were located in the deep lobe. All histologically confirmed cases of malignancy were excluded. All 9 operations were performed successfully. No patient exhibited any permanent postoperative complication. Neither hematomas of the parotid region nor salivary fistula occurred. One patient had slight transient postoperative facial paresis. The scars were almost invisible. All patients had excellent cosmetics and complete function of the facial nerve. The patients were followed up for 5.1 to 7.0 years. Tumor recurrence developed in 1 patient who subsequently underwent curative parotidectomy. Extracapsular dissection through preauricular and retroauricular incisions is a feasible technique, providing excellent cosmetic outcome in the treatment of benign parotid neoplasms in children.

  7. New models of experimental parotitis and parotid gland distension in rats.

    PubMed

    Okada-Ogawa, Akiko; Shinoda, Masamichi; Honda, Kuniya; Iwata, Koichi

    2012-01-01

    A significant reduction of the escape threshold to mechanical stimulation of the lateral facial skin was observed bilaterally at days 2 and 3 after unilateral complete Freund's adjuvant (CFA) administration into parotid gland. A slight reduction of mechanical escape threshold was also observed in rats with saline administration. The parotid gland inflammation was verified and quantified by measuring the tissue Evans' blue dye extravasation. The Evans' blue concentration in the parotid gland tissues was significantly greater in the CFA-injected rats than that of the saline-injected rats at 72 h after treatment. On day 10 after CFA administration into the parotid gland, the Evans' blue concentration was recovered to the control level. The administration of capsaicin into the parotid gland did not alter neuronal activities in the transition zone between the trigeminal spinal subnucleus interpolaris and caudalis (Vi/Vc). In contrast, capsaicin administration induced significant increases in the receptive field size and mechanical and cold responses of neurons located in superficial laminae of the C1/C2. The subgroup of C1/C2 neurons responded to mechanical distension of the parotid gland, whereas no Vi/Vc neurons responded to parotid distension.

  8. Diagnostic value of metabolic heterogeneity as a reliable parameter for differentiating malignant parotid gland tumors.

    PubMed

    Kim, Bum Soo; Kim, Seong-Jang; Pak, Kyoungjune

    2016-06-01

    Exact classifying between malignant and benign tumors in the parotid gland is important because the cancer has relatively poor prognosis. There have been several studies that F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) can differentiate between malignant and benign parotid gland tumors. However, the role of FDG PET is still controversial because many benign parotid gland tumors, such as Warthin's tumor and pleomorphic adenoma, show high FDG uptake. We hypothesized that metabolic heterogeneity would differentiate malignant parotid tumors because tumoral heterogeneity is an important characteristic in the malignancies. From January 2010 to April 2015, we retrospectively reviewed the 46 patients who showed FDG uptake at the parotid gland. To differentiate malignant parotid gland tumors, we obtained maximum SUV and mean SUV. Metabolic tumor volume and total lesion glycolysis were measured as metabolic volumetric parameters. We also included heterogeneity parameters of FDG PET such as heterogeneity factor (HF) and the coefficient of variation for all patients. There was significant difference of HF between malignant (-0.30 ± 0.25; range -0.937 to -0.084) and benign parotid gland tumors (-0.06 ± 0.05; range -0.291 to -0.012; p < 0.0001). In receiver operating characteristic analysis, when ≤-0.084 was used as the cut-off value for HF, the sensitivity and specificity were 100 % (95 % CI 81.5-100) and 89.2 % (95 % CI 71.8-97.7), respectively. HF showed the highest area under the curve of 0.947 among the parameters. In logistic regression analysis, the HF was the most powerful factor for differentiation of the parotid gland tumors (p = 0.002). Our results suggest that HF can be utilized as a reliable and non-invasive method for differentiation of malignant and benign parotid gland tumors.

  9. Immunohistochemical study of basal cell adenoma in the parotid gland.

    PubMed

    Hamano, H; Abiko, Y; Hashimoto, S; Inoue, T; Shimono, M; Takagi, T; Noma, H

    1990-02-01

    Basal cell adenoma of the parotid gland was studied with immunohistochemical methods. We observed cells in the tumor with positive reaction to polyclonal keratin, prekeratin, monoclonal PKK-1, polyclonal S-100 protein, monoclonal S-100 protein (alpha), secretory component, actin and laminin. However, no cells which stained positively with monoclonal KL-1, amylase, carcinoembryonic antigen, or epithelial membrane antigen were recognized. From these immunohistochemical results and our ultrastructural observations reported previously, we conclude that the cells constituting the basal cell adenoma are ductal, myoepithelial, and squamous cells but not secretory ones. It is also suggested that the origins of basal cell ademona as well as those of pleomorphic and clear cell adenoma are undifferentiated cells of intercalated duct.

  10. 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.

  11. [Sialadenosis of the parotid gland. Ultrastructural, clinical and experimental findings in disturbances of secretion (author's transl)].

    PubMed

    Donath, K

    1976-01-01

    Among the secretory disturbances ("Dyschylien") of salivary glands the sialadenosis of the parotid gland is a clinic and a morphologic definited entity. The typical clinical symptom is a bilateral, often recurrent, and painless swelling of the parotid gland. The characteristic pathological findings consist in an acinar cell hypertrophy without any inflammatory signs. According to this definition, sialadenosis has to be separated from those diseases of salivary glands, which are primarily altered by inflammation of the salivary tissue with secondary secretory disturbances. From flinical point of view it is possible to distinguish the following kinds of sialadenosis according to the syntropy with various diseases: Endocrine sialadenosis (in diabetes mellitus, dysfunction of gonads, pituitary gland, thyroid gland etc.); dystrophic-metabolic sialadenosis (malnutrition, avitaminosis, alcohilsm, chronic liver diseases etc.), and neurogenic sialadenosis (dysfunction of the vegetative nervous system, drug damages e.g. antihypertensive agents). The question arises, whether all forms of sialadenosis have a common etiology and a coincidental pathogenic factor. The following studies were carried out with the aim to find further details concerning the etiology and pathogenesis of sialadenosis. The study is based on the following material: a) 126 Biopsies of parotid glands from patients with sialadenosis (Register of salivary gland diseases at the Institute of Pathology, University of Hamburg, supported by Deutsche Forschungsgemeinschaft). This material was collected from 1965 to 1973. b) 80 Biopsies of parotid glands from patients with other diseases (parotitis [4]; acinic cell carcinoma [4]; other parotid and oral tumors [72]; for comparison. c) Experimental studies on the parotid salivary glands of Wistar-rats. The biopsies of the parotid glands were studied histologically, morphometrically, and ultrastructurally. The investigations centered on the ultrastruct of sialadenosis

  12. Myoepithelioma of the Parotid Gland Presenting as a Retroauricular Cutaneous nodule: A Case Report.

    PubMed

    Mochizuki, Yumi; Omura, Ken; Tanaka, Kae; Sakamoto, Kei; Yamaguchi, Akira

    2013-06-01

    We are reporting a case of recurrent myoepithelioma of the parotid gland, that emerged as a cutaneous mass. She had a retroauricular subcutaneous mass with an underlying diagnosis of a cutaneous myoepithelioma, which was excised at a hospital's Dermatology Department 2 years earlier. The tumour was observed above the platysma and it was considered as a cutaneous myoepithelioma without the parotid gland structures. She had undergone a partial parotidectomy approximately 20 years earlier. At her first visit to our department, there was no evidence of facial nerve palsy or cervical lymphadenopathy. The radiological findings showed a multinodular growing mass of the parotid gland, just beneath the retroauricular skin and a total parotidectomy was performed. It was considered that even if the cutaneous mass emerged, the relationship between the cutaneous mass and the parotid gland should be pre-surgically examined by computed tomography (CT) or Magnetic resonance image (MRI). A long-term continuous follow-up was also needed.

  13. Congenital Unilateral Agenesis of the Parotid Gland: A Case Report and Review of the Literature

    PubMed Central

    Teymoortash, Afshin

    2016-01-01

    Congenital unilateral agenesis of the parotid gland is a rare condition with only few cases reported in the literature. A review of 21 cases in the available literature is presented in this article. We report on a further case of a 34-year-old woman with agenesis of the left parotid gland and lipoma of the right cheek. Clinicopathological characteristics of described cases in the literature were discussed. PMID:27895943

  14. Value of apparent diffusion coefficient calculation in the differential diagnosis of parotid gland tumors.

    PubMed

    Yerli, H; Agildere, A M; Aydin, E; Geyik, E; Haberal, N; Kaskati, T; Oguz, D; Ozluoglu, L N

    2007-11-01

    The differential diagnosis of parotid gland tumors is often difficult with conventional magnetic resonance imaging. To determine whether the calculation of the apparent diffusion coefficient (ADC) is valuable for making the differential diagnosis of parotid tumors. Thirty parotid masses in 28 patients and 24 healthy parotid glands in 12 controls were examined in this prospective study. Diffusion-weighted magnetic resonance imaging with echo-planar spin-echo sequences was used to evaluate each subject. The ADC of each tumor and each healthy parotid gland was calculated. Tumor diagnoses were confirmed by the results of histopathologic analysis. The following types of masses were identified: 11 Warthin tumors, nine pleomorphic adenomas, seven malignant tumors, one basal cell adenoma, and two benign cysts. The mean ADC value for the Warthin tumors was 0.97+/-0.16 x 10(-3) mm(2)/s, for the pleomorphic adenomas was 1.74+/-0.37 x 10(-3) mm(2)/s, for the malignant tumors was 1.04+/-0.35 x 10(-3) mm(2)/s, and for the normal parotid glands was 0.34+/-0.20 x 10(-3) mm(2)/s. The respective ADC value for the single basal cell adenoma was 1.40 x 10(-3) mm(2)/s. Statistically significant differences were identified between the subjects with pleomorphic adenoma and those with another type of parotid tumor, and between subjects with healthy parotid glands and those with a tumor. Calculating the ADC appears to be useful in differentiating pleomorphic adenomas from other types of parotid gland tumors.

  15. Sialendoscopy and sialendoscopically-assisted operations in the treatment of lithiasis of the submandibular and parotid glands: our experience of 239 cases.

    PubMed

    Kopeć, Tomasz; Wierzbicka, Małgorzata; Kałużny, Jarosław; Młodkowska, Anna; Szyfter, Witold

    2016-09-01

    We present the results of treatment of sialolithiasis of the submandibular and parotid glands using sialendoscopy and sialendoscopy-assisted surgery. Between 2009-2013, 397 consecutive patients (mean (range) age 48 (18-76) years) were treated for obstructive diseases of the major salivary glands (sialolithiasis n=239, 175 submandibular and 64 parotid). In a total of 175 patients with 191 stones in the submandibular gland treated by endoscopic retrieval or surgical release, 149 patients (85%) were rendered free of stones (by sialendoscopy alone n=82, and sialendoscopy with operation n=67) Twenty patients (11%) had residual stones and 6 patients (4%) required excisionof the gland. Sixty-four patients had 71 stones removed from the parotid gland by endoscopic retrieval or surgical release and 43 (67%) were free of stones (by sialendoscopy alone n=25, and sialendoscopy with operation n=18). Twenty patients (31%) had residual stones and one (2%) required removal of the gland. In the group of patients whose stones were removed endoscopically, the effectiveness of sialendoscopy was 87% and 85%, respectively. We confirm that sialendoscopy and sialendoscopy-assisted removal is the current treatment of choice for stones in the submandibular and parotid glands. The indications for excision of the gland are becoming less common as first-line treatment, although it is still indispensable in some cases.

  16. 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.

  17. EFFECT OF IRRADIATION ON MICROVASCULAR ENDOTHELIAL CELLS OF PAROTID GLANDS IN THE MINIATURE PIG

    PubMed Central

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

    2013-01-01

    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 Mg2+-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. PMID:20832188

  18. Investigations on parotid gland recovery after IMRT in head and neck tumor patients.

    PubMed

    Stock, Markus; Dörr, Wolfgang; Stromberger, Carmen; Mock, Ulrike; Koizar, Susanne; Pötter, Richard; Georg, Dietmar

    2010-12-01

    in recent years, the role of intensity-modulated radiotherapy (IMRT) for head and neck irradiation has increased. The main motivation is sparing the parotid gland and reduction of xerostomia. Generally, relative parotid volumes have been evaluated for treatment outcome and planning constraints, neglecting that absolute parotid volumes can vary significantly. The aim of the present study was to investigate changes in parotid gland function and set this in relation to absolute volumes. 46 head and neck patients were treated by sparing at least the contralateral parotid gland. The mean dose to the contralateral gland was limited to 26 Gy. Parotid function was measured with scintigraphy before and at 3, 6, 9, and 12 months after radiotherapy. Gland recovery was correlated with absolute parotid gland volumes and mean dose. Finally the dose-effect relationship was investigated. the dose-volume histograms (DVHs) for the ipsi- and contralateral glands were significantly different. A correlation between absolute volumes receiving certain doses and the function loss after 3, 6, 9, and 12 months was found. The most significant correlation was found for the absolute volume that received at least 40 Gy (aV40). ED50 values of 23-38 Gy were observed for more than 50% function loss and and 52-68 Gy afor more than 75% function loss. the mean dose, aV40 or aV26, revealed similar correlations with the excretion rate and with recovery. Hence, also absolute volumes can be used for treatment planning. Longer recovery times show higher ED50 values indicating partial regeneration of gland functions.

  19. 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.

  20. Accessory parotid gland with ectopic fistulous duct - Surgical view: A case report and review of current literature

    PubMed Central

    Yadav, G. D.; Yadav, Anju; Soni, Jatin; Chaudhary, Ghisulal

    2014-01-01

    Accessory parotid glands are a common clinical occurrence and usually drain into the main Stenson's duct by small ductules and thereby, into the buccal cavity. Presence of an accessory parotid gland with an ectopic fistulous duct is a rare occurrence. Clinical findings, imaging studies, biochemical tests, histopathological examination are needed for appropriate surgical management. It is extremely rare case with ectopic fistulous duct in an accessory parotid gland managed surgically by internalization of the duct to open into the buccal mucosa and excision of pre-aural appendages. Further to this, we give a comprehensive review of literature on accessory parotid gland and duct anomalies. PMID:25937745

  1. Review of accessory parotid gland tumors: pathologic incidence and surgical management.

    PubMed

    Newberry, Travis R; Kaufmann, Christopher R; Miller, Frank R

    2014-01-01

    The current study presents our experience with accessory parotid gland masses and reviews the literature on accessory parotid tumor incidence and surgical management. Based on our results, we advocate a standard parotidectomy approach with routine facial nerve dissection at the time of excision. We performed a retrospective chart review and comprehensive literature review on incidence of accessory parotid gland neoplasms. A retrospective chart review of all patients with mid-cheek masses treated by the senior author was conducted from January 2003 to January 2009. The tumor size at presentation, FNA biopsy, pathologic diagnosis, and surgical treatment were recorded for 13 patients. In the case series, 54% of lesions were benign (n=7) and 46% were malignant (n=6) including benign pathologies of 4 pleomorphic adenomas, 2 lymphadenitis, 1 monomorphic adenoma and malignant pathologies of 2 mucoepidermoid carcinoma, 2 B-cell lymphomas, 1 adenocarcinoma, and 1 myofibrosarcoma. Surgical intervention was performed on all patients with standard parotidectomy incision for accessory parotid mass excision after identification and tracing of facial nerve and its branches. The present study provides support for a standard parotid incision with identification of the facial nerve at the time of surgical incision as this resulted in successful excision of accessory parotid tumors with favorable cosmetic results and without facial paralysis or tumor recurrence. Literature review of 152 cases of accessory parotid gland lesions, revealed a pooled incidence of 70% benign and 30% malignant. © 2013.

  2. Salivary gland surgery and medical malpractice.

    PubMed

    Hong, Steven S; Yheulon, Christopher G; Sniezek, Joseph C

    2013-04-01

    To better understand the causes and outcomes of lawsuits involving salivary gland surgery by analyzing malpractice litigation trends to prevent future litigation and improve physician education. Analysis of a national database. All US civil trials. The WESTLAW database was reviewed from January 1987 to March 2011. Data were compiled on the demographics of the defendant, anatomic site of injury, initial pathology, nature of injury, legal allegations, verdicts, and indemnities. Twenty-six cases met inclusion criteria and were selected for review. Verdicts/settlements for the plaintiffs predominated (58%), and the average sum of the plaintiff's monetary award was $933,235. Sixteen cases (62%) involved injury to the parotid gland/duct, with 10 cases involving injury to the facial nerve. No cases were filed on the grounds of failure to use facial nerve monitoring. Nine cases (35%) involved injury to the submandibular gland/duct. The most common legal allegations listed were improper performance followed by unnecessary procedures. If failure or inadequate consent was a component of the legal allegations, the verdict outcome significantly favored the defendants. Our study reveals that the plaintiffs in litigations involving salivary gland surgery have a slight advantage in outcomes with a fairly substantial award. Our litigation review reiterates the importance of detailed anatomic knowledge of the lingual and facial nerve to avoid the pitfalls of surgical error and consequent litigation. In addition, thorough preoperative evaluation of salivary gland pathology, including radiographic studies and needle biopsy, may help avoid errors in diagnosis and subsequent litigations.

  3. Adaptive parotid gland hypertrophy induced by dietary treatment of GSE in rats.

    PubMed

    Inoue, Kaoru; Morikawa, Tomomi; Matsuo, Saori; Tamura, Kei; Takahashi, Miwa; Yoshida, Midori

    2014-08-01

    In a 13-week feeding toxicity study of grape skin extract (GSE) performed previously, 5.0% GSE showed diffuse hypertrophy and basophilia in rat parotid glands. To clarify whether the change in the parotid glands was an adverse effect of GSE, 6-week-old male F344 rats were fed a diet containing 5.0% GSE or were administered a dose corresponding to the dietary concentration via gavage for 4 weeks, and the treatment was stopped for 2 weeks. To ascertain the effect of astringency, other animals were fed a diet containing 5.0% tannic acid (TA) using the same protocol as the GSE feed group. Control groups were fed a basal diet or were administered sterilized distilled water by gavage. In the GSE and TA feed groups, diffuse severe hypertrophy and basophilia in the parotid glandular epithelial cells were observed. Macroscopic, microscopic, and ultrastructural characteristics consistent with cellular hypertrophy was less apparent after the recovery period in both feed groups. In contrast, no changes were observed in the parotid glands of the gavage GSE and control groups at week 4. Based on these findings of parotid hypertrophy without cytotoxicity, the data from this and previous studies suggest that hypertrophy of the parotid glands induced by feeding treatment with GSE is an adaptive non-adverse effect that is reversible upon removal of the sialotrophic agent. © 2013 by The Author(s).

  4. A fibrous histiocytoma of intermediate malignancy arisen from the parotid gland.

    PubMed

    Khalkhali, Kazem; Azizi, Mohammad-Reza; Atighechi, Saeid

    2007-01-01

    The light microscopic and immunohistochemical characteristics of a case of fibrous histiocytoma of intermediate malignancy arising from the parotid gland are presented. This neoplasm is rare in this site and must be distinguished from other spindle cell tumors of the parotid gland, particularly those of epithelial and myoepithelial origins. Histologic characteristics similar to those displayed by dermatofibroma and dermatofibrosarcoma protuberans help to differentiate this tumor from other spindle cell tumors. The absence of cytochemical epithelial markers is useful for establishing the diagnosis. This tumor appears to have arisen from mesenchymal elements within the gland.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. The landmark for removal of sialoliths using sialendoscopy alone in parotid gland sialolithiasis.

    PubMed

    Kondo, Norio; Yoshihara, Toshio; Yamamura, Yukie; Kusama, Kaoru; Sakitani, Eri; Seo, Yukako; Tachikawa, Mayako; Kujirai, Keiko; Ono, Erika; Maeda, Yasuyo; Nojima, Tomohito; Tamiya, Akiko; Sato, Emiri; Nonaka, Manabu

    2017-06-23

    To assess the general guidelines for removal of sialoliths in parotid gland sialolithiasis using sialendoscopy alone. We analyzed 34 sialoliths treated using sialendoscopy in 26 patients with parotid gland sialolithiasis. We divided the Stensen's duct and parotid gland into for parts using computed tomography findings: (A) front of the masseter, (B) anterior and lateral to the center (anterolateral) of the masseter, (C) posterior and lateral to the center (posterolateral) of the masseter, (D) behind of the masseter. The location and size of each sialolith was assessed. The removal rates of sialoliths in the different locations by sialendoscopy alone were as follows: front of the masseter, 68.8%; anterolateral of the masseter, 60.0%; posterolateral of the masseter, 0%; and behind of the masseter, 33.3%. The removal rate using sialendoscopy alone was significantly higher in the sections anterior to the center of the masseter than in those posterior to the center of the masseter (66.7% [14/21] vs. 20.0% [2/10]; P=0.019). The size of the sialolith was not correlated to the removal rate by sialendoscopy alone. Sialoliths of the parotid gland located in positions anterior to the center of the masseter are significantly easier to remove by sialendoscopy alone. The center of the masseter is a general landmark for removal of sialoliths from the parotid gland using sialendoscopy alone. The size of the sialolith is not correlated with removal, except rare huge sialoliths. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. 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

  11. Capsular significance in parotid tumor surgery: reality and myths of lateral lobectomy.

    PubMed

    Donovan, D T; Conley, J J

    1984-03-01

    Historically, parotid gland surgery has evolved from an operation of surgical enucleation to that of lateral lobectomy or total parotidectomy with facial nerve dissection. While the enucleation operation originally resulted in recurrence rates as high as 45% in some series, the technique of lateral lobectomy has resulted in recurrence rates of 2% in benign tumors. However, the currently recommended procedure of lateral lobectomy or total parotidectomy with facial nerve preservation for benign or low grade malignant tumors is not a pure en bloc resection in most cases, and in fact enucleation in part or total is often the reality of the operation. Tumor characterization, technical features, and operative findings of parotid gland surgery are examined in 100 consecutive cases. In over 60% of the cases, superficial or total parotidectomy with facial nerve preservation incorporated the principle of limited enucleation or capsular dissection at some point in the technique. The illusion that en bloc removal of parotid tumors with wide surgical margins is discredited. The reality of the procedure and the reasons for its success are examined.

  12. Parapharyngeal space tumor surgery using a modified cervical-parotid approach.

    PubMed

    Okamoto, Isaku; Tsukahara, Kiyoaki; Sato, Hiroki

    2017-10-05

    The cervical approach to parapharyngeal space tumors is blind in cases involving an approach to the vicinity of the skull base from below. We therefore devised a procedure to improve the safety of surgery in the vicinity of the skull base. With this surgical technique, the temporal branch from the main trunk is first identified, as in the case of parotid gland tumor surgery. We then approach the skull base by entering the posterior aspect of the parotid gland tissue from above the temporal branch and anterior auricular space, allowing clear visual confirmation of the upper part of the tumor. Combining this approach with the conventional cervical approach, which is used for the lower part, the tumor can be separated from top to bottom. We have applied this combined approach in eight patients to date, and post-operative courses have been good, with no cases of facial paralysis. This modified cervical-parotid approach offers a very useful surgical procedure for parapharyngeal space tumors with respect to preservation of the facial nerve and tumor separation in the vicinity of the skull base.

  13. Castration decreases amylase release associated with muscarinic acetylcholine receptor downregulation in rat parotid gland.

    PubMed

    Busch, Lucila; Borda, Enri

    2003-05-01

    1 The mechanism and receptor subtypes involved in carbachol-stimulated amylase release and its changes after castration were studied in parotid slices from male rats. 2 Carbachol induced both amylase release and inositol phosphate (IP) accumulation in parotid slices from control and castrated rats, but castration induced a decrease of carbachol maximal effect. The effect of castration was reverted by testosterone replacement. 3 The selective M(1) and M(3) muscarinic receptor antagonists, pirenzepine and 4-diphenylacetoxy-N-methylpiperidine methiodide, respectively, inhibited carbachol-stimulated amylase release and IP accumulation in a dose-dependent manner in parotid slices from control and castrated rats. 4 A diminution of binding sites of muscarinic receptor in parotid membrane from castrated rats was observed. Competition binding assays showed that both, M(1) and M(3) muscarinic receptor subtypes are expressed in membranes of parotid glands from control and castrated rats, M(3) being the greater population. 5 These results suggest that amylase release induced by carbachol in parotid slices is mediated by phosphoinositide accumulation. This mechanism appears to be triggered by the activation of M(1) and M(3) muscarinic receptor subtypes. Castration induced a decrease of the maximal effect of carbachol evoked amylase release and IP accumulation followed by a diminution in the number of parotid gland muscarinic acetylcholine receptors.

  14. Primary clear cell carcinoma of parotid gland: Case report and review of literature

    PubMed Central

    Rodríguez, Marta Saldaña; Reija, Maria Fe García; Rodilla, Irene González

    2013-01-01

    Clear cell carcinoma (CCC) is a rare low-grade carcinoma that represents only 1% to 2% of all salivary glands tumors. The finding of a clear cell tumor in a parotid gland involves the necessity of differential diagnosis between primary clear cell parotid tumors and metastases, mainly from kidney. The biological behavior is not very aggressive and development, which is very slow, is usually asymptomatic and indeed, the tumor often reaches considerable dimensions before being diagnosed. The treatment of choice is the surgical excision. There are rare cases of local recurrence and distant metastases. The aim of this article is to report a primary CCC in the parotid gland that microscopically closely resembled a metastatic CCC of renal origin, making microscopic differentiation difficult. PMID:23798840

  15. Giant pleomorphic adenoma of the parotid gland: an unusual case presentation and literature review.

    PubMed

    Tarsitano, A; Pizzigallo, A; Giorgini, F; Marchetti, C

    2015-10-01

    Pleomorphic adenoma is the most common type of all salivary gland tumours. Although uncommon, cases of giant pleomorphic adenomas have been described in the medical literature, the majority involving the parotid gland. This paper describes an unusual case of a giant adenoma arising in the parotid gland. The patient underwent surgical resection of the giant tumour, which was one of the largest pleomorphic adenoma reported in recent literature. This case has prompted us to evaluate the behaviour of those benign tumours, which suggested that aesthetic and social morbidity is sufficient to justify, when possible, early tumour excision, despite the relatively low risk of malignant transformation. Management of this unusual tumour is discussed, and the literature on giant parotid tumours is reviewed.

  16. Congenital salivary fistula of an accessory parotid gland in Goldenhar syndrome.

    PubMed

    Sun, Z; Sun, L; Zhang, Z; Ma, X

    2012-01-01

    We report two cases of congenital salivary fistula of an accessory parotid gland, and we discuss its occurrence in Goldenhar syndrome. Two teenagers complained of a congenital cheek fistula with constant salivary discharge. Computed tomography fistulography and sialography were performed. The diagnosis of Goldenhar syndrome was established based on clinical and imaging findings. Previously reported cases are reviewed and the clinical and radiological features summarised. In these two patients, a salivary fistula of an accessory parotid gland was demonstrated on computed tomography fistulography, and did not communicate with Stensen's duct. Deformity of Stensen's duct and hypoplasia of the ipsilateral mandibular ramus were present. Tragal appendices have frequently been reported in such cases. A congenital cheek salivary fistula of an accessory parotid gland should be considered indicative of Goldenhar syndrome.

  17. Primary clear cell carcinoma of parotid gland: Case report and review of literature.

    PubMed

    Rodríguez, Marta Saldaña; Reija, Maria Fe García; Rodilla, Irene González

    2013-01-01

    Clear cell carcinoma (CCC) is a rare low-grade carcinoma that represents only 1% to 2% of all salivary glands tumors. The finding of a clear cell tumor in a parotid gland involves the necessity of differential diagnosis between primary clear cell parotid tumors and metastases, mainly from kidney. The biological behavior is not very aggressive and development, which is very slow, is usually asymptomatic and indeed, the tumor often reaches considerable dimensions before being diagnosed. The treatment of choice is the surgical excision. There are rare cases of local recurrence and distant metastases. The aim of this article is to report a primary CCC in the parotid gland that microscopically closely resembled a metastatic CCC of renal origin, making microscopic differentiation difficult.

  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.

  19. Increase nitric oxide synthase activity in parotid glands from rats with experimental periodontitis.

    PubMed

    Miozza, V; Borda, E; S-Borda, L; Busch, L

    2010-11-01

    In this study we investigated the activity of the nitric oxide synthase (NOS) in parotid glands from rats with experimental periodontitis and controls. Periodontitis was produced by a ligature placed around the cervix of the two lower first molar. Experiments were carried out 22 days after the ligature. Ligation caused an increase in parotid NOS activity. The selective blocker of the inducible isoform of the enzyme partially inhibited its activity in parotid glands from rat with ligature. In controls, the activity was partially inhibited by the antagonists of the selective neural and endothelial isoforms. NOS activity in rats with ligature was cyclic adenosine monophosphate (cAMP)-dependent while in controls it was calcium-dependent. Prostaglandin E₂ concentration was increased in parotid gland from rats with ligature. The inhibitor of prostaglandin production, FR 122047, diminished both, prostaglandin production and NOS activity. In rats with ligature unstimulated amylase released is increased. Both, prostaglandin and NOS were involved in the increment of amylase release. It can be concluded that in parotid glands from ligated rats, prostaglandin E₂ production is increased and, through cAMP accumulation, activates the inducible NOS isoform. The increment of nitric oxide production participates in the increase in basal amylase release. © 2010 John Wiley & Sons A/S.

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

    PubMed

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

    1974-07-01

    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.

  1. 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

  2. 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.

  3. Minimally invasive endoscopic-assisted resection of benign tumors in the accessory parotid gland: 5 case studies.

    PubMed

    Xie, Lei; Zhang, Deguang; Lu, M M Xiaoxiao; Gao, B M Li

    2012-08-01

    A modified Blair's incision or standard facelift incision is recommended to remove tumors in the accessory parotid gland. These incisions frequently result in long and visible scars. Therefore, the authors have introduced an endoscopic approach via a small preauricular incision to achieve excision of benign tumors in the accessory parotid gland. The endoscopic surgical technique was performed on 5 patients with benign tumors in the accessory parotid gland. Endoscopic-assisted resection of the benign tumors in the accessory parotid gland was feasible in all 5 patients. This procedure lasted 105 minutes on average. Facial paralysis, salivary fistula, and ear-lobular numbness were not found postoperatively. The follow-up period was 1 year, during which no Frey's syndrome and recurrence were found. All preauricular scars were aesthetically satisfactory. The minimally invasive endoscopic approach via a small preauricular incision is an optional method of the accessory parotid gland benign tumor resection. Copyright © 2011 Wiley Periodicals, Inc.

  4. Relapsed Acinic Cell Carcinoma of the Parotid Gland With Diffuse Distant Metastasis

    PubMed Central

    Khelfa, Yousef; Mansour, Munthir; Abdel-Aziz, Yousef; Raufi, Ali; Denning, Krista; Lebowicz, Yehuda

    2016-01-01

    Acinic cell carcinoma (ACC) is an uncommon salivary gland neoplasm that generally displays an indolent growth pattern. Most cases arise in the major glands, particularly the parotid. However, it can arise from minor salivary glands in the oral cavity and aero-digestive tract. Although ACC is generally a low-grade malignant tumor, poorly differentiated and high-grade transformed variants exhibit a propensity for late recurrence and metastasis. There are no adequate clinical trials that define the optimal approach to patients with metastatic salivary gland tumors due to its rarity. Systemic therapy is reserved for cases where local therapy, such as radiation or metastasectomy, is not appropriate. Nevertheless, there is insufficient data in the literature regarding the chemotherapy of choice for metastatic ACC. In this article, we report a case of metastatic ACC of the right parotid gland that progressed on carboplatin and paclitaxel after partial response followed by doxorubicin and is currently on checkpoint inhibitor treatment. PMID:27847831

  5. 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.

  6. Endoscopic-Assisted Resection of Benign Tumors of the Accessory Parotid Gland.

    PubMed

    Zhang, Da-ming; Wang, You-yuan; Liang, Qi-xiang; Song, Fan; Chen, Wei-liang; Zhang, Bin

    2015-08-01

    Modified endoscopically assisted resection of benign tumors in the accessory parotid gland region (APGR) has been reported, and the surgery confers a potential risk of injury to the great auricular nerve. This clinical research study provides an updated approach for the resection of benign tumors of the APGR. Thirteen cases diagnosed with primary benign tumors in the APGR were treated by endoscopically assisted resection through a margin of the tragus, and its feasibility was evaluated. All tumors were completely resected. The procedures lasted 45 to 70 minutes (mean, 54 minutes). None of the endoscopically assisted surgeries proceeded to open surgery. The patients were followed for 3 to 14 months, without postoperative complications, including pain, facial or auricular nerve weakness, salivary fistula, infection, tumor recurrence, Frey syndrome, or depression deformity. The scars were concealed and esthetically satisfactory. Endoscopically assisted resection of benign tumors through a margin of the tragus in the APGR is a safe technique that achieves excellent esthetic and functional results. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. [Two cases of anesthesia mumps in the upper parotid gland after general anesthesia in the lateral position].

    PubMed

    Adachi, Yushi; Suzuki, Katsumi; Itagaki, Taiga; Obata, Yukako; Doi, Matsuyuki; Sato, Shigehito

    2008-09-01

    We describe two cases of acute transient swelling of the upper side of parotid glands of the patients after general anesthesia in the lateral position. The serum amylase levels in the patients were not increased and the enlargement of the parotid gland was diagnosed as anesthesia mumps. Previous reports suggested that mechanical compression might produce the swelling of the secreting organ, but our patients showed temporal parotid enlargement in the upper free side. Although, pre-medication with atropine might become a cause of parotid gland swelling, we anesthetized these patients without anti-cholinergic drugs. Procedures of oro-tracheal intubation and stimuli of endotracheal tube may induce impairment of the normal flow of saliva and lead to enlargement of the parotid gland.

  8. The presence of facial nerve weakness on diagnosis of a parotid gland malignant process.

    PubMed

    Wierzbicka, Małgorzata; Kopeć, Tomasz; Szyfter, Witold; Kereiakes, Thomas; Bem, Grażyna

    2012-04-01

    The objectives of this article are to assess the frequency and significance of facial paralysis and undiagnosed nerve infiltration in patients with parotid malignancies. 103 patients with parotid gland malignancies were treated in a single institution, the tertiary center for ENT at the University Department in Poznan between 1996 and 2006. Facial palsy at the initial presentation was found in 32 patients. The stage of the primary tumor in the examined group of 103 patients is as follows: 20-T1, 31-T2, 20-T3, 32-T4. The correlation between facial nerve function before treatment and patients' characteristics, including the treatment methods, were analyzed. Intact facial nerve function at patient presentation was a very strong prognostic factor determining the treatment and final outcome for malignant neoplasms of parotid gland. Similarly, T stage and a high-grade malignant histology had a direct influence on the duration of patients' survival.

  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. Primary unclassified sarcoma of the parotid gland: a case of diagnostic and therapeutic challenge.

    PubMed

    Saravakos, Panagiotis; Hartwein, Joerg; Fayyazi, Afshin

    2017-05-01

    Malignant salivary gland sarcomas represent a clinically and histologically diagnostic challenge. Primary unclassified sarcomas of the parotid gland consist a rare salivary gland tumor. We report an unusual case of such a tumor, which occurred in the right parotid gland of a 54-year-old male and presented as an asymptomatic painless mass. The pathologoanatomical examination revealed a rhabdoid large-cell unclassified sarcoma. The patient was treated with superficial parotidectomy and adjuvant radiotherapy. No recurrence was noted in a 10-year follow-up period. Due to the rare occurrence of primary unclassified sarcomas, there is no evidence-based treatment of choice. An optimal approach is best planned in a multidisciplinary setting, taking into consideration the resectability of the tumor, individual patient characteristics, presence of local or distant metastatic activity, local infiltrative behavior and tumor stage. A close follow-up of the patient is strongly recommended.

  11. 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

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

    PubMed

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

    1988-08-01

    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.

  13. Radioprotective effects of pyrroloquinoline quinone on parotid glands in C57BL/6J mice

    PubMed Central

    Huang, Yuanqing; Chen, Ning; Miao, Dengshun

    2016-01-01

    The aim of the present study was to investigate whether pyrroloquinoline quinine (PQQ) serve a radioprotective role in parotid gland damage induced by total body irradiation (TBI) in C57BL/6J mice. A total of 15 female 8-week-old C57BL/6J mice were randomly assigned into three treatment groups: i) Untreated control (no irradiation); ii) 4 gray (Gy) X-ray irradiation; iii) 4 Gy X-ray irradiation with additional dietary PQQ (4 mg PQQ/kg in normal diet). Each group included five mice. After 4 weeks, all animals were collected for evaluating the phenotype, body weight, pathological and biochemical parameters. The results indicated that PQQ had biological effects on total body phenotype. PQQ could partially rescue TBI-induced damage to parotid glands. In addition, PQQ served radioprotective effects on parotid glands via multiple mechanisms, such as promoting proliferation, inhibiting apoptosis and senescence, upregulating antioxidant ability, scavenging reactive oxygen species and reducing DNA damage. The results of the present study demonstrate that PQQ serves a radioprotective role in parotid gland damage induced by TBI, possibly via inhibiting oxidative stress and participating in DNA damage repair. The study provides experimental and theoretical knowledge for the development of radioprotective clinical drugs. PMID:28105098

  14. Solitary fibrous tumor of the accessory parotid gland: a unique case.

    PubMed

    Apuhan, Tayfun; Iwenofu, Hans; Özer, Enver

    2013-01-01

    Solitary fibrous tumors are benign spindle-cell neoplasms, mostly originating from the visceral pleura. They are common in individuals aged 20-70 with no sex predilection. To our knowledge, this is the unique case of the solitary fibrous tumor originating from the accessory parotid gland in the literature.

  15. Myoepithelioma of the Parotid Gland Presenting as a Retroauricular Cutaneous nodule: A Case Report

    PubMed Central

    Mochizuki, Yumi; Omura, Ken; Tanaka, Kae; Sakamoto, Kei; Yamaguchi, Akira

    2013-01-01

    We are reporting a case of recurrent myoepithelioma of the parotid gland, that emerged as a cutaneous mass. She had a retroauricular subcutaneous mass with an underlying diagnosis of a cutaneous myoepithelioma, which was excised at a hospital’s Dermatology Department 2 years earlier. The tumour was observed above the platysma and it was considered as a cutaneous myoepithelioma without the parotid gland structures. She had undergone a partial parotidectomy approximately 20 years earlier. At her first visit to our department, there was no evidence of facial nerve palsy or cervical lymphadenopathy. The radiological findings showed a multinodular growing mass of the parotid gland, just beneath the retroauricular skin and a total parotidectomy was performed. It was considered that even if the cutaneous mass emerged, the relationship between the cutaneous mass and the parotid gland should be pre-surgically examined by computed tomography (CT) or Magnetic resonance image (MRI). A long-term continuous follow-up was also needed. PMID:23905130

  16. Radioactive seed migration following parotid gland interstitial brachytherapy.

    PubMed

    Fan, Yi; Huang, Ming-Wei; Zhao, Yi-Jiao; Gao, Hong; Zhang, Jian-Guo

    2017-09-15

    To evaluate the incidence and associated factors of pulmonary seed migration after parotid brachytherapy using a novel migrated seed detection technique. Patients diagnosed with parotid cancer who underwent permanent parotid brachytherapy from January 2006 to December 2011 were reviewed retrospectively. Head and neck CT scans and chest X-rays were evaluated during routine follow-up. Mimics software and Geomagic Studio software were used for seed reconstruction and migrated seed detection from the original implanted region, respectively. Postimplant dosimetry analysis was performed after seeds migration if the seeds were still in their emitting count. Adverse clinical sequelae from seed embolization to the lung were documented. The radioactive seed implants were identified on chest X-rays in 6 patients. The incidence rate of seed migration in 321 parotid brachytherapy patients was 1.87% (6/321) and that of individual seed migration was 0.04% (6/15218 seeds). All migrated seeds were originally from the retromandibular region. No adverse dosimetric consequences were found in the target region. Pulmonary symptoms were not reported by any patient in this study. In our patient set, migration of radioactive seeds with an initial radioactivity of 0.6-0.7 mCi to the chest following parotid brachytherapy was rare. Late migration of a single seed from the central target region did not affect the dosimetry significantly, and patients did not have severe short-term complications. This study proposed a novel technique to localize the anatomical origin of the migrated seeds during brachytherapy. Our evidence suggested that placement of seeds adjacent to blood vessels was associated with an increased likelihood of seed migration to the lungs. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  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. Ultrastructural studies of the parotid glands in sialadenosis.

    PubMed

    Donath, K; Seifert, G

    1975-01-01

    30 parotid biopsies of patients with sialadenosis--a symmetrical, painless, non-inflammatory, recurrent parotid swelling--were studied by electron microscopy. The patients suffered from different diseases, such as diabetes mellitus, liver diseases, hypertension and other affections. Parotid biopsies from 25 patients with slight parotitis or with oral cancer were used as controls. Morphometric studies reveal that the parotid swelling is caused by an enlargement of acinar cells. In controls the average diameters of the acinar cells are 30 to 40 mu. In sialadenosis the diameters are enlarged to 50 to 70 mu, in some cases to a maximum of 100 mu. Histologically the cytoplasm of the enlarged acinar cells shows either a granular pattern due to a numerical increase in secretory granules or a vacuolar transformation. Ultrastructurally the vacuolar transformed acinar cells also contain an increased number of granules with less electron density than the surrounding cytoplasm. Three types of sialadenosis can be distinguished with regard to the electron density of the acinar granules: a) a dark granular type, b) a pale granular type and c) a mixed granular type. The mixed granular type probably develops from the dark granular form. Alterations leading to the destruction of the myoepithelial cells were observed in all three types of sialadenosis with minimal changes in the dark granular type. Degenerative alterations of the autonomic nervous system are evident in all three groups with most pronounced changes in the pale granular type of sialadenosis. The ultrastructural alterations are interpreted as a disturbance of secretion, probably primarily caused by the degeneration of the autonomic nervous system. The alteration of the autonomic nervous system is suggested to be the common pathogenetic principle in all types of human sialadenosis occurring with different basic diseases. The enlargement of the acinar cells is the result of an intracellular disturbance in the secretory

  19. Clinicopathological features and treatment outcomes of the rare, salivary duct carcinoma of parotid gland.

    PubMed

    Al-Qahtani, Khalid Hussain; Tunio, Mutahir A; Bayoumi, Yasser; Gurusamy, Venkada Manickam; Bahamdain, Fahad Ahmed A; Fatani, Hanadi

    2016-05-16

    Salivary ductal carcinoma (SDC) of parotid gland is a rare and aggressive entity; accounting for 1-3 % of all malignant salivary gland tumors, 0.2 % of epithelial salivary gland neoplasms, 0.5 % of salivary gland carcinomas, and 1.1 % of parotid gland carcinomas. Here in we aimed to evaluate the clinico-pathological features and treatment outcomes of parotid gland SDC in Saudi population. Among 38 patients with parotid malignancies, who were treated in two major tertiary care referral cancer centers between December 2007 and December 2014, seven cases (18.4 %) were found to have SDC, which were investigated for clinicopathological features, locoregional recurrences (LRRs), distant metastasis (DM) and survival rates. Mean age of cohort was 62.3 years (range: 41-83) and female predominant (71.4 %). All patients underwent total parotidectomy and ipsilateral neck dissection. Mean tumor size was 3.4 cm (range: 2.1-5.3); perineural invasion (85.8 %); lymph node involvement (42.9 %); and HER-2 neu overexpression (28.6 %). Postoperative radiation therapy (PORT) was given to six patients (dose: 50-66 Gy). Median follow-up was 20.2 months (range: 11-48). LRRs were seen in five (71.4 %) patients (base of skull, 3 patients; cervical nodes, one patient; parotid bed, one patient). LRRs were salvaged with resection (two patients) and re-irradiation (one patient with base of skull). DM in lungs was seen in three patients (42.8 %); one treated with carboplatin/paclitaxel based chemotherapy. The 4-year disease free and overall survival rates were 16.7 % and 40 % respectively. SDC of parotid gland is a rare and aggressive entity, and most of LRRs were seen in the base of skull, which warrants inclusion of base of skull in clinical target volume in PORT planning. Role of anti HER-2 targeted therapy in SDC with HER-2 neu overexpression needs further investigations.

  20. A comparative study of salivary secretion by parotid and mandibular glands of anaesthetized Capra hircus: effect of pilocarpine.

    PubMed

    Castellano, C; Moreno, M; Raggi, L A; Martinez de Victoria, E; Mataix, F J

    1986-01-01

    A study was made of basal secretion and the effect of the infusion of pilocarpine on the flow and composition of saliva in the parotid and mandibular glands of the anaesthetized lactating goat. In the parotid gland there was a basal flow (1.6 +/- 0.29 microliter/min) which was not present in the mandibular gland. There is a statistically significant dose-effect relationship between pilocarpine and salivary flow in both glands. Salival composition and its variation with respect to the flow of saliva did not conform to either of the two glands to an exclusive monogastric or ruminant model.

  1. Large lipid-rich mammary analogue secretory carcinoma of parotid gland: An unusual case.

    PubMed

    Joshi, Prashant; Mridha, Asit Ranjan; Singh, Shuchita; Kinra, Prateek; Ray, Ruma; Thakar, Alok

    2015-01-01

    Mammary analogue secretory carcinoma (MASC) of the salivary gland is a malignant tumor which bears morphologic, immunohistochemical and molecular features similar to those of mammary secretory carcinoma. The tumor is considered as a low-grade malignancy perhaps slightly more aggressive than acinic cell carcinoma. High-grade transformation with recurrences, regional nodal involvement, metastases, and cancer-related death has been reported in a few cases. We report an unusual case of large MASC of the parotid gland in a young patient without regional lymph node involvement. To the best of our knowledge till date such a large MASC of the salivary gland has not been reported in the English literature.

  2. Reduced MIBG accumulation of the parotid and submandibular glands in idiopathic Parkinson's disease.

    PubMed

    Haqparwar, Jaweed; Pepe, Antonio; Fassbender, Klaus; Dillmann, Ulrich; Ezziddin, Samer; Schaefer, Andrea; Leppert, Daniela; Spiegel, Jörg

    2017-01-01

    Alpha-synuclein pathology (ASP) is a characteristic histopathological finding in idiopathic Parkinson's disease (PD). The ASP involves not only the brain but also extracranial structures. In the present study we utilized MIBG scintigraphy to measure the sympathetic innervation of the major salivary glands. We were interested in whether MIBG uptake in the major salivary glands represents a potential biomarker for ASP in PD. We investigated 77 PD patients (age 61 ± 10 years, mean ± SD), while 15 non-PD patients (age 58 ± 15 years) with arterial hypertension, who underwent MIBG scintigraphy to exclude pheochromocytoma, served as age-matched controls. The MIBG uptake of the parotid glands and the submandibular glands was quantified by means of a region of interest technique. The sublingual glands were too small for an exact measurement. We applied Generalized Estimating Equations (GEE) to identify and remove factors which may bias the statistical correlation analysis. The PD patients showed a significantly lower MIBG uptake in the parotid and submandibular glands than the controls (p < 0.0001). MIBG uptake in the PD patients did not correlate with clinical severity (Hoehn and Yahr stage, motor part of the UPDRS) or disease duration. MIBG uptake in the parotid and submandibular glands might be a candidate biomarker for PD. The missing correlation between MIBG uptake and clinical PD parameters suggests that ASP of the extracranial sympathetic superior cervical ganglion, which innervates the major salivary glands, develops independently from the cerebral dopaminergic nigrostriatal ASP. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Re-engineering primary epithelial cells from rhesus monkey parotid glands for use in developing an artificial salivary gland.

    PubMed

    Tran, Simon D; Sugito, Takayuki; Dipasquale, Giovanni; Cotrim, Ana P; Bandyopadhyay, Bidhan C; Riddle, Kathryn; Mooney, David; Kok, Marc R; Chiorini, John A; Baum, Bruce J

    2006-10-01

    There is no satisfactory conventional treatment for patients who experience irreversible salivary gland damage after therapeutic radiation for head and neck cancer or because of Sjögren's syndrome. Additionally, if most parenchyma is lost, these patients also are not candidates for evolving gene transfer strategies. To help such patients, several years ago we began to develop an artificial salivary gland. In the present study, we used a non-human primate tissue source, parotid glands from rhesus monkeys, to obtain potential autologous graft cells for development of a prototype device for in situ testing. Herein, we present 3 major findings. First, we show that primary cultures of rhesus parotid gland (RPG) cells are capable of attaining a polarized orientation, with Na(+)/K(+)-adenosine triphosphatase, zonula occludens-1, and claudin-1 distributed in specific domains appropriate for epithelial cells. Second, we show that RPG cells exhibit 2 essential epithelial functions required for graft cells in an artificial salivary gland device (i.e., an effective barrier to paracellular water flow and the generation of a moderate transepithelial electrical resistance). Third, we show that RPG cells can express functional water channels, capable of mediating directional fluid movement, after transduction by adenoviral and adeno-associated virus type 2 vectors. Together these results demonstrate that it is feasible to individually prepare RPG cells for eventual use in a prototype artificial salivary gland.

  4. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients

    PubMed Central

    GUDMUNDSSON, Jens Kristjan; AJAN, Aida; ABTAHI, Jahan

    2016-01-01

    ABSTRACT Objective Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses. Material and Methods Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined. Results Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%), followed by Warthin’s tumor (17.5%). The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV) was 73% and negative predictive value (NPV) was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue. Conclusion FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy. PMID:28076460

  5. 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.

  6. Castleman disease of the parotid gland in a pediatric patient: a case report.

    PubMed

    Kumar, Sudesh; Al Abri, Rashid; Kadir, Nasreen Abdul; Lokuhetty, Dilani

    2014-01-01

    Castleman disease, also called angiofollicular lymph node hyperplasia, is a rare lymphoproliferative disorder characterized by enlarged hyperplastic lymph nodes. Affected patients usually present with mediastinal lymphadenopathy; sometimes other groups of lymph nodes are involved, with or without associated systemic manifestations. We report a case of Castleman disease involving the intraparotid lymph node in a 15-year-old boy who presented with a 3-month history of a painless swelling of the right parotid gland. Fine-needle aspiration cytology of the mass revealed only reactive hyperplasia. The diagnosis of Castleman disease was established on histopathologic examination of the resected mass. We discuss the clinical course, histopathologic features, radiologic characteristics, and management of Castleman disease of the parotid gland in a pediatric patient.

  7. 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.

  8. [Intralesional Pingyangmycin therapy for 51 infantile patients with parotid gland hemangiomas].

    PubMed

    Wang, Li-Li; Gao, Qing-Hong; Liu, Kun; Wang, Xiao-Yi; Wang, Chang-Mei; Wen, Yu-Ming

    2009-04-01

    To investigate the indication and outcome of intralesional Pingyangmycin (PYM) therapy for parotid gland hemangiomas in early childhood. 51 infantile patients with hemangiomas in the parotid gland were studied retrospectively, which had been treated in the clinic of West China Hospital of Stomatology, Sichuan University during the 15-year period from May 1990 to May 2005. In this study, 21 were male, 30 were female, and the ratio of male to female was 1:1.43. The age of the children ranged from 6 months to 4 years, with an average age of 10 months. 38 were deep-seated hemangiomas, and 13 were mixed hemangiomas. 27 were in the right parotid gland and 24 in the left, no bilateral case. All the patients underwent intralesional injection of a solution of 8 mg PYM in 8 mL normal saline mixed with 5 mg dexamethasone. The total dose of PYM ranged from 20mg to 35 mg, which was administered 0.5 or 1 mg per injection. SPSS10.0 software package was used to compare the treatment efficacy between the patients with hemangioma <4 cm in diameter and >or=4 cm in diameter. Hemangiomas of 42 cases (82.35%) showed complete resolution with good appearance, 8 cases (15.69%) were partly regressed, and 1 case (1.96%) had no obvious size change. No serious side effects were seen, such as pulmonary fibrosis and growth inhibition. No significant correlation was found between treatment efficacy and tumor size. Intralesional PYM therapy maybe is a selective primary therapy option for parotid gland hemangioma, and ultrasonography should be useful for diagnosis and treatment of this lesion.

  9. [Mucoepidermoid cancer of parotid gland in 14-years-old girl--case report].

    PubMed

    Amernik, Katarzyna; Wasilewska, Małgorzata; Lubiński, Jakub; Walaszek, Ireneusz; Grzelec, Halina; Peregud-Pogorzelski, Jarosław; Jaworowska, Ewa

    2012-01-01

    Malignant tumors of salivary glands are rare, especially in children. We present a case report of 14-years-old girl affected by mucoepidermoid cancer of parotid gland. Patient was admitted to our Department in May 2007 due to small, hard, moveable tumor localized in right mandibular angle. The VII nerve function was normal. Fine needle aspiration revealed inflammatory cells without atypical cytologic features. Intraoperative tumor was hard, with irregular surface, surrounded by capsule, connected with the main trunk of facial nerve and cartilaginous part of external auditory meatus. Tumor was excised together with superficial part of parotid gland and surrounding lymph nodes. After operation no signs of facial nerve damage were observed. Postoperative histopathological examination revealed mucoepidermoid cancer, in 2 out of 6 specimens neoplasmatic cells were seen in border of excised tissue. In June 2007 the second operation was performed. Remain part of parotid gland was removed with right facial nerve and conservative lymph node resection. Facial nerve and its branches were reconstructed with sural and great auricular nerve as donor grafts. The symptoms of nerve damage were observed in early postoperative days adequate to 5th degree of House-Brackman scale (HB5). 4 years after operation function of facial nerve is estimated on HB3. The girl is under regular oncological and laryngological control free of neoplasm recurrence. Diagnostics and treatment of malignant parotid tumors in children are difficult and clinical picture must be always taken into consideration as the most important factor. Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  10. Traumatic diseases of parotid gland and sequalae. Review of literature and case reports.

    PubMed

    Akinbami, B O

    2009-06-01

    Parotid gland injuries are accompanied by a large number of sequelae. The aim of this paper is to highlight the importance of thorough management of these parotid glandinjuries especially at initial presentation in order to minimize the complications that accompany these injuries. A review of the aetiology and management of the existing cases of parotid gland injuries obtained from published journals and internet search as well as a report of two cases managed in our centre is presented in this paper. A total of about 70 cases in the previous literatures were reviewed of which assault was responsible for almost 90% of the cases. Sialoceles and fistulae were the main sequelae of these injuries. More than half of the cases (54%) were managed by conservative methods. Surgical drainage was done in about 44% cases; where the Stenson's ducts were accessible, primary repair was done. Excision of the gland was done in very few cases. The two cases managed in our centre were due to assault from broken bottles and road traffic accident respectively and both were managed by conservative methods. The first patient was a case of sialocele following the injury, which resolved within 3 weeks after the cyst formation with reduction in food intake, aspirations and external surgical drainage; while the second patient was a case of persistent fistula which healed after about 5 weeks following the trauma. Follow-up of both patients for about 3 months revealed no further leakage or accumulation of saliva. Management of these injuries involves a thorough understanding of the structure and function of the parotid gland and closely related tissues.

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

    PubMed

    Erovic, Boban M; Shah, Manish D; Bruch, Guillem; Johnston, Meredith; Johnston, U; Kim, John; O'Sullivan, Brian; Perez-Ordonez, Bayardo; Weinreb, Ilan; Atenafu, Eshetu G; de Almeida, John R; Gullane, Patrick J; Brown, Dale; Gilbert, Ralph W; Irish, Jonathan C; Goldstein, David P

    2015-10-29

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

  12. 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. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. 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.

  14. Effect of fractionated radiotherapy on the parotid gland: an experimental study in Brazilian minipigs

    PubMed Central

    Stramandinoli-Zanicotti, Roberta Targa; Sassi, Laurindo Moacir; Schussel, Juliana Lucena; Torres, Maria Fernanda; Funchal, Melissa; Smaniotto, Gustavo Henrique; Dissenha, José Luis; Carvalho, Andre Lopes

    2013-01-01

    Summary Introduction: Radiotherapy (RT) of head and neck neoplasms often damages the salivary glands. Aim: To examine the pattern of morphologic changes resulting from RT of the head and neck region in minipig parotid glands in a clinical and experimental research setting. Methods: Twelve 18-month-old male Brazilian minipigs weighing 30–40 kg were selected. Eight minipigs were assigned to the experimental group (group 1) and 4 to the control group (group 2). The RT was performed under general anesthesia at Erasto Gaertner Hospital, Curitiba, Brazil, using an á/â ratio of 2.5. The minipigs from group 1 underwent 3 sessions of irradiation with Cobalt 60 of the head and neck, bilaterally, with 3 exposures of 8 Gy each at 7-day intervals for a total dose of 24 Gy. The animals were sacrificed 12 weeks post-RT. Results: The irradiated parotid glands displayed reductions in the size and number of acini as well as loss of secretory granules. The presence of fibrosis and loss of parenchyma relative to non-irradiated glands were observed, with an average reduction in volume of 54%. Conclusions: Our results demonstrate that this model for parotid gland damage resulting from an RT regimen appears to be useful for preclinical large animal studies of RT-induced damage and testing novel potential treatment options. Although recent advances in radiation therapy, such as intensity-modulated radiation therapy, have reduced the dose and limited the field of radiation, considerable salivary gland injury still occurs and can greatly impact the patient's quality of life after cancer treatment. PMID:25992008

  15. [Possible relation between viruses and oromaxillofacial tumors. V. Demonstration of hemagglutination-inhibiting anti-BK virus antibodies in patients with tumors of the parotid gland].

    PubMed

    Stoian, M; Zaharia, O; Suru, M; Constantinescu, E; Goldstein, I; Nastac, E

    1987-01-01

    Anti-BK-virus hemagglutination inhibiting antibodies were revealed in 81.8% of the patients with parotid gland tumors. Results of the investigations conducted on oromaxillofacial tumors including the parotid gland ones are discussed from the point of view of the presence of viral antigens (herpes-, SV40 and BK-viruses) and of specific antibodies. Possible implication of the papova viruses in the etiopathogenesis of the parotid gland tumors in humans are also discussed.

  16. Sialadenosis of the parotid gland: report of four cases diagnosed by fine-needle aspiration cytology.

    PubMed

    Ascoli, V; Albedi, F M; De Blasiis, R; Nardi, F

    1993-01-01

    Four patients presented with a history of recurrent bilateral swellings of parotid glands. Fine-needle aspiration (FNA) specimens showed highly cellular smears containing clusters of enlarged acini and numerous naked nuclei. A diagnosis consistent with sialadenosis was made considering the distinct morphologic appearance: micrometric measurements in all cases, in addition to histology and electron microscopy in two cases confirmed this hypothesis. A review of clinical histories revealed hormonal, nutritional and neurogenic disorders, which are known to be associated with sialadenosis. In the work-up of salivary gland swellings, it is important to recognize cytologically this underestimated entity, which does not necessarily require surgical treatment.

  17. Dopamine actions in vitro on enzyme and electrolyte secretion from normal and sympathectomized rat parotid glands.

    PubMed Central

    Danielsson, A; Henriksson, R; Sundström, S; Wester, P

    1988-01-01

    1. Adult rats were denervated unilaterally by removal of the left superior cervical ganglion or chemically denervated with 6-hydroxydopamine or reserpine. Two weeks later the parotid glands were used for in vitro secretory studies and their catecholamines and major metabolites were measured. 2. Noradrenaline concentrations were reduced 2 weeks after surgical sympathectomy and reserpine pre-treatment 18 h previously, whereas 6-hydroxydopamine pre-treatment for 3 days reduced both noradrenaline and dopamine concentrations. 3. Dopamine caused a prominent amylase release from incubated control glands. However, a subsensitivity for dopamine-induced amylase release was recorded on the denervated side. 4. Dopamine caused a prominent potassium efflux measured as 86Rb+ efflux from control glands, but was without effect in denervated glands. This is in contrast to noradrenaline-induced 86Rb+ efflux which was equally effective in both denervated and control glands. 5. Dopamine caused [3H]noradrenaline efflux in control glands, but was without effect in surgically denervated glands and in glands pre-treated with reserpine or 6-hydroxydopamine. 6. It is concluded that dopamine-induced potassium release is caused by a presynaptic action on noradrenergic nerves, whereas dopamine-induced amylase release has a presynaptic and a postsynaptic component. The results suggest a specific action of dopamine in salivary glands, with different effects on enzyme release and ionic fluxes. PMID:2473198

  18. [Application of helix water jet to parotid surgery].

    PubMed

    Zhang, Dong-Kun; Guo, Zhu-Ming; Zhang, Quan; Zeng, Zong-Yuan; Chen, Fu-Jin; Chen, Wen-Kuan; Li, Hao; Wang, Shun-Lan

    2008-01-01

    Dissecting the facial nerves safely is an important guarantee for the accomplishment of parotidectomy and reduction of postoperative complications. This study was to explore the application of helix water jet to parotidectomy. Clinical data of 43 patients with parotid tumors, who received operation with helix water jet from Feb. 2004 to Feb. 2005 at Cancer Center of Sun Yat-Sen University, were analyzed. Meanwhile, traditional techniques in parotidectomy was performed in 36 patients (control group). Duration of operation, postoperative drainage volume, postoperative hospitalization, and occurrence of postoperative complications, such as facial nerve dysfunction and salivary fistula, of the 2 groups were compared. The postoperative drainage volume was significantly lower in water jet group than in control group [(9.89+/-3.74) mL vs. (12.15+/-2.11) mL, P<0.05]. There were no significant differences in duration of operation [(90.28+/-25.30) min vs. (76.32+/-20.74) min, P>0.05], postoperative hospitalization [(6.39+/-1.38) days vs. (6.45+/-1.05) days, P>0.05] between the two groups. Of the 43 patients in water jet group, 6 (14.0%) had grade II facial nerve dysfunction and 1 (2.3%) had grade III facial nerve dysfunction; of the 36 patients in control group, 5 (13.9%) had grade II facial nerve dysfunction, 2 (5.6%) had grade III facial nerve dysfunction, 1 (2.8%) had grade IV facial nerve dysfunction and 1 (2.8%) had salivary fistula. There was no permanent facial nerve dysfunction occurred in both groups. There was no significant difference in the occurrence of complications between the two groups. Nine patients who retained nervus auricularis magnus suffered from slight numbness symptom of auricular lobule. Use of helix water jet in parotid surgery is safe and confers some advantages over conventional methods of parotid dissection.

  19. 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.

  20. High-resolution MRI of the human parotid gland and duct at 7 Tesla.

    PubMed

    Kraff, Oliver; Theysohn, Jens M; Maderwald, Stefan; Kokulinsky, Patrick C; Dogan, Zeynel; Kerem, Alexander; Kruszona, Stefan; Ladd, Mark E; Gizewski, Elke R; Ladd, Susanne C

    2009-09-01

    MR techniques have been reported as an alternative to conventional sialography. High-field systems (7 T) provide new contrasts coupled with increased signal-to-noise ratio, and hence higher spatial resolution. To our knowledge, no measurements of the parotid gland at 7 T have been reported. Therefore, our study aimed to optimize sequences for high-field MR imaging of the parotid gland and duct, as well as the facial nerve at 7 T and show the potential of high field imaging. A 7 T whole-body scanner was used together with a 10-cm-diameter loop coil. Various GRE (MEDIC, DESS) and TSE (PD/T2, STIR) sequences were optimized and subsequently tested on 4 healthy volunteers and 4 patients. High-resolution images were compared with 1.5 T images both quantitatively (signal-to-noise ratio, contrast-to-noise) and qualitatively (visual rating of 2 independent readers). The high 0.6 mm isotropic resolution of the 3D DESS sequence was very useful for defining an oblique orientation with most of the duct being in-plane for subsequent imaging. With the MEDIC sequence, very fine branches of the duct were visible; furthermore, MEDIC yielded a very good depiction of lymph nodes. Severe specific absorption rate problems were observed with the STIR sequence at 7 T. Gland tissue in tumor patients can be well characterized with the PD/T2 TSE. Highest contrast-to-noise between duct and gland was achieved with the 7 T DESS. At 1.5 T, only the STIR sequence showed comparable quality to the overall superiority of the 7 T sequences. The facial nerve could only be depicted close to the skull base. MR imaging at 7 T provides excellent image contrast and resolution of the parotid gland and duct. The proposed protocol offers a noninvasive examination within about 30 minutes.

  1. [A case of gigantic pleomorphic adenoma of the parotid gland].

    PubMed

    Namysłowski, G; Misiołek, M; Kubik, P; Misiołek, H; Morawski, K

    1996-01-01

    The case of big size pleomorphic adenoma of the partoid gland was presented. Attention was paid on the necessity of the surgical treatment of pleomorphic adenomas by superficial or total parotidectomies. Possibility of the post operative complications avoidance, even in such big cases was emphasized.

  2. 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.

  3. [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.

  4. Multi-atlas-based Segmentation of the Parotid Glands of MR Images in Patients Following Head-and-neck Cancer Radiotherapy

    PubMed Central

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

    2015-01-01

    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. PMID:25914491

  5. Immunolocalisation of cartilage-derived retinoic acid-sensitive protein in pleomorphic adenoma of the parotid salivary gland.

    PubMed

    Devlin, H; Sloan, P

    2001-02-01

    Pleomorphic adenoma of the parotid salivary glands often contains chondroid elements and may exhibit cartilaginous and osseous differentiation, although the latter is extremely rare. Twenty-nine pleomorphic adenomas (PAs) of the parotid gland were examined immunohistochemically for the distribution of cartilage-derived retinoic acid-sensitive protein (CD-RAP), a recently described marker of chondrocytes, which may be important in the morphogenesis and development of the salivary gland. In the normal parotid gland, the ductal cells expressed CD-RAP, but not the myoepithelial cells. In the pleomorphic salivary adenomas, the duct-like cells, but not the myoepithelial cells, expressed CD-RAP. Since many authorities consider myoepithelial cells to be the source of the chondroid matrix, it is surprising that these cells do not express the chondrocytic marker, CD-RAP. Putative neoplastic myoepithelium in the pleomorphic adenoma and some cells in the myxochondroid areas expressed S-100 and calponin.

  6. Multiple clear-cell sarcomas of small intestine with parotid gland metastasis: A case report

    PubMed Central

    Su, Hao; Liu, Wen-Sheng; Ren, Wen-Hao; Wang, Peng; Shi, Lei; Zhou, Hai-Tao

    2017-01-01

    Clear-cell sarcoma is a rare, malignant soft tissue tumor that displays melanocytic differentiation with a distinct molecular profile. It is rarely localized in the gastrointestinal tract. Herein we reported a case of multiple synchronous clear-cell sarcomas of the gastrointestinal tract with parotid gland metastasis. A 51-year-old male patient presented with a growing painless mass under the right ear. A preoperative positron emission tomography/computed tomography showed multiple intestinal masses and a mass in the right parotid with increased glucose uptake, and he underwent operative treatment with resection of three tumors in the jejunum and ileum and then received a right parotidectomy. Postoperative pathological examination showed that cells in the intestinal tumor were consistent with clear-cell sarcoma of the gastrointestinal tract, and the malignant cells in the parotid gland were similar to the intestinal tumor. Immunohistochemical studies revealed positive expression of HMB-45, Melan-A, and S-100. EWSR1 gene fusion transcripts were undetectable by fluorescence in situ hybridization. PMID:28405155

  7. 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

  8. Ultrasound GLCM texture analysis of radiation-induced parotid-gland injury in head-and-neck cancer radiotherapy: An in vivo study of late toxicity

    PubMed Central

    Yang, Xiaofeng; Tridandapani, Srini; Beitler, Jonathan J.; Yu, David S.; Yoshida, Emi J.; Curran, Walter J.; Liu, Tian

    2012-01-01

    Purpose: Xerostomia (dry mouth), secondary to irradiation of the parotid glands, is one of the most common side effects of head-and-neck cancer radiotherapy. Diagnostic tools able to accurately and efficiently measure parotid gland injury have yet to be introduced into the clinic. This study's purpose is to investigate sonographic textural features as potential imaging signatures for quantitative assessment of parotid-gland injury after head-and-neck radiotherapy. Methods: The authors have investigated a series of sonographic features obtained from the gray level co-occurrence matrix (GLCM) – a second order statistical method of texture analysis. These GLCM textural features were selected based on empirical observations that the normal parotid gland exhibits homogeneous echotexture, whereas the postradiotherapy parotid gland often exhibits heterogeneous echotexture. We employed eight sonographic features: (1) angular second moment (ASM), (2) inverse differential moment (IDM), (3) contrast, (4) variance, (5) correlation, (6) entropy, (7) cluster shade, and (8) cluster prominence. Altogether, sonographic properties of the parotid glands were quantified by their degrees of homogeneity (ASM and IDM), heterogeneity (contrast and variance), smoothness (correlation), randomness (entropy), and symmetry (cluster shade and prominence). The sonographic features were tested in a pilot study of 12 postradiotherapy patients and 7 healthy volunteers. The mean follow-up time for the postradiotherapy patients was 17.2 months (range: 12.1–23.9 months) and the mean radiation dose to the parotid glands was 32.3 Gy (range: 11.0–63.4 Gy). Each participant underwent one ultrasound study in which longitudinal (vertical) ultrasound scans were performed on the bilateral parotids – a total of 24 postirradiation and 14 normal parotid glands were examined. The 14 normal parotid glands served as the control group. A radiologist contoured the parotid glands on the B-mode images and the

  9. ConA and UEA-I lectin histochemistry of parotid gland mucoepidermoid carcinoma.

    PubMed

    Sobral, Ana Paula V; Rego, Moacyr J B M; Cavalacanti, Carmelita L B; Carvalho, Luiz B; Beltrão, Eduardo I C

    2010-03-01

    Mucoepidermoid carcinoma (MEC) corresponds to 5-12% of all salivary gland tumours, and is classified as low, intermediate or high grade. Traditionally, immunohistochemistry was considered as the complementary tool for diagnosis of salivary gland neoplasia. Lectin histochemistry has also been increasingly used in recent years. In this work, lectins were used as histochemical markers for normal and transformed parotid glands. Biopsy specimens of 15 cases diagnosed as MEC (low, intermediate and high grade) of the parotid gland were trypsin- and methanol-H(2)O(2)-treated and incubated with horseradish peroxidase (HRP)-conjugated lectins, Concanavalin A (Con A-HRP) and Ulex europeus I (UEA-I-HRP). Con A stained the neoplasic cells of MEC (all grades). In high and intermediate cases, ductal cells were weakly stained by Con A. UEA-I weakly stained normal cells of the excretory duct and neoplasic cells in high grade. Neoplasic cells in intermediate grade were moderately stained and in low grade, the cell membrane was intensely stained with UEA-I. Stroma presented a direct relation between malignancy and staining intensity for UEA-I. The results indicated that lectin histochemistry distinguished the cell biology among histological grades of MEC.

  10. 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.

  11. AAV5-mediated gene transfer to the parotid glands of non-human primates

    PubMed Central

    Voutetakis, A; Zheng, C; Cotrim, AP; Mineshiba, F; Afione, S; Roescher, N; Swaim, WD; Metzger, M; Eckhaus, MA; Donahue, RE; Dunbar, CE; Chiorini, JA; Baum, BJ

    2010-01-01

    Salivary glands are potentially useful target sites for multiple clinical applications of gene transfer. Previously, we have shown that serotype 2 adeno-associated viral (AAV2) vectors lead to stable gene transfer in the parotid glands of rhesus macaques. As AAV5 vectors result in considerably greater transgene expression in murine salivary glands than do AAV2 vectors, herein we have examined the use of AAV5 vectors in macaques at two different doses (n = 3 per group; 1010 or 3 × 1011 particles per gland). AAV5 vector delivery, as with AAV2 vectors, led to no untoward clinical, hematological or serum chemistry responses in macaques. The extent of AAV5-mediated expression of rhesus erythropoietin (RhEpo) was dose-dependent and similar to that seen with an AAV2 vector. However, unlike results with the AAV2 vector, AAV5 vector-mediated RhEpo expression was transient. Maximal expression peaked at day 56, was reduced by ~80% on day 84 and thereafter remained near background levels until day 182 (end of experiment). Quantitative PCR studies of high-dose vector biodistribution at this last time point showed much lower AAV5 copy numbers in the targeted parotid gland (~1.7%) than found with the same AAV2 vector dose. Molecular analysis of the conformation of vector DNA indicated a markedly lower level of concatamerization for the AAV5 vector compared with that of a similar AAV2 vector. In addition, cellular immunological studies suggest that host response differences may occur with AAV2 and AAV5 vector delivery at this mucosal site. The aggregate data indicate that results with AAV5 vectors in murine salivary glands apparently do not extend to macaque glands. PMID:19759566

  12. 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.

  13. 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

  14. 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.

  15. Partial Superficial, Superficial, and Total Parotidectomy in the Management of Benign Parotid Gland Tumors: A 10-Year Prospective Study of 205 Patients.

    PubMed

    Stathopoulos, Panagiotis; Igoumenakis, Dimosthenis; Smith, William P

    2017-06-23

    The aim of this report is to present an overview of the authors' experience in treating parotid gland tumors for a period of 10 years. This report describes patients' demographics, surgical outcomes, and complications and discusses the management of benign disease with particular emphasis on the importance of facial nerve dissection. A total of 205 consecutive patients with different parotid gland tumors underwent surgery at Northampton General Hospital (Northampton, UK) from October 2000 to November 2010. Data were prospectively collected and entered into an electronic database. Patients' demographics, clinical tumor size, type of operation, fine-needle aspiration result, facial nerve status, final histopathologic report, and intraoperative and postoperative complications were recorded and analyzed. This study confirmed that good results in low recurrence rate and minimal risk of facial nerve weakness can be achieved with operations less aggressive than traditional superficial parotidectomy, such as partial superficial parotidectomy. Transient facial nerve palsy was significantly more frequent after total (40%; P < .001) and superficial (28%; P < .05) parotidectomy, respectively, than after partial superficial parotidectomy (9.6%). Because the risk or recurrence is higher when surgery is performed by inexperienced surgeons, the authors advocate that parotid gland surgery should be performed by adequately trained operators and the surgical specimen ideally should be examined by a histopathologist experienced in the diagnosis of salivary gland tumors. Recurrence rate for these tumors increases with time; therefore, long-term follow-up is required for these patients. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  16. 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.

  17. 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

  18. [Possible relation between viruses and oromaxillofacial tumors. III. Demonstration of the SV40 antigen and anti-SV40 antibodies in patients with tumors of the parotid gland].

    PubMed

    Stoian, M; Zaharia, O; Suru, M; Goldstein, I; Nastac, E

    1987-01-01

    SV40 antigen was detected in 7 of 13 malignant tumors developed in the head and neck region. Specific complement fixing antibodies were found in all the patients with the SV40 antigen present in the parotid gland tumoral cells. Incidence of the anti-SV40 complement fixing antibodies in parotid gland tumor bearing patients was of 69.6%.

  19. Experimental periodontitis induces a cAMP-dependent increase in amylase activity in parotid glands from male rats.

    PubMed

    Miozza, Valeria; Borda, Enri; Sterin-Borda, Leonor; Busch, Lucila

    2009-12-01

    It is known that subjects with periodontitis show enhanced amylase concentration in saliva. Our purpose was to analyze the release of amylase in parotid glands from rats with experimental periodontitis and controls. We present evidence that periodontitis induces an increase in resting amylase activity and release without changes in isoproterenol-induced amylase secretion. Changes in amylase were reverted by the inhibition of the adenylyl cyclase by SQ 22536, the cyclooxygenase type 1 by FR 122047 and by blocking the vasoactive intestinal peptide (VIP) receptor with VIP 6-28. Parotid glands from rats with periodontitis showed an increase in cAMP levels that was also reverted in the presence of SQ 22536, FR 122047 and VIP 6-28. We concluded that both PGE(2) and VIP are produced in parotid glands from rats with periodontitis and, by activating their own receptors in acinar cells, induce cAMP accumulation leading to an increase in amylase basal secretion.

  20. Dermoid cyst of the parotid gland: report of a rare entity with literature review.

    PubMed

    Yigit, Nuri; Karslioglu, Yildirim; Yildizoglu, Uzeyir; Karakoc, Omer

    2015-06-01

    Dermoid cysts (DCs)are benign lesions and histologically composed of tissues originating from ectoderm and mesoderm, but not endoderm. Approximately 7 % of all DCs are seen in head and neck area. However, parotid gland is an extremely rare localization in which DCs develop, and only 17 cases have been reported in the literature to date. Correct preoperative diagnosis is difficult to be established due to the rarity and ambiguous radiological findings. We report a case of a 21-year old man. All previous reports reviewed and the pathogenesis as well as the histopathologic and radiologic features are discussed.

  1. Facial Nerve Schwannoma of Parotid Gland: Difficulties in Diagnosis and Management.

    PubMed

    Damar, Murat; Dinç, Aykut Erdem; Şevik Eliçora, Sultan; Bişkin, Sultan; Erten, Gül; Biz, Serdar

    2016-01-01

    Facial nerve schwannomas (FNS) are encapsulated benign tumors arising from Schwann cells of seventh cranial nerve. Most of the facial nerve schwannomas are localized in intratemporal region; only 9% of cases involve a portion of the extratemporal segment. Preoperative diagnosis is often unclear; diagnosis is often made intraoperatively. Management of intraparotid FNS is troublesome because of the facial nerve paralysis. In this report we presented a case of intraparotid schwannoma in a 55-year-old male patient complaining of a painless mass without peripheral facial nerve palsy in left parotid gland. Clinical features, preoperative and intraoperative diagnosis, and difficulties during management are discussed with the review of the literature.

  2. Facial Nerve Schwannoma of Parotid Gland: Difficulties in Diagnosis and Management

    PubMed Central

    Damar, Murat; Dinç, Aykut Erdem; Şevik Eliçora, Sultan; Bişkin, Sultan; Erten, Gül; Biz, Serdar

    2016-01-01

    Facial nerve schwannomas (FNS) are encapsulated benign tumors arising from Schwann cells of seventh cranial nerve. Most of the facial nerve schwannomas are localized in intratemporal region; only 9% of cases involve a portion of the extratemporal segment. Preoperative diagnosis is often unclear; diagnosis is often made intraoperatively. Management of intraparotid FNS is troublesome because of the facial nerve paralysis. In this report we presented a case of intraparotid schwannoma in a 55-year-old male patient complaining of a painless mass without peripheral facial nerve palsy in left parotid gland. Clinical features, preoperative and intraoperative diagnosis, and difficulties during management are discussed with the review of the literature. PMID:26904338

  3. Management of midcheek masses and tumors of the accessory parotid gland.

    PubMed

    De Riu, Giacomo; Meloni, Silvio M; Massarelli, Olindo; Tullio, Antonio

    2011-05-01

    Tumors of the lateral wall of the mouth have different origins and behaviors. These lesions often arise from salivary tissues, such as the accessory parotid gland, but tumors can also originate from the muscles, buccal fat pad, or other structures. Surgical approaches are limited in this region by the presence of the facial nerve and the Stensen's duct. In this article, we present 9 cases of midcheek masses that were operated on via extra- or intraoral approaches. We discuss the problems related to the diagnosis of such tumors, as well as the indications and rationales for different treatment approaches.

  4. 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.

  5. Bilateral multiple sialolithiasis of the parotid gland in a patient with Sjögren’s syndrome

    PubMed Central

    Konstantinidis, I; Paschaloudi, S; Triaridis, S; Fyrmpas, G; Sechlidis, S; Constantinidis, J

    2007-01-01

    Summary The presence of multiple calculi in the major salivary glands is an uncommon finding. Sjögren’s syndrome is a chronic autoimmune disease characterized by lymphocyte-mediated destruction of the exocrine glands. The case is presented of a 49-year-old female with Sjögren’s syndrome found to have bilateral multiple sialolithiasis in the parenchyma of the parotid glands. The patient presented with a right sided painful inflamed swelling of the parotid region. Even though she had been diagnosed with primary Sjögren’s syndrome 3 years prior to admission, she did not report any previous episode of sialadenitis. Full blood count showed leukocytosis (white blood cells = 14,900/106L) with neutrophilia (75%). Radiological assessment included ultrasound and computed tomography scan of the parotids which demonstrated intra-parenchymal multiple calculi of both parotid glands and obstruction of the right Stensen’s duct. The patient was treated with intravenous antibiotics and anti-inflammatory drugs. On the second day of hospitalisation, she reported spontaneous extrusion of a calculus during massage of the gland, with immediate relief of symptoms. In patients with Sjögren’s syndrome and radiological findings of calculi in the major salivary glands, close observation is mandatory for better control of recurrent sialadenitis and early recognition of mucosa-associated lymphoid tissue lymphomas. PMID:17601211

  6. Accessory parotid gland with ectopic fistulous duct - Diagnosis by ultrasonography, digital fistulography, digital sialography and CT fistulography. A case report and review of current literature

    PubMed Central

    Kulkarni, Chaitanya Dattatray; Mittal, Shireesh Kumar; Katiyar, Vikas; Pathak, Ojaswi; Sood, Shashank

    2011-01-01

    Accessory parotid glands are a common clinical occurrence and usually drain into the main Stenson's duct by small ductules and thereby, into the buccal cavity. Presence of an accessory parotid gland with an ectopic fistulous duct is a rare occurrence. We present the imaging findings in a case of right accessory parotid gland with ectopic fistulous duct associated with bilateral pre-aural appendages. Diagnostic workup was done by ultrasonography, sono-fistulography, contrast digital fistulography, contrast digital sialography and computed tomography fistulography. Imaging showed a right accessory parotid gland lying anterior to and separate from the main parotid gland draining via an ectopic fistulous duct opening over the right cheek. The child was managed surgically by internalisation of the duct to open into the buccal mucosa and excision of pre-aural appendages. PMID:22470802

  7. Accessory parotid gland with ectopic fistulous duct--diagnosis by ultrasonography, digital fistulography, digital sialography and CT fistulography. A case report and review of current literature.

    PubMed

    Kulkarni, Chaitanya Dattatray; Mittal, Shireesh Kumar; Katiyar, Vikas; Pathak, Ojaswi; Sood, Shashank

    2011-01-01

    Accessory parotid glands are a common clinical occurrence and usually drain into the main Stenson's duct by small ductules and thereby, into the buccal cavity. Presence of an accessory parotid gland with an ectopic fistulous duct is a rare occurrence. We present the imaging findings in a case of right accessory parotid gland with ectopic fistulous duct associated with bilateral pre-aural appendages. Diagnostic workup was done by ultrasonography, sono-fistulography, contrast digital fistulography, contrast digital sialography and computed tomography fistulography. Imaging showed a right accessory parotid gland lying anterior to and separate from the main parotid gland draining via an ectopic fistulous duct opening over the right cheek. The child was managed surgically by internalisation of the duct to open into the buccal mucosa and excision of pre-aural appendages.

  8. Acquired von Willebrand's disease associated with epithelial myoepithelial carcinoma of the parotid salivary gland

    PubMed Central

    Chilvers, Geoffrey Spencer; Porter, Graham

    2014-01-01

    This is the first case report of a patient with acquired von Willebrand's disease (AvWD) secondary to epithelial myoepithelial carcinoma (EMC) of the parotid salivary gland. This patient presented to haematology following an abnormal bleeding episode with von Willebrand factor Ristocetin cofactor (VWF:RCo) <5% and VWF:Ag 13%. He was diagnosed with AvWD. At the same time he was found to have a left parotid lump which was excised following a multidisciplinary team meeting. This was histologically reported as an EMC. Following excision, unusually this patient's AvWD did not resolve. Extensive investigation looking for other causes of the AvWD did not reveal any other potential cause; therefore, due to the similar timing of onset of both pathologies it is felt that the AvWD in this case is secondary to the EMC. This case report highlights the presentation, investigation and management of AvWD and parotid lumps as well as discussing proposed pathophysiological mechanisms for AvWD. PMID:25096657

  9. Likelihood-fuzzy analysis of parotid gland shrinkage in radiotherapy patients.

    PubMed

    Pota, Marco; Scalco, Elisa; Sanguineti, Giuseppe; Belli, Maria Luisa; Cattaneo, Giovanni Mauro; Esposito, Massimo; Rizzo, Giovanna

    2014-01-01

    In head-and-neck radiotherapy, an early detection of patients who will undergo parotid glands shrinkage during the treatment is of primary importance, since this condition has been found to be associated with acute toxicity. In this work, a recently proposed approach, here named Likelihood-Fuzzy Analysis, based on both statistical learning and Fuzzy Logic, is proposed to support the identification of early predictors of parotid shrinkage from Computed Tomography images acquired during radiotherapy. For this purpose, a set of textural image parameters was extracted and considered as candidate of parotid shrinkage prediction; for all these parameters and combinations of maximum three of them, a fuzzy rule base was extracted, gaining very good results in terms of accuracy, sensitivity and specificity. The performance of classification was also compared to a classical Fisher's Linear Discriminant Analysis and found to provide better results. Moreover, the use of Fuzzy Logic allowed obtaining an interpretable description of the relations between textural features and the shrinkage process.

  10. 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.

  11. 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.

  12. Acquired von Willebrand's disease associated with epithelial myoepithelial carcinoma of the parotid salivary gland.

    PubMed

    Chilvers, Geoffrey Spencer; Porter, Graham

    2014-08-05

    This is the first case report of a patient with acquired von Willebrand's disease (AvWD) secondary to epithelial myoepithelial carcinoma (EMC) of the parotid salivary gland. This patient presented to haematology following an abnormal bleeding episode with von Willebrand factor Ristocetin cofactor (VWF:RCo) <5% and VWF:Ag 13%. He was diagnosed with AvWD. At the same time he was found to have a left parotid lump which was excised following a multidisciplinary team meeting. This was histologically reported as an EMC. Following excision, unusually this patient's AvWD did not resolve. Extensive investigation looking for other causes of the AvWD did not reveal any other potential cause; therefore, due to the similar timing of onset of both pathologies it is felt that the AvWD in this case is secondary to the EMC. This case report highlights the presentation, investigation and management of AvWD and parotid lumps as well as discussing proposed pathophysiological mechanisms for AvWD. 2014 BMJ Publishing Group Ltd.

  13. 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

  14. Changes in rat parotid salivary proteins associated with liquid diet-induced gland atrophy and isoproterenol-induced gland enlargement.

    PubMed

    Johnson, D A

    1984-01-01

    The composition of secretory proteins in the parotid saliva of untreated rats, fed a stock pelleted diet (CON), was compared to that of rats maintained on a liquefied diet (LIQ), so as to reduce gland secretory activity, and to rats treated chronically with isoproterenol (ISO), so as to enhance activity. Each experimental treatment resulted in marked changes in protein composition. In CON rats, the basic and acidic proline-rich proteins accounted for 25 per cent of all secretory protein. In LIQ rats, the proportion was 13 per cent. Several basic proline-rich proteins were absent and the major acidic proline-rich protein was markedly reduced. Amylase was reduced whereas DNase and a leucine-rich protein (fraction I) were increased. The proportion of cystine-rich protein (fraction V) was not different from CON rats. The changes observed in the saliva of ISO rats were in marked contrast to these findings. Basic and acidic proline-rich proteins were increased and accounted for 90 per cent of all secretory protein, amylase was responsible for the remaining 10 per cent. Thus the composition of secretory proteins in the parotid saliva of rats can be altered by experimental conditions which affect gland secretory activity. The mechanisms by which these changes occur is not known.

  15. Atrophy of myoepithelial cells in parotid glands of diabetic mice; detection using skeletal muscle actin, a novel marker☆

    PubMed Central

    Nashida, Tomoko; Yoshie, Sumio; Haga-Tsujimura, Maiko; Imai, Akane; Shimomura, Hiromi

    2013-01-01

    In mouse parotid glands, we found expression of skeletal muscle actin (actin-α1) protein and mRNA. We isolated myoepithelial cells from the mouse parotid glands and investigated their actin-α1 expression because smooth muscle actin (actin-α2) has been used as a marker for myoepithelial cells. We used actin-α1 expression to identify pathological changes in diabetic non-obese diabetic (NOD; NOD/ShiJcl) mice—a mouse model for Sjögren's syndrome—and found myoepithelial cells to be decreased or atrophied in the diabetic state. PMID:23772384

  16. Relapsed Acinic Cell Carcinoma of the Parotid Gland With Diffuse Distant Metastasis: Case Report With Literature Review.

    PubMed

    Khelfa, Yousef; Mansour, Munthir; Abdel-Aziz, Yousef; Raufi, Ali; Denning, Krista; Lebowicz, Yehuda

    2016-01-01

    Acinic cell carcinoma (ACC) is an uncommon salivary gland neoplasm that generally displays an indolent growth pattern. Most cases arise in the major glands, particularly the parotid. However, it can arise from minor salivary glands in the oral cavity and aero-digestive tract. Although ACC is generally a low-grade malignant tumor, poorly differentiated and high-grade transformed variants exhibit a propensity for late recurrence and metastasis. There are no adequate clinical trials that define the optimal approach to patients with metastatic salivary gland tumors due to its rarity. Systemic therapy is reserved for cases where local therapy, such as radiation or metastasectomy, is not appropriate. Nevertheless, there is insufficient data in the literature regarding the chemotherapy of choice for metastatic ACC. In this article, we report a case of metastatic ACC of the right parotid gland that progressed on carboplatin and paclitaxel after partial response followed by doxorubicin and is currently on checkpoint inhibitor treatment.

  17. Ultrastructural phosphatase histochemistry of submandibular and parotid salivary glands of man.

    PubMed

    Harrison, J D; Auger, D W; Badir, M S

    1988-02-01

    Thiamine pyrophosphatase was demonstrated in the Golgi complex and acid phosphatase in the GERL of acinar cells of submandibular and parotid glands and were previously demonstrated in cells of intercalary ducts. Thiamine pyrophosphatase was also demonstrated in the Golgi complex of cells of striated and excretory ducts and myoepithelial cells. Acid phosphatase was also demonstrated in lysosomes. Alkaline phosphatase was rarely demonstrated light microscopically at luminal surfaces of striated and excretory ducts and electron microscopically in luminal vesicles in cells of striated ducts. The demonstration of the phosphatases in Golgi complexes and GERLs indicates that investigations on these structures in experimental animals are relevant to human salivary glands and supports the opinion that ductal cells as well as acinar cells secrete organic material. The presence of alkaline phosphatase at luminal surfaces of striated and excretory ducts suggests that resorption as well as secretion may occur in them.

  18. Carcinoma ex pleomorphic adenoma of parotid gland with hepatic metastasis: clinic-radiological case report.

    PubMed

    Dhillon, Manu; Tomar, Divya; Sharma, Manu; Goel, Samta; Srivastava, Siddharth

    2014-04-01

    Pleomorphic adenoma originally called the mixed tumour is a neoplasm commonly involving major salivary glands. The spectrum of malignancy in pleomorphic adenoma comprises three distinct entities - Carcinoma ex pleomorphic adenoma, carcinosarcoma and benign metastasising pleomorphic adenoma. Carcinoma ex pleomorphic adenoma consists of pleomorphic adenoma with a malignant epithelial component. Occasionally, carcinomas ex pleomorphic adenoma develops metastasis. Here we are reporting here a case of benign pleomorphic adenoma arising in parotid gland which turned into malignancy after four years. The patient developed facial nerve paralysis suggesting malignant transformation. Along the course of the disease, the patient developed regional metastasis to lymph nodes and neck and distant metastasis to liver. This case report emphasises the role of advanced imaging modalities in the early diagnosis of the condition and evaluation of metastasis. The patients with this condition should be treated early for favorable outcome and investigated for distant metastasis.

  19. Valproic acid-associated sialadenosis of the parotid and submandibular glands: diagnostic and therapeutic aspects.

    PubMed

    Mauz, P S; Mörike, K; Kaiserling, E; Brosch, S

    2005-04-01

    Sialadenosis has been defined as a non-inflammatory, parenchymatous salivary gland disease causing recurrent, bilateral swelling of the salivary glands. As an adverse drug reaction of valproic acid, sialadenosis is very rare. To our knowledge, it has been reported only once in the world literature to date. We present herein the case of a patient with valproic acid-associated sialadenosis of both the parotid and submandibular glands. This appears to be the first published case of a patient who received surgical treatment. On light and electron microscopy of all the affected salivary glands, granular sialadenosis with predominantly moderate electron-dense secretory cytoplasmatic granules was observed. No relevant degenerative alterations were seen. There was no histological evidence of peripheral neuropathy of the nerve supply, leading to disordered activity of acinar cells by loss of neurosecretory granules. Lateral parotidectomy, performed under neuromonitoring control for safety reasons, is the treatment of choice for chronic recurrent parotitis that does not respond to conservative therapy, particularly if the cosmetic deformity is unacceptable to the patient. If the submandibular glands are involved, partial removal is recommended.

  20. Single Cell Clones Purified from Human Parotid Glands Display Features of Multipotent Epitheliomesenchymal Stem Cells

    PubMed Central

    Yi, TacGhee; Lee, Songyi; Choi, Nahyun; Shin, Hyun-Soo; Kim, Junghee; Lim, Jae-Yol

    2016-01-01

    A better understanding of the biology of tissue-resident stem cell populations is essential to development of therapeutic strategies for regeneration of damaged tissue. Here, we describe the isolation of glandular stem cells (GSCs) from a small biopsy specimen from human parotid glands. Single colony-forming unit-derived clonal cells were isolated through a modified subfractionation culture method, and their stem cell properties were examined. The isolated clonal cells exhibited both epithelial and mesenchymal stem cell (MSC)-like features, including differentiation potential and marker expression. The cells transiently displayed salivary progenitor phenotypes during salivary epithelial differentiation, suggesting that they may be putative multipotent GSCs rather than progenitor cells. Both epithelial and mesenchymal-expressing putative GSCs, LGR5+CD90+ cells, were found in vivo, mostly in inter-secretory units of human salivary glands. Following in vivo transplantation into irradiated salivary glands of mice, these cells were found to be engrafted around the secretory complexes, where they contributed to restoration of radiation-induced salivary hypofunction. These results showed that multipotent epitheliomesenchymal GSCs are present in glandular mesenchyme, and that isolation of homogenous GSC clones from human salivary glands may promote the precise understanding of biological function of bona fide GSCs, enabling their therapeutic application for salivary gland regeneration. PMID:27824146

  1. 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.

  2. Diffuse large B-cell lymphoma of the parotid gland: Cytological, histopathological, and immunohistochemical features: A rare case report

    PubMed Central

    Andola, Sainath K; Masgal, Meenakshi M; Reddy, Rajeev M

    2016-01-01

    Primary malignant lymphomas of the salivary glands are rare, accounting for 2-5% of salivary gland tumors and 5% of extranodal lymphomas, frequently seen in the parotid gland. There are single case reports mentioned in the literature. Clinical presentation is not characteristic and the disease is often overlooked with delay in diagnosis and treatment. We are reporting a case of bilateral parotid gland lymphoma in a 55-year-old male, presented with bilateral enlarged parotids. Magnetic resonance imaging (MRI) showed bilateral enlarged parotid glands with multiple well-defined intraparotid lesions. Fine Needle Aspiration Cytology (FNAC) of both showed mixed population of lymphoid cells with large monocytoid cells with scant cytoplasm, anisonucleosis with prominent nucleoli, and numerous mitoses suggestive of non-Hodgkin's lymphoma (NHL). Histopathology showed sheets of large lymphoma cells destructing the salivary acini and infiltrating the periparotid fat. Immunohistochemistry (IHC) showed diffuse CD20 positivity, B-cell lymphoma 6 protein (Bcl-6) was focally positive and negative for cluster of differentiation (CD) 3, CD5, CD10, and Multiple myeloma oncogene-1 (MUM1) which led to the diagnosis of NHL-Diffuse large B cell type. PMID:28028340

  3. Parotid gland tumours in a West Indian population: Comparison to world trends

    PubMed Central

    RAMDASS, MICHAEL J.; MAHARAJ, KHEMANAND; MOOTEERAM, JUSTIN; DWARIKA, WENDELL; TILLUCKDHARRY, CLYDE; BARROW, SHAHEEBA

    2015-01-01

    The epidemiology of parotid gland tumours in Trinidad and Tobago and the wider Caribbean is currently unknown. Therefore, an analysis of the pathological records was conducted to determine the pattern of this disease in Trinidad and Tobago. A retrospective analysis was conducted on all parotid gland tumours and the demographic and histological data were analysed. Data from 60 cases were collected over a period of 8 years (October, 2003 to February, 2012), including 56 primary and 4 secondary tumours (1 basal cell carcinoma and 3 metastatic tumours). The patients included 31 men and 29 women, with a mean age of 48.7 years and an age range of 21–73 years (peak age, 51–60 years). The surgical interventions included 53 superficial parotidectomies, 6 radical parotidectomies and 1 biopsy. Of the 56 primary tumours, 41 were benign [34 pleomorphic adenomas and 7 Warthin's tumours (adenolymphomas)], accounting for 73.2% of the cases. The malignant lesions included 6 squamous cell carcinomas, 3 mucoepidermoid carcinomas, 2 acinic cell carcinomas, 2 adenoid cystic carcinomas, 1 anaplastic carcinoma and 1 papillary carcinoma, accounting for 26.8% of the total cases, without any age predominance. The pattern of disease distribution was similar to that indicated by worldwide data, with benign primary lesions accounting for ~80% of the cases (pleomorphic adenomas, 80% and Warthin's tumours, 20%). The most common carcinomas were mucoepidermoid and adenoid cystic types, as indicated by worldwide data; however, in our series, squamous cell carcinoma was the most common type, followed by mucoepidermoid, acinic cell and adenoid cystic carcinomas. The present study will hopefully provide useful information on parotid pathology in Trinidad and Tobago and encourage further research in this field. PMID:25469289

  4. 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.

  5. Development of the glandular epithelium of the bovine parotid gland during ontogenesis.

    PubMed

    Eisenbrückner, A; Fink, C; Kressin, M

    2003-06-01

    The development of the parotid gland was examined in 36 bovine embryos and foetuses with a crown-rump-length (CRL) from 28 up to 1000 mm by light, transmission electron microscopical and actin-immunohistochemical methods. The anlage of the parotid gland in an embryo with 28 mm CRL can be found at the lateral angle of the primitive oral cavity as a local thickening of the epithelium. During the second month, the differentiation of primary ducts and endbuds starts and a lumen develops in the primary ducts. At the end of the second month a lumen appears in the terminal endbuds. In the immature endpiece cells first secretory granules can be seen from a CRL of 240 mm. In the third month differentiation between intra- and inter-lobular ducts is possible. Immature myoepithelial cells present as a basal layer of flattened cells between the epithelial cells and the basement membrane at the end of the second month. During further development they increase in number, become more flattened and form long cellular processes. At the end of the fourth month isolated actin filament bundles are formed, which were also detected by an antibody against smooth muscle actin. The actin filaments condense continuously until they fill the cell processes completely at the end of foetal development.

  6. Sialadenosis of the salivary glands of the head. Studies on the physiology and pathophysiology of parotid secretion.

    PubMed

    Chilla, R

    1981-01-01

    Sialadenosis is a noninflammatory disease of the salivary glands of the head. It is observed in connection with endocrine disorders, malnutrition and neurologic diseases. The parotid glands are predominantly affected by a parenchymatous swelling. Based on morphologic and biochemical investigations it can be assumed that disorders of the gland's acinar protein secretion are responsible for sialadenosis. Changes in secretory behavior are caused by either excessive stimulation ('stimulatory proteodyschylia') or by inhibition of secretion ('inhibitory proteodyschylia'). The origin of these secretory disorders is very likely to be found in the vegetative nerve system. The pathophysiology of sialadenosis can therefore only be understood after elucidation of the physiologic mechanisms of salivary gland secretion. Research in the field of biophysical and biochemical principles underlying parotid secretion has made considerable progress in recent years. A comprehensive review of this new evidence is necessary for the understanding of experimental studies on the pathogenesis of sialadenosis.

  7. 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.

  8. [Stenon or Stensen duct. How sholud we call the secretory duct of the parotid gland? Brief biography of its discoverer].

    PubMed

    Morais Pérez, D

    2004-01-01

    The duct of the parotid gland had been indiscriminately named Stenon's duct or Stensen's duct. In order to establish its origin we carried out a biographic search and a brief revision of the life of the great anatomist, geologist, palaeontologist, bishop and finally Saint Nicolaus Stensen.

  9. Mammary analog secretory carcinoma of the parotid gland: A case report and literature review.

    PubMed Central

    Balanzá, Ricardo; Arrangoiz, Rodrigo; Cordera, Fernando; Muñoz, Manuel; Luque-de-León, Enrique; Moreno, Eduardo; Toledo, Carlos; González, Edgar

    2015-01-01

    Background Mammary analog secretory carcinoma (MASC) was first described in 2010 by Skálová et al. This entity shares morphologic and immunohistochemical features with the secretory carcinoma (SC) of the breast. MASC usually presents as an asymptomatic mass in the parotid gland and predominantly affects men. This tumor is considered a low-grade carcinoma but has the potential for high-grade transformation. We report one MASC case and a review of world literature. Case report A 66-year-old male patient presented because he noticed a mass of approximately 3 × 3 cm on the right pre-auricular region. Physical examination demonstrated a 3 × 3.5 cm, firm, fixed, non-tender mass in the right pre-auricular region. An MRI of the head and neck showed an ovoid heterogeneous lesion, dependent of the right parotid gland of 27 × 28 mm. We performed a superficial parotidectomy with identification and preservation of the facial nerve. The immunophenotype was positive for epithelial membrane antigen (EMA), CK8/18, vimentin, S-100 protein, and mammoglobin. No further surgical interventions or adjuvant therapies were needed. The patient will have a close follow up. Conclusion The presence of t(12;15) (p13;q25) translocation which results in the ETV6-NTRK3 gene fusion or positive immunochemical studies for STAT5, mammoglobin and S100 protein, are necessary to confirm the diagnosis of MASC. MASC treatment should mimic the management of other low-grade malignant salivary gland neoplasms. The inhibition of ETV6-NTRK3 gene fusion could be used as treatment in the future. PMID:26496413

  10. Mammary analog secretory carcinoma of the parotid gland: A case report and literature review.

    PubMed

    Balanzá, Ricardo; Arrangoiz, Rodrigo; Cordera, Fernando; Muñoz, Manuel; Luque-de-León, Enrique; Moreno, Eduardo; Toledo, Carlos; González, Edgar

    2015-01-01

    Mammary analog secretory carcinoma (MASC) was first described in 2010 by Skálová et al. This entity shares morphologic and immunohistochemical features with the secretory carcinoma (SC) of the breast. MASC usually presents as an asymptomatic mass in the parotid gland and predominantly affects men. This tumor is considered a low-grade carcinoma but has the potential for high-grade transformation. We report one MASC case and a review of world literature. A 66-year-old male patient presented because he noticed a mass of approximately 3×3cm on the right pre-auricular region. Physical examination demonstrated a 3×3.5cm, firm, fixed, non-tender mass in the right pre-auricular region. An MRI of the head and neck showed an ovoid heterogeneous lesion, dependent of the right parotid gland of 27×28mm. We performed a superficial parotidectomy with identification and preservation of the facial nerve. The immunophenotype was positive for epithelial membrane antigen (EMA), CK8/18, vimentin, S-100 protein, and mammoglobin. No further surgical interventions or adjuvant therapies were needed. The patient will have a close follow up. The presence of t(12;15) (p13;q25) translocation which results in the ETV6-NTRK3 gene fusion or positive immunochemical studies for STAT5, mammoglobin and S100 protein, are necessary to confirm the diagnosis of MASC. MASC treatment should mimic the management of other low-grade malignant salivary gland neoplasms. The inhibition of ETV6-NTRK3 gene fusion could be used as treatment in the future. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Warthin tumor within the superficial lobe of the parotid gland: a suggested criterion for diagnosis.

    PubMed

    Sagiv, Doron; Witt, Robert L; Glikson, Eran; Mansour, Jobran; Shalmon, Bruria; Yakirevitch, Arkadi; Wolf, Michael; Alon, Eran E; Slonimsky, Guy; Talmi, Yoav P

    2017-04-01

    The location of Warthin tumor (WT) in the parotid gland impacts the surgical approach and may be indicative of the elusive origin of this intriguing entity. Location in the deep versus superficial lobe of the gland is not directly addressed when defining WT characteristics. Our observation, of rare occurrence of deep lobe WT, if at all, led to the current investigation. The study design is cohort study. This is a retrospective chart review of all patients undergoing parotidectomy for WT in two tertiary academic referral centers: the Sheba Medical Center (SMC), Israel, and the Christiana Care (CC), Newark, Delaware, USA. 122 consecutive adult patients underwent parotidectomy for WT (72 from SMC and 50 from CC). Seventy percent were males, with a mean age of 60.6 years. Bilateral WT or multi-centric WT were found in 9.8 and 17.2% of the cases, respectively. In one case, the tumor was described as originating in the deep lobe. In all other cases, the tumor originated and was limited to the superficial lobe. 99.2% of WT originated in the superficial lobe, corresponding with the few reports directly addressing its location in the gland. The reason for the tumor to be limited almost uniformly to the superficial lobe is unknown, and could be related to the etiopathogenesis of this elusive entity. We suggest adding tumor location within the superficial lobe to the common characteristics of WT (male, smoking, and lower pole) that serve as "common criterion" while evaluating a parotid lesion.

  12. Further evidence for AQP8 expression in the myoepithelium of rat submandibular and parotid glands.

    PubMed

    Wellner, Robert B; Redman, Robert S; Swaim, William D; Baum, Bruce J

    2006-02-01

    Previously (Wellner et al., Pflugers Arch 441:49-56, 2000) we suggested that the localization of the aquaporins (AQPs) AQP5 and AQP8 in the apical and basolateral membranes of rat submandibular gland (SMG) acinar cells, respectively, provides for transcellular water flow during saliva formation. While the localization of AQP5 in this gland has been verified in several laboratories, there have been differing reports regarding AQP8 localization. Other investigators subsequently reported that AQP8 is not expressed in the acinar or ductal cells of the major salivary glands of the rat, but in the myoepithelium of each gland. Thus, we have carried out additional studies: (1) to reassess the localization of AQP8 in the rat SMG and (2) to assess the localization of AQP8 in the rat parotid gland (PG). Initially, we compared the localizations of AQP8 with recognized basolateral markers in acinar cells [the Na+,K+-ATPase and the Na+-K+-2Cl- cotransporter (NKCC1)]. Our results indicated that Na+,K+-ATPase localized in both the basal and lateral membranes of rat SMG acinar cells, whereas AQP8 was detected only in the basal regions of the acini. In the rat PG, AQP8 was invested near intercalated ducts and adjacent acini, whereas NKCC1 localized in the basolateral membranes of acinar cells. As these results were suggestive of myoepithelial localization in both glands, we compared AQP8 localization with the localization of smooth muscle actin, a myoepithelial marker. We found that AQP8 and smooth muscle actin colocalized in both the rat SMG and PG, providing additional strong support for a myoepithelial localization of AQP8. Thus, in agreement with an earlier report by other investigators (Elkjaer et al., Am J Physiol Renal Physiol 281:F1047-F1057, 2001), we report that AQP8 is expressed in the myoepithelial cells, but not in the acinar cells, of both the rat SMG and PG.

  13. 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.

  14. 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

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

    2016-11-01

    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.

  15. 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

  16. ( 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.

  17. 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.

  18. Radioprotection of the rat parotid gland by WR-2721 and isoproterenol and its modification by propranolol

    SciTech Connect

    Sodicoff, M.; Conger, A.D.

    1983-04-01

    The aminothiol WR-2721 and ..beta..-adrenergic agonist isoproterenol both conferred considerable radioprotection to the rat parotid gland. Isoproterenol acts on the ..beta..-receptor, and its specific antagonist, propranolol, eliminated isoproterenol's protective effect, implicating the ..beta..-receptor and possibly cAMP in the mechanism of the protection. Since other sulfhydryl-containing protectants have been shown to elevate cAMP it was reasoned that WR-2721 might do so as well. However, the radioprotection conferred by WR-2721 was not reduced by propranolol, showing that the ..beta..-receptor played no part in WR-2721's action. The possible role of cAMP in radioprotection by isoproterenol is discussed.

  19. Sialochemistry of whole, parotid, and labial minor gland saliva in patients with oral lichen planus.

    PubMed

    Gandara, B K; Izutsu, K T; Truelove, E L; Mandel, I D; Sommers, E E; Ensign, W Y

    1987-11-01

    This study was undertaken to determine whether oral lichen planus in otherwise healthy patients is associated with sialochemical abnormalities. Unstimulated and stimulated whole saliva, stimulated parotid saliva, and stimulated labial minor gland saliva were collected from 25 patients with oral lichen planus and from 25 age- and sex-matched controls. Flow rate and salivary concentrations of immunoglobulins A and G, albumin, amylase, lysozyme, lactoferrin, and total protein were determined by standard analytical techniques. Concentrations of inorganic components including sodium, potassium, calcium, chloride, and phosphate were also measured. No significant differences were found between the lichen planus patients and the controls. These findings do not support an association between oral lichen planus and salivary dysfunction in otherwise healthy patients.

  20. A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland.

    PubMed

    Casale, Manuele; Capuano, Francesco; Sabatino, Lorenzo; Pace, Annalisa; Oliveto, Giuseppe; Vella, Paola; Moffa, Antonio; Salvinelli, Fabrizio

    2016-01-01

    The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with "Warthin tumor." We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications.

  1. Expression of nuclear receptors (AhR, PXR, CAR) and transcription factor (Nrf2) in human parotid gland.

    PubMed

    Droździk, Agnieszka; Kowalczyk, Robert; Urasińska, Elzbieta; Kurzawski, Mateusz

    2013-01-01

    Nuclear receptors and transcription factors coordinate expression of many genes, and regulation of their expression determines cellular response to various endo- and exogenous factors. There is paucity of data regarding expression of nuclear receptors and factors in salivary glands. In the present study, a focus was placed on human parotid gland expression of aryl hydrocarbon receptor (AhR), pregnane X receptor (PXR, NR1I2), constitutive androstane receptor (CAR, NR1I3) and nuclear factor E2-related factor 2 (Nrf2). Parotid salivary tissue was obtained from patients undergoing the gland dissection. Quantitative real-time PCR aimmunohistochemical staining were used for expression studies. The highest mRNA expression was documented for NFE2L2 coding for Nrf2. Lower expression was seen in the case of AHR gene coding for AhR. PXR was constitutively present at very low level and CAR expression was below the limit of quantification. Immunohistochemical evaluation of the parotid gland specimens revealed cytoplasmic Nrf2 expression in striated duct cells as well as within myoepithelial cells. Acinar cells were mostly negative for Nrf2. Expression of AhR was found within the cytoplasm in striated duct cells. Acinar and myoepithelial cells were negative for AhR. Having in mind their role in regulating function of many enzymes and transmembrane transporters, expression of these factors seem play a role in salivary gland physiology, pathology as well as drug transport and metabolism.

  2. 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

  3. Cystic lesions of the parotid gland: radiologic-pathologic correlation according to the latest World Health Organization 2017 Classification of Head and Neck Tumours.

    PubMed

    Takita, Hirotaka; Takeshita, Tohru; Shimono, Taro; Tanaka, Hiroko; Iguchi, Hiroyoshi; Hashimoto, Shigeo; Kuwae, Yuko; Ohsawa, Masahiko; Miki, Yukio

    2017-08-23

    The latest World Health Organization 2017 Classification of Head and Neck Tumours includes a new chapter on tumors and tumor-like lesions of the neck and lymph nodes. Tumor-like lesions include a variety of cystic lesions of the parotid gland. Cystic lesions of the parotid gland can be divided into three groups: non-neoplastic cysts, benign tumors with macrocystic change, and malignant tumors with macrocystic change. It is important to distinguish these lesions from one another because treatment and patient management differ among the three groups. The purpose of this review is to describe the magnetic resonance imaging and scintigraphy findings and the histopathologic characteristics of each parotid gland lesion based on the latest World Health Organization 2017 Classification of Head and Neck Tumours and to summarize the key points of differential diagnosis for cystic lesions of the parotid gland.

  4. 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.

  5. The role of aryl hydrocarbon receptor (AhR) in the pathology of pleomorphic adenoma in parotid gland.

    PubMed

    Drozdzik, Agnieszka; Kowalczyk, Robert; Lipski, Mariusz; Łapczuk, Joanna; Urasinska, Elzbieta; Kurzawski, Mateusz

    2016-01-01

    Pleomorphic adenoma (benign mixed tumor) is one of the most common salivary gland tumors. However, molecular mechanisms implicated in its development are not entirely defined. Therefore, the study aimed at definition of aryl hydrocarbon receptor (AhR) involvement in pleomorphic adenoma pathology, as the AhR controlled gene system was documented to play a role in development of various human tumors. The study was carried out in pleomorphic adenoma and control parotid gland tissues where gene expression of AHR, AhR nuclear translocator (ARNT), AhR repressor (AHRR), as well as AhR controlled genes: CYP1A1 and CYP1B1, at mRNA and protein (immunohistochemistry) levels were studied. Functional evaluation of AhR system was evaluated in HSY cells (human parotid gland adenocarcinoma cells) using 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as AhR specific inducer. Pleomorphic adenoma specimens showed cytoplasmic and nuclear AhR expression in epithelial cells as well as in mesenchymal cells. In parotid gland AhR was expressed in cytoplasm of duct cells. Quantitative expression at mRNA level showed significantly higher expression of AHR, ARNT and CYP1B1, and comparable levels of CYP1A1 in pleomorphic adenoma tissue in comparison to healthy parotid gland. The HSY cell study revealed significantly higher expression level of AHRR in HSY as compared with MCF-7 cells (human breast adenocarcinoma cell line used as reference). Upon TCDD stimulation a drop in AHRR level in HSY cells and an increase in MCF-7 cells were observed. The HSY and MCF-7 cell proliferation rate (measured by WST-1 test) was not affected by TCDD. Summarizing both in vitro and in vivo observations it can be stated that AhR system may play a role in the pathology of pleomorphic adenoma. Copyright © 2015. Published by Elsevier Ltd.

  6. Fluid and amylase secretion by perfused parotid gland: physio-morphological approach.

    PubMed Central

    Murakami, M; Yoshimura, K; Sugiya, H; Segawa, A; Loffredo, F; Testa-Riva, F; Riva, A

    2000-01-01

    Whole gland perfusion technique was applied to rat parotid glands to assess whether amylase affects fluid secretion. Control perfusion without any secretagogue evoked no spontaneous secretion. Carbachol (CCh 1 microM) induced both amylase and fluid secretion with distinctive kinetics. Fluid secretion occurred constantly around 60 microL/g-min, whereas amylase secretion exhibited an initial peak, followed by a rapid decrease to reach a plateau. Isoproterenol (Isop 1 microM) alone did not induce fluid secretion although it evoked amylase secretion as measured in isolated perfused acini. Addition of Isop during CCh stimulation evoked a rapid and large rise in amylase secretion accompanied by small increase in oxygen consumption. Morphological observations carried out by HR SEM and TEM revealed exocytotic profiles following Isop stimulation. CCh stimulation alone seldom showed exocytotic profiles, suggesting a low incidence of amylase secretion during copious fluid secretion. Combined stimulation of CCh and Isop induced both vacuolation and exocytosis along intercellular canaliculi. These findings suggest that control of salivary fluid secretion is independent of the amylase secretion system induced by CCh and/or Isop. PMID:10981508

  7. Laminin-111 Peptides Conjugated to Fibrin Hydrogels Promote Formation of Lumen Containing Parotid Gland Cell Clusters.

    PubMed

    Nam, Kihoon; Jones, Joshua P; Lei, Pedro; Andreadis, Stelios T; Baker, Olga J

    2016-06-13

    Previous studies showed that mouse submandibular gland cells form three-dimensional structures when grown on Laminin-111 gels. The use of Laminin-111 for tissue bioengineering is complicated due to its lack of purity. By contrast, the use of synthetic peptides derived from Laminin-111 is beneficial due to their high purity and easy manipulation. Two Laminin-111 peptides have been identified for salivary cells: the A99 peptide corresponding to the α1 chain from Laminin-111 and the YIGSR peptide corresponding to the β1 chain from Laminin-111, which are important for cell adhesion and migration. We created three-dimensional salivary cell clusters using a modified fibrin hydrogel matrix containing immobilized Laminin-111 peptides. Results indicate that the YIGSR peptide improved morphology and lumen formation in rat parotid Par-C10 cells as compared to cells grown on unmodified fibrin hydrogel. Moreover, a combination of both peptides not only allowed the formation of functional three-dimensional salivary cell clusters but also increased attachment and number of cell clusters. In summary, we demonstrated that fibrin hydrogel decorated with Laminin-111 peptides supports attachment and differentiation of salivary gland cell clusters with mature lumens.

  8. Bilateral Basaloid Squamous Cell Carcinoma of the Parotid Gland: A Case Report and Review of the Literature

    PubMed Central

    Rivero, Alexander; Tang, Christopher G; Rasgon, Barry M

    2017-01-01

    Introduction: We describe the first known case of bilateral basaloid squamous cell carcinoma of the parotid gland, and we review existing literature. Case Presentation: A previously healthy, 70-year-old white man presented with a 2-cm enlarging mass in the tail of the right parotid gland. Magnetic resonance imaging and computed tomography showed ipsilateral pathologic adenopathy. Results of fine-needle aspiration revealed a high-grade malignancy with squamous features. The patient underwent a right total parotidectomy and modified radical neck dissection. Final pathologic findings revealed a basaloid squamous cell carcinoma. Four years after the initial resection, the patient presented with an enlarging left parotid mass. Findings of fine-needle aspiration and imaging were similar to those 4 years earlier. The patient received a left total parotidectomy and modified radical neck dissection. Postoperative radiation therapy was performed after each surgical intervention. He remains disease free at 4-year follow-up after the second mass was resected. Discussion: Squamous cell carcinoma with basaloid features is a rare and aggressive type of squamous cell carcinoma. To our knowledge, this is the first case report of bilateral parotid basaloid squamous cell carcinoma. PMID:28333602

  9. The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery.

    PubMed

    Lu, I-Cheng; Chang, Pi-Ying; Su, Miao-Pei; Chen, Po-Nien; Chen, Hsiu-Ya; Chiang, Feng-Yu; Wu, Che-Wei

    2017-08-01

    The use of neuromuscular blocking agent (NMBA) during anesthesia may interfere with facial nerve monitoring (FNM) during parotid surgery. Sugammadex has been reported to be an effective and safe reversal of rocuronium-induced neuromuscular block (NMB) during surgery. This study investigated the feasibility and clinical effectiveness of sugammadex for NMB reversal during FNM in Parotid surgery. Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25) and sugammadex group (Group S, n = 25). Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%). In group S, rapid reverse of NMB was found and the twitch (%) recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery. Copyright © 2017. Published by Elsevier Taiwan.

  10. Giant cell-rich osteosarcoma of the parotid gland: An exceptionally rare entity at an unusual site.

    PubMed

    Huang, Eric C; Ghazikhanian, Varand; Qian, Xiaohua

    2016-12-01

    Giant cell-rich osteosarcoma is a rare histologic variant of conventional osteosarcoma that affects mainly the extremities. Extraskeletal giant cell-rich osteosarcoma is therefore exceedingly rare. Here, we report the first case of this uncommon tumor involving the parotid gland in a 62-year-old male who presented with initial right jaw swelling. Radiologic work-up revealed a 6.2 cm mass involving the right parotid gland. Fine-needle aspiration cytology showed numerous multinucleated giant cells in a background of dyshesive epithelioid cells and rare clusters of spindle stromal cells, suspicious for malignancy. The subsequent excisional biopsy showed histopathologic features diagnostic for giant cell-rich osteosarcoma. Diagn. Cytopathol. 2016;44:1107-1111. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. 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.

  12. 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

  13. Comparison of two different IMRT planning techniques in the treatment of nasopharyngeal carcinoma. Effect on parotid gland radiation doses.

    PubMed

    Uzel, E K; Karaçam, S; Eliçin, O; Uzel, O

    2013-07-01

    To compare the effect of two different intensity-modulated radiation therapy (IMRT) planning techniques on parotid gland doses in patients with nasopharyngeal carcinoma (NPC). Radiotherapy for 10 NPC patients referred to the University of Istanbul Cerrahpasa Medical School was planned with arc- and static seven-field IMRT. The simultaneous integrated boost (SIB) technique was used to deliver 70 Gy (2.12 Gy per fraction) to the primary tumor and involved nodes; 60 Gy (1.81 Gy per fraction) to the entire nasopharynx and 54 Gy (1.63 Gy per fraction) to elective lymph nodes in 33 fractions. Plans also aimed to keep the mean parotid dose below 26 Gy and limit the maximum doses to the spinal cord and brain stem to 45 and 54 Gy, respectively. Mean parotid gland doses for the two planning techniques were compared using a paired t-test. Target coverage and dose inhomogeneity were evaluated by calculating conformity- (CI) and homogeneity index (HI) values. Target coverage and dose homogeneity were identical and good for both planning techniques: CI = 1.05 ± 0.08 and 1.05 ± 0.08; HI = 1.08 ± 0.02 and 1.07 ± 0.01 for arc- and static field IMRT, respectively. Mean doses to contralateral parotid glands were 25.73 ± 4.27 and 27.73 ± 3.5 Gy(p = 0.008) for arc- and static field IMRT plans, respectively, whereas mean ipsilateral parotid doses were 30.65 ± 6.25 and 32.55 ± 5.93 Gy (non-significant p-value), respectively. Mean monitor units (MU) per fraction for the 10 patients were considerably lower for arc- than for static field treatments-540.5 ± 130.39 versus 1288.4 ± 197.28 (p < 0.001). Normal tissues--particularly the parotid glands--are better spared with the arc technique in patients with NPC. MU and treatment times are considerably reduced in arc IMRT plans.

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

    PubMed Central

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

    2015-01-01

    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 automated

  15. 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

  16. Mucoepidermoid carcinoma-associated expression of MUC5AC, MUC5B and mucin-type carbohydrate antigen sialyl-Tn in the parotid gland.

    PubMed

    Matse, Johannes H; Bharos, Wiresh K; Veerman, Enno C I; Bloemena, Elisabeth; Bolscher, Jan G M

    2017-10-01

    The aberrant expression of mucins and mucin-type carbohydrates has been described in many types of cancer, including mucoepidermoid carcinoma (MEC), a malignant salivary gland tumor. In this study, we examined the aberrant expression patterns of mucins (MUC1, MUC4, MUC5AC and MUC5B), simple mucin-type carbohydrate antigens (Tn, sialyl-Tn and T) and mature carbohydrate antigens (Lewis(a) and sulfo-Lewis(a) antigens) in MEC originating from the parotid gland, which normally does not secrete mucins. We conducted an immunohistochemical study to investigate the presence of mucins and carbohydrates in 24 MEC samples originating from the parotid gland and in surrounding normal tissue of the same gland in comparison 6 samples of normal salivary glands. The expression levels were compared with respect to the histological grading. Furthermore, 24 MEC samples from non-parotid salivary glands were included. We observed loss of topology of membrane-bound MUC1 and MUC4, and de novo expression of MUC5AC, MUC5B and sialyl-Tn in MEC that originated in the parotid gland. Furthermore, mucins MUC1, MUC4 and carbohydrate antigens Tn, sialyl-Tn, T, Lewis(a) and sulfo-Lewis(a) were overexpressed in MEC samples compared to surrounding normal salivary gland tissues. MUC1 was expressed in both low- and high grade MECs, whereas MUC4 was not expressed in high grade MECs of the parotid gland. During the development of MEC in the parotid gland, the genes for gel-forming secretory mucins are switched on. Besides these MEC tissues overexpress short oligosaccharides, suggesting that the glycosylation machinery is altered. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Ultrasonography of major salivary glands compared with parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren's syndrome.

    PubMed

    Mossel, Esther; Delli, Konstantina; van Nimwegen, Jolien F; Stel, Alja J; Kroese, Frans G M; Spijkervet, Fred K L; Vissink, Arjan; Arends, Suzanne; Bootsma, Hendrika

    2017-07-28

    To assess the validity of ultrasound of major salivary glands (sUS) compared with parotid and labial gland biopsies, sialometry, anti-SSA/Ro antibody status and classification criteria in patients clinically suspected with primary Sjögren's syndrome (pSS). 103 consecutive outpatients with clinically suspected pSS underwent sUS. Parenchymal echogenicity, homogeneity, hypoechogenic areas, hyperechogenic reflections and clearness of salivary gland border were scored according to the Hocevar scoring system. Total ultrasound score was calculated as the sum of these domains (range 0-48). Absolute agreement between sUS and parotid (83%) and labial (79%) gland biopsy outcome was good. Negative sUS predicts negative parotid gland biopsy, and positive sUS predicts positive labial gland biopsy. Compared with the American European Consensus Group (AECG) classification, sUS showed an absolute agreement of 82%, sensitivity of 71% and specificity of 92%. Compared with the American College of Rheumatology (ACR) classification, absolute agreement was 86%, sensitivity was 77% and specificity was 92%. Compared with the ACR-European League Against Rheumatism (EULAR) classification, absolute agreement was 80%, sensitivity was 67% and specificity was 94%. Positive sUS predicts classification, but negative sUS does not exclude classification. The combination of positive sUS with presence of anti-SSA/Ro antibodies or negative sUS with absence of anti-SSA/Ro antibodies showed a high predictive value for classification as pSS or non-pSS. In our prospective inception cohort study derived from daily clinical practice, absolute agreement between sUS and salivary gland biopsies was slightly higher for parotid compared with labial gland biopsies. The combination of positive sUS and presence of anti-SSA/Ro antibodies highly predicts classification according to the AECG, ACR and ACR-EULAR classification criteria. © Article author(s) (or their employer(s) unless otherwise stated in the text of

  18. Antioxidant profile, carbonyl and lipid oxidation markers in the parotid and submandibular glands of rats in different periods of streptozotocin induced diabetes.

    PubMed

    Zalewska, Anna; Knaś, Małgorzata; Maciejczyk, Mateusz; Waszkiewicz, Napoleon; Klimiuk, Anna; Choromańska, Magdalena; Matczuk, Jan; Waszkiel, Danuta; Car, Halina

    2015-09-01

    The aim of this study was to estimate the antioxidants barrier, and the oxidative stress in the salivary glands of rats in different periods of streptozotocin induced diabetes. Rats were divided in: 4 control (C2/4/10/14) and 4 experimental (DM2/4/10/14) groups. Salivary glands were removed 2/4/10/14 weeks after streptozotocin injection. Peroxidase (Px), uric acid (UA), total antioxidant status (TAS), superoxide dismutases (SODs), catalase (CAT), malonylodialdehyde (MDA), advanced glycation end products (AGE) concentrations were examined. TAS, Px were lower in the parotid diabetic glands throughout the whole experiment. TAS in the submandibular diabetic glands was lower in 2nd and 4th and higher in 14th week. Px in the submandibular diabetic glands was reduced in 4th and increased in 14th week. UA was lower in parotid, elevated in submandibular diabetic glands in 4th, 10th, 14th weeks. In the submandibular as compared to parotid glands an increase in TAS and UA was observed in 10th and 14th, Px in 14th week. In all periods, a significant increase in AGE was observed in both diabetic salivary glands. An increase in MDA was observed in the parotid diabetic glands in the 4th, 10th, 14th of the study. In the submandibular glands this increase was observed in the 2nd, 4th, 10th week, in the 14th week, the MDA level was significantly reduced in comparison to the control. The antioxidants of parotid glands are deficient throughout the whole experiment. In the last period submandibular glands copy with free radicals, becoming the main antioxidant's source. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. 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

  20. 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.

  1. A longitudinal evaluation of early anatomical changes of parotid gland in intensity modulated radiotherapy of nasopharyngeal carcinoma patients with parapharyngeal space involvement.

    PubMed

    Zhang, Yingting; Lin, Chengguang; Wu, Jianhua; Jiang, Xiaobo; Lee, Shara W Y; Tam, Shing-Yau; Wu, Vincent W C

    2017-09-01

    Radiotherapy of nasopharyngeal carcinoma patients with parapharyngeal space (PPS) involvement may deliver high dose to the parotid gland. This study evaluated parotid gland changes during and up to 3 months after radiotherapy. Kilovoltage computed tomography (CT) scans of head and neck region of 39 nasopharyngeal carcinoma patients with PPS involvement were performed at pre-radiotherapy, 10th, 20th and 30th fractions and 3 months after treatment. The parotid glands were contoured in pre-radiotherapy planning CT scan and in subsequent scans. Dice similarity coefficient (DSC), percentage volume change and centroid movement between the planning CT and the subsequent CTs were obtained from the contouring software. In addition, the distance between medial and lateral borders of parotid glands from the mid-line at various time intervals were also measured. The ipsilateral parotid gland received a mean dose of about 5 Gy higher than the contralateral side. The mean DSC and parotid volume decreased by more than 30% at 20th fraction and reached the minimum at 30th fraction. Partial recovery was observed at 3 months after treatment. The centroid displacement followed a similar pattern, which moved medially and superiorly by an average of 0.30 cm and 0.18 cm, respectively, at 30th fraction. The changes in ipsilateral gland were slightly greater than the contralateral side. Substantial volume change and medial movement of parotid gland were observed with slightly greater magnitude in the ipsilateral side. Adaptive radiotherapy was suggested at around 15th to 20th fraction so as to optimise the original dose distribution of the plan. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  2. Lipoma of the cheek presenting with recurrent sialadenitis of the right parotid gland: a case report.

    PubMed

    Tom, Osundwa; Tom, Ochola

    2016-11-03

    Lipomas are benign neoplasms arising from adipose tissue. Oral lipomas have been reported in the buccal mucosa, tongue, floor of the mouth and lips; however, the case of a lipoma occurring as an antecedent lesion to recurrent sialadenitis is hitherto unreported in the English literature. We report the case of an intraoral lipoma occurring with signs and symptoms of recurrent sialadenitis in a 15-year-old Kenyan girl of Kikuyu descent. The lipoma was antecedent leading to partial obstruction and stasis related to the right Stensen's duct culminating in recurrent sialadenitis of the ipsilateral parotid gland. Due to the slow growth, softness, diffuse nature and lack of pain, lipomas may exist below the diagnostic radar, hence, the need to have a high index of suspicion and utilize diagnostic aids as necessary. In this case magnetic resonance imaging was key in establishing the existence of the lipoma. The lipoma was excised with resolution of the recurrent sialadenitis. The purpose of this report is to present the diagnostic challenge emanating from the pressure effects of an intraoral soft tissue lipoma masquerading as recurrent sialadenitis with a view to improving on patient care through sensitization.

  3. 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

  4. A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland

    PubMed Central

    Casale, Manuele; Capuano, Francesco; Sabatino, Lorenzo; Pace, Annalisa; Oliveto, Giuseppe; Vella, Paola; Moffa, Antonio; Salvinelli, Fabrizio

    2016-01-01

    The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with “Warthin tumor.” We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications. PMID:28228953

  5. Sodium tungstate on some biochemical parameters of the parotid salivary gland of streptozotocin-induced diabetic rats: a short-term study.

    PubMed

    Leite, Mariana Ferreira; Nicolau, José

    2009-02-01

    Several studies have shown the antidiabetic properties of sodium tungstate. In this study, we evaluated some biochemical parameters of the parotid salivary gland of streptozotocin-induced diabetic rats treated with sodium tungstate solution (2 mg/ml). The studied groups were: untreated control (UC), treated control (TC), untreated diabetic (UD), and treated diabetic (TD). After 2 and 6 weeks of treatment, parotid gland was removed and total protein and sialic acid (free and total) concentration and amylase and peroxidase activities were determined. Data were compared by variance analysis and Tukey test (p < 0.05). The sodium tungstate treatment modestly decreased the glycemia of streptozotocin-induced diabetic rats. At week 2 of the study, parotid gland of diabetic rats presented a reduction of total protein concentration (55%) and an increase of amylase (120%) and peroxidase (160%) activities, free (150%) and total (170%) sialic acid concentration. No alteration in the evaluated parameters at week 6 of the study was observed. Sodium tungstate presented no significant effect in parotid gland. Our results suggest that diabetes causes initial modification in biochemical composition of parotid. However, this gland showed a recovery capacity after 6 week of the experimental time. Sodium tungstate has no effect in peripheral tissues, such as salivary glands.

  6. Comparison of Complications in Parotid Surgery With Harmonic Scalpel Versus Cold Instruments.

    PubMed

    Yang, Xiaoyong; Yu, Yang; Li, Dapeng; Dong, Li

    2017-02-22

    Complications following parotid surgery with harmonic scalpel versus cold instruments were seldom discussed. The authors retrospectively analyzed the medical record of 94 patients who received parotid surgery at Tianjin National Clinical Research Center for Cancer between January 2012 and October 2015, and compared the complications in patients operated with either Harmonic FCS9 (HF) or traditional cold instruments (CI). The mean operative time was 65.1 minutes in HF group versus 88.9 minutes for CI group. Intraoperative blood loss was 35 mL in HF group versus 55 mL in CI group. The mean drainage time was 3.7 days in HF group compared with 4.9 days in CI group. The mean total drainage volume was 62 mL in HF group versus 89 mL in CI group. The occurrence of Frey syndrome showed no difference in these 2 groups. Thus, the use of the HF in the surgical treatment of parotid disease is safe and confers advantages over conventional methods of parotid dissection.

  7. Temporal bone osteoradionecrosis after surgery and radiotherapy for malignant parotid tumors.

    PubMed

    Leonetti, John P; Marzo, Sam J; Zender, Chad A; Porter, Ryan G; Melian, Edward

    2010-06-01

    To assess the incidence of osteoradionecrosis (ORN) of the temporal bone after surgery with radiotherapy for malignant parotid tumors. A tertiary care, academic medical center. All patients who underwent surgical resection with postoperative radiotherapy (RT) for a malignant parotid tumor between July 1988 and July 2007. A retrospective chart analysis to determine the extent of surgery, the RT parameters, and the incidence of ORN of the temporal bone. The incidence of ORN in 3 subgroups of patients. The 221 patients with malignant parotid tumors who underwent surgical resection with postoperative RT were divided into groups 1, parotidectomy only; 2, parotidectomy with mastoidectomy; and 3, parotidectomy with subtotal petrosectomy. The overall incidence of temporal bone ORN in group 1 was 2 (2%) of 106; in group 2, 8 (13%) of 64; and in group 3, 0 (0%) of 51. The incidence of temporal bone ORN is higher after mastoidectomy for facial nerve identification or resection in patients undergoing parotidectomy with postoperative radiotherapy. Oversew of the ear canal with mastoid obliteration should be considered in this subgroup of patients to avoid this long-term complication of radiotherapy used in the treatment of malignant parotid tumors.

  8. Dosimetric consequences of the parotid glands using CT-to-CBCT deformable registration during IMRT for late stage head and neck cancers

    NASA Astrophysics Data System (ADS)

    Conill, Annette L.

    Patients receiving Intensity Modulated Radiation Therapy (IMRT) for late stage head and neck (HN) cancer often experience anatomical changes due to weight loss, tumor regression, and positional changes of normal anatomy (1). As a result, the actual dose delivered may vary from the original treatment plan. The purpose of this study was (a) to evaluate the dosimetric consequences of the parotid glands during the course of treatment, and (b) to determine if there would be an optimal timeframe for replanning. Nineteen locally advanced HN cancer patients underwent definitive IMRT. Each patient received an initial computerized tomography simulation (CT-SIM) scan and weekly cone beam computerized tomography (CBCT) scans. A Deformable Image Registration (DIR) was performed between the CT-SIM and CBCT of the parotid glands and Planning Target Volumes (PTVs) using the Eclipse treatment planning system (TPS) and the Velocity deformation software. A recalculation of the dose was performed on the weekly CBCTs using the original monitor units. The parameters for evaluation of our method were: the changes in volume of the PTVs and parotid glands, the dose coverage of the PTVs, the lateral displacement in the Center of Mass (COM), the mean dose, and Normal Tissue Complication Probability (NTCP) of the parotid glands. The studies showed a reduction of the volume in the PTVs and parotids, a medial displacement in COM, and alterations of the mean dose to the parotid glands as compared to the initial plans. Differences were observed for the dose volume coverage of the PTVs and NTCP of the parotid gland values between the initial plan and our proposed method utilizing deformable registration-based dose calculations.

  9. 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

  10. 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.

  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. Copyright © 2016 Elsevier GmbH. All rights reserved.

  12. Effects of regions of interest methods on apparent coefficient measurement of the parotid gland in early Sjögren's syndrome at 3T MRI.

    PubMed

    Xu, Xiaoquan; Su, Guoyi; Hu, Hao; Wang, Yanyan; Hong, Xunning; Shi, Haibin; Wu, Feiyun

    2017-01-01

    The apparent diffusion coefficient (ADC) has been used to assess parotid gland abnormalities in Sjögren's syndrome (SS) patients; however, few data exist on the influence of region of interest (ROI) methods on ADC measurements. To assess the influence of ROI methods on ADC measurement, and their diagnostic ability in detecting parotid gland abnormalities in early SS patients. Thirteen early SS patients underwent parotid gland diffusion-weighted imaging scans at a 3.0 T MR unit. Two readers independently measured the parotid gland ADC value using three different ROIs (whole-gland [WG], single-slice [SS], and reader-based circular [RBC]). The ADC value based on three different ROIs (ADC-ROIWG, ADC-ROISS, ADC-ROIRBC) were compared between the SS group and a matched healthy control (HC) group (n = 19). Receiver operating characteristic (ROC) curves and intra-class correlation coefficients (ICC) were used to determine the diagnostic ability and reproducibility of the parameters. The ADC-ROIWG, ADC-ROISS, and ADC-ROIRBC in the SS group were all significantly higher than those in HC group (all P < 0.05). The ADC-ROIWG showed better diagnostic ability than did ADC-ROIRBC (P = 0.0200), while no significant difference was found between ADC-ROIWG and ADC-ROISS (P = 0.4636). The ROIWG method showed the best inter- and intra-reader agreement (ICC, 0.902 and 0.928, respectively), followed by ROISS and ROIRBC. The ROI methods can influence the parotid gland ADC measurements and their diagnostic ability. Considering our results, we suggest using in clinical practice single-slice ROIs to measure the ADC of the parotid gland. © The Foundation Acta Radiologica 2016.

  13. An invasive adenocarcinoma of the accessory parotid gland: a rare example developing from a low-grade cribriform cystadenocarcinoma?

    PubMed

    Nakatsuka, Shin-ichi; Harada, Hiroshi; Fujiyama, Hiroshi; Takeda, Koji; Kitamura, Koji; Kimura, Hayato; Nagano, Teruaki; Ito, Mahito; Asada, Yuji

    2011-12-07

    Low-grade cribriform cystadenocarcinoma (LGCCA) is a rare tumor of the salivary gland that exhibits clinically indolent behavior. In this paper, we present a case of invasive adenocarcinoma of the accessory parotid gland in a young male that exhibited histology suggestive of an association of LGCCA. A 27-year-old man presented with a subcutaneous tumor in his left cheek. The tumor was separated from the parotid gland and located on the masseter muscle. The tumor was resected, and the postoperative histological diagnosis was adenocarcinoma, not otherwise specified (ANOS). The tumor exhibited papillary-cystic and cribriform proliferation of the duct epithelium and obvious stromal infiltration. Some tumor nests were rimmed by myoepithelium positive for smooth muscle actin, p63, and cytokeratin 14, indicating the presence of intraductal components of the tumor. Tumor cells exhibited mild nuclear atypia, and some of them presented an apocrine-like appearance and had cytoplasmic PAS-positive/diastase-resistant granules and hemosiderin. Other cells had foamy cytoplasm with microvacuoles. Immunohistochemistry revealed that the almost all of the tumor cells were strongly positive for S-100. These histological findings suggest the possibility that ANOS might arise secondarily from LGCCA. This is an interesting case regarding the association between ANOS and LGCCA in oncogenesis. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1226764594634693.

  14. Radiopharmacokinetics of radioiodine in the parotid glands after the administration of lemon juice.

    PubMed

    Van Nostrand, Douglas; Bandaru, Varalakshmi; Chennupati, Shyam; Wexler, Jason; Kulkarni, Kanchan; Atkins, Frank; Mete, Mihriye; Gadwale, Gurudev

    2010-10-01

    The ability of sialagogues to increase or decrease radiation induced-sialoadenitis and/or xerostomia after therapeutic administration of ¹³¹I is controversial. To evaluate this we measured the radiopharmacokinetics of ¹²³I in the parotid glands (PGs) after its administration of lemon juice (LJ). A retrospective review was performed on all patients who had a salivary gland scan performed before ¹³¹I therapy between July 2008 and April 2009 at the Washington Hospital Center. Two hours after ¹²³I was given orally, dynamic scintigraphy was initiated. Five milliliters of LJ was given 5 minutes later. Then, the patient was imaged for 1 hour (phase 1) at which point the sequence was repeated (phase 2). Twenty-three patients were studied. For each PG, the presence or absence of uptake was assessed, and based on background corrected counts, the mean, range, and standard deviation were determined for multiple radiopharmacokinetic parameters such as (i) percent radioiodine washout, (ii) time from LJ administration to re-accumulation of radioiodine to pre-LJ activity, and (iii) percent reduction in radiation absorbed dose to the PGs if LJ had been re-administered at the time the radioiodine activity re-accumulated to the pre-LJ activity. The mean  ± one standard deviation and range for percent washout were 84%  ± 18% (35%-100%) and 83%  ±  21% (37%-100%) in phase 1 and 2, respectively. The times from LJ to re-accumulation of the radioiodine to the pre-LJ activity were 21  ± 10 minutes (4-45 minutes) and 40  ± 14 minutes (12-62 minutes) for phase 1 and 2, respectively. The estimated percent reduction in radiation absorbed dose to the PGs following the first and second administration of LJ was 37%  ± 14% (13%-93%) and 47% ± 16% (21%-97%), respectively. The washout of radioiodine from the PGs is rapid but transient. Early repeat administration may result in continued and cumulative reduction of radiation absorbed dose in the PGs.

  15. 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

  16. Stationary facial nerve paresis after surgery for recurrent parotid pleomorphic adenoma: a follow-up study of 219 cases in Denmark in the period 1985-2012.

    PubMed

    Nøhr, Anders; Andreasen, Simon; Therkildsen, Marianne Hamilton; Homøe, Preben

    2016-10-01

    The purpose was to assess degree of permanent facial nerve dysfunction after surgery for recurrent pleomorphic adenoma (RPA) of the parotid gland, including variables that might influence re-operation outcomes. Nationwide retrospective longitudinal cohort study including a questionnaire survey of patients undergoing surgery for RPA. Of 219 living patients, 198 (92 %) responded and 127 (63 %) reported no facial dysfunction. Statistically significant associations were found between number of surgeries and permanent facial nerve dysfunction of all degrees (OR 1.43, 95 % CI 1.16-1.78, p = 0.001). A not significant tendency for females to be associated with worse outcome was found (p = 0.073). Risks of different degrees of paresis after the second-fourth surgeries were found (OR 1.86-2.19, p < 0.05). Our study demonstrates a significant correlation between number of surgeries for RPA of the parotid and severity of facial nerve paresis. This is important when informing and planning treatment of these patients.

  17. 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

  18. Germinal centres in diagnostic labial gland biopsies of patients with primary Sjögren's syndrome are not predictive for parotid MALT lymphoma development.

    PubMed

    Haacke, Erlin A; van der Vegt, Bert; Vissink, Arjan; Spijkervet, Fred K L; Bootsma, Hendrika; Kroese, Frans G M

    2017-10-01

    Patients with primary Sjögren's syndrome (pSS) have an increased risk of developing non-Hodgkin's lymphoma (NHL), particularly parotid gland mucosa-associated lymphoid tissue (MALT) lymphomas. Presence of germinal centres (GCs) in labial gland biopsies has been suggested as predictive factor for NHL. We assessed whether presence of GCs is increased in labial gland biopsies from patients with pSS who developed parotid MALT lymphoma, the dominant NHL-subtype in pSS, compared with patients with pSS who did not develop lymphoma. Eleven labial gland biopsies from patients with pSS that were taken prior to parotid MALT lymphoma development were compared with biopsies of 22 matched pSS controls (1:2) who did not develop lymphoma. Biopsies were evaluated for GCs (H&E and Bcl6). Labial gland biopsies of pSS MALT lymphoma patients, revealed GCs in 2/11 (18%) H&E sections and 3/11 (27%) Bcl6 stained sections. In controls, GCs were present in 4/22 (18%) of H&E sections and 5/22 (23%) of Bcl6 stained sections. Presence of GCs in labial gland biopsies does not differ between patients with pSS that develop parotid MALT lymphoma and patients with pSS who do not develop lymphoma. The presence of GCs in labial gland biopsies is therefore not a predictive factor for pSS-associated parotid MALT lymphomas. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Association rare d'un adenome pleomorphe et d'un carcinome epithelial myoepithelial de la glande parotide

    PubMed Central

    Jahidi, Ali; Hemmaoui, Bouchaib; Noureddine, Errami; Youssef, Darouassi; Issam, Rharrasi; Hafsa, Chahdi; Benariba, Fouad

    2014-01-01

    Le Carcinome épithélial - myoépithélial (CEM) est une tumeur maligne rare des glandes salivaires touchant principalement la glande parotide. Son association avec un adénome pléomorphe est exceptionnelle. Nous rapportons le cas d'une femme de 57 ans avec adénome pléomorphe de la glande parotide évoluant depuis plusieurs années. L'augmentation récente du volume de la glande associée à l'apparition d'adénopathies cervicales homolatérales nous a fait penser à une transformation maligne. L'examen histologique final après parotidectomie totale a montré une association inattendue d'un adénome pléomorphe et un CEM. Le CEM est une tumeur maligne de bas grade. Elle peut survenir de novo ou sur un adénome pléomorphe. La transformation maligne de l'adénome est suspectée devant l'augmentation rapide du volume de l'adénome avec apparition d'adénopathies cervicales. Toutefois, ces modifications cliniques peuvent annoncer l'apparition d'une tumeur distincte. Malgré sa tendance à la récidive locale et un faible potentiel métastatique, de rares cas de CEM peuvent avoir un comportement agressif et des métastases à distance. Le traitement consiste principalement en une résection chirurgicale complète si possible suivie d'une radiothérapie dans le but de prévenir la récidive locale. PMID:25368716

  20. Evaluation of a rapamycin-regulated serotype 2 adeno-associated viral vector in macaque parotid glands

    PubMed Central

    Zheng, Changyu; Voutetakis, Antonis; Metzger, Mark; Wainer, Sandra; Cotrim, Ana P.; Eckhaus, Michael A.; Rivera, Victor M.; Clackson, Tim; Chiorini, John A.; Donahue, Robert E.; Dunbar, Cynthia E.; Baum, Bruce J.

    2009-01-01

    OBJECTIVES Salivary glands are useful target organs for local and systemic gene therapeutics. For such applications, the regulation of transgene expression is important. Previous studies by us in murine submandibular glands showed that a rapamycin transcriptional regulation system in a single serotype 2, adeno-associated viral (AAV2) vector was effective for this purpose. The present study evaluated if such a vector was similarly useful in rhesus macaque parotid glands. METHODS A recombinant AAV2 vector (AAV-TF-RhEpo-2.3w), encoding rhesus erythropoietin (RhEpo) and a rapamycin-inducible promoter, was constructed. The vector was administered to macaques at either of two doses (1.5×1011 [low dose] or 1.5×1012 [high dose] vector genomes) via cannulation of Stensen’s duct. Animals were followed for 12–14 weeks and treated at intervals with rapamycin (0.1 or 0.5 mg/kg) to induce gene expression. Serum chemistry, hematology and RhEpo levels were measured at interval. RESULTS AAV-TF-RhEpo-2.3w administration led to low levels of rapamycin-inducible RhEpo expression in the serum of most macaques. In five animals no significant changes were seen in serum chemistry and hematology values over the study. One macaque, however, developed pneumonia, became anemic and subsequently required euthanasia. After the onset of anemia, a single administration of rapamycin led to significant RhEpo production in this animal. CONCLUSION Administration of AAV-TF-RhEpo-2.3w to macaque parotid glands was generally safe, but led only to low levels of serum RhEpo in healthy animals following rapamycin treatment. PMID:20374510

  1. Aspiration biopsy of mammary analogue secretory carcinoma of accessory parotid gland: another diagnostic dilemma in matrix-containing tumors of the salivary glands.

    PubMed

    Levine, Pascale; Fried, Karen; Krevitt, Lane D; Wang, Beverly; Wenig, Bruce M

    2014-01-01

    Mammary analogue secretory carcinoma (MASC) is a newly described rare salivary gland tumor, which shares morphologic features with acinic cell carcinoma, low-grade cystadenocarcinoma, and secretory carcinoma of the breast. This is the first reported case of MASC of an accessory parotid gland detected by aspiration biopsy with radiologic and histologic correlation in a 34-year-old patient. Sonographically-guided aspiration biopsy showed cytologic features mimicking those of low-grade mucoepidermoid carcinoma, including sheets of bland epithelial cells, dissociated histiocytoid cells with intracytoplasmic mucinous material, and spindle cells lying in a web-like matrix. Histologic sections showed a circumscribed tumor with microcystic spaces lined by bland uniform epithelial cells and containing secretory material. The tumor cells expressed mammaglobin and BRST-2. The cytologic features, differential diagnosis, and pitfalls are discussed. The pathologic stage was pT1N0. The patient showed no evidence of disease at 1 year follow-up.

  2. [Surgery of the parathyroid gland].

    PubMed

    Fukunari, Nobuhiro

    2012-11-01

    The introduction of various techniques for minimally invasive parathyroidectomy (MIP) has changed both the conceptual and surgical approach to parathyroid disease. The perceived advantages of minimally invasive surgery among both clinicians and patients have been a major factor in the development of new surgical techniques, as well as refinement of preoperative localization techniques such as high-sensitive ultrasound and technetium sestamibi scanning. MIP for primary hyperparathyroidism has become an accepted part of endocrine surgical practice worldwide. In recent years, medical management of hyperparathyroidism has been made possible with the use of therapeutics specifically aimed at the calcium-sensing receptor, a cell-surface protein widely viewed as the primary regulator of parathyroid hormone secretion. The calcimimetic agent cinacalcet is approved for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis and for the treatment of hypercalcemia in patients with parathyroid carcinoma. Cinacalcet is also expected to be useful in the treatment of intractable hypercalcemia in patients with primary hyperparathyroidism for whom parathyroidectomy is indicated but surgery is clinically inappropriate or contraindicated.

  3. Effect of mobile phone use on salivary concentrations of protein, amylase, lipase, immunoglobulin A, lysozyme, lactoferrin, peroxidase and C-reactive protein of the parotid gland.

    PubMed

    Hashemipour, M S; Yarbakht, M; Gholamhosseinian, A; Famori, H

    2014-05-01

    The possibility of side effects associated with the electromagnetic waves emitted from mobile phones is a controversial issue. The present study aimed to evaluate the effect of mobile phone use on parotid gland salivary concentrations of protein, amylase, lipase, immunoglobulin A, lysozyme, lactoferrin, peroxidase and C-reactive protein. Stimulated salivary samples were collected simultaneously from both parotid glands of 86 healthy volunteers. Salivary flow rate and salivary concentrations of proteins, amylase, lipase, lysozyme, lactoferrin, peroxidase, C-reactive protein and immunoglobulin A, were measured. Data were analysed using t-tests and one-way analyses of variance. Salivary flow rate and parotid gland salivary concentrations of protein were significantly higher on the right side compared to the left in those that predominantly held mobile phones on the right side. In addition, there was a decrease in concentrations of amylase, lipase, lysozyme, lactoferrin and peroxidase. The side of dominant mobile phone use was associated with differences in salivary flow rate and parotid gland salivary concentrations, in right-dominant users. Although mobile phone use influenced salivary composition, the relationship was not significant.

  4. 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.

  5. [Possible relation between viruses and oromaxillofacial tumors. IV. Presence of the herpes antigen and anti-herpes antibodies in patients with tumors of the parotid gland].

    PubMed

    Stoian, M; Suru, M; Zaharia, O; Constantinescu, E; Goldstein, I; Nastac, E

    1987-01-01

    The presence of herpesvirus antigen and of antiherpesvirus antibodies was detected in 46% and in 36.3%, respectively, of the patients bearing parotid gland tumors. Very high titers of antiherpesvirus antibodies were found in 70.6% of the patients with nasopharyngeal carcinoma.

  6. Perineural Spread of Mucoepidermoid Carcinoma of Parotid Gland Involving V, VI, and VII Cranial Nerves Demonstrated on Positron Emission Tomography/Computed Tomography.

    PubMed

    Chandra, Piyush; Nath, Satish

    2017-01-01

    Perineural spread (PNS) in head and neck malignancies has been associated with extremely poor prognosis. Through this interesting case, we demonstrate the PNS of a mucoepidermoid carcinoma of parotid gland with simultaneous involvement of V, VI, and VII cranial nerves identified on positron emission tomography/computed tomography.

  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. 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. PMID:27756995

  9. Cytological diagnosis of deep-seated cellular hemangioma of the parotid gland by using cell button technique.

    PubMed

    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. Epithelial-mesenchymal transdifferentiation and extracellular matrix gene expression in pleomorphic adenomas of the parotid salivary gland.

    PubMed

    Aigner, T; Neureiter, D; Völker, U; Belke, J; Kirchner, T

    1998-10-01

    Mesenchymal and epithelial cell differentiation are assumed to be dichotomic primary events in embryonic development. In this study, pleomorphic adenomas of the parotid gland were analysed as a model which shows morphological features of both epithelial and mesenchymal tissue types. Using matrix gene expression profiles as a supplementary criterion for the identification of cellular phenotypes, areas with unequivocal epithelial and mesenchymal differentiation could be demonstrated. Many areas displayed a transitional phenotype with cells showing both epithelial and mesenchymal features. The data provide evidence that epithelial-mesenchymal transitions represent the basic principle of the tisuse heterogeneity in pleomorphic adenomas. Thus, pleomorphic adenomas demonstrate the potential of adult (neoplastic) epithelial cells to transdifferentiate into mesenchymal cells in vivo.

  11. 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

  12. 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

  13. Does lemon juice increase radioiodine reaccumulation within the parotid glands more than if lemon juice is not administered?

    PubMed

    Kulkarni, Kanchan; Van Nostrand, Douglas; Atkins, Francis; Mete, Mihriye; Wexler, Jason; Wartofsky, Leonard

    2014-02-01

    The protective effect of sialagogues following I therapy became controversial after a study proposed that sialagogues increase the reaccumulation of I in the parotid glands (PGs) to a level higher than when sialagogues are not administered ('rebound effect'). The present study examined PG radiopharmacokinetics within 2-4 h after radioiodine administration to evaluate whether sialagogues cause a 'rebound effect'. This prospective study was conducted at the Medstar Washington Hospital Center. The study patients had (i) differentiated thyroid cancer, (ii) no history of salivary gland disease or medications affecting the salivary glands, (iii) a clinical salivary scan (SS) with lemon juice (LJ) (SSwLJ) that was performed before I therapy, and (iv) a second SS performed without LJ (SSwoLJ) performed prior to I therapy after giving informed consent. Each PG was assessed for I uptake using time-activity curves (TACs) that were (i) corrected for background and decay, (ii) smoothed using a seven-point unweighted moving average, and (iii) normalized to the administered I activity. TACs of the SSwLJ and SSwoLJ were compared with activity at each time point over 120 min. Areas under the TACs for the PGs were calculated for each gland's SSwLJ and SSwoLJ, and the relative percentage change in potential radiation absorbed dose (PRAD) was calculated. A total of 2100 time points were analyzed in nine patients (18 PGs). I activity in the PGs on SSwLJ exceeded activity seen on the SSwoLJ at 134 time points (6.3%), and 98 (73%) of these were on the basis of spontaneous salivation during SSwoLJ. Mean percentage decrease in relative PRAD was 34.2±17.4% (range, 3.1-66.1%). During the time period studied, LJ administration did not result in a 'rebound effect' but resulted in mean relative decrease of 34.2% in PRAD to the PGs.

  14. [Detection of Epstein-Barr viral genome in tumor cells of Warthin's tumor of parotid gland].

    PubMed

    Wang, D; Deng, C; Tan, X; Wang, Y

    1999-05-01

    To evaluate the relations between Warthin's tumors of salivary gland and Epstein-Barr virus (EBV). 75 cases of salivary gland Warthin's tumor and 20 cases of normal salivary gland tissue were examined for to detect EBV genoma by using the polymerase chain reaction (PCR) of DNA, 62 cases of single Warthin's tumor and 13 cases of multiple/bilateral Warthin's tumor's. EBV DNA was detected in 13 cases of single Wathin's tumors, 9 cases of multiple/bilateral Warthin's tumor and 3 cases of normal salivary gland. There was a close relationship between EBV and multiple/bilateral Warthin's tumors.

  15. Influence of parasympathetic non-adrenergic, non-cholinergic mechanisms on [3H]thymidine uptake in rat parotid salivary glands in response to mastication following upon a liquid regimen.

    PubMed

    Ekström, J; Reinhold, A C

    2001-12-01

    A role for parasympathetic non-adrenergic, non-cholinergic (NANC) mechanisms in parotid gland cell hyperplasia in response to mastication was investigated. Following a liquid regimen for 1 week, aiming at glandular inactivity, rats were offered hard chow for 2 h to throw their parotid glands into secretory activity. In response to the increasing demands, [3H]thymidine incorporation into the trichloroacetic acid-insoluble material increased by 76% in normally innervated glands, while there was no increase in glands parasympathetically denervated in advance. In innervated glands of rats pretreated with atropine and alpha- and beta-adrenoceptor blockers the increase was 46%. The results suggest a potential contribution of parasympathetic NANC mechanisms to the mitotic response of the parotid gland under natural feeding conditions.

  16. 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.

  17. 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

  18. 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

  19. Extracapsular dissection of benign parotid tumors using a retroauricular hairline incision approach.

    PubMed

    Roh, Jong-Lyel

    2009-05-01

    Extracapsular dissection has emerged as a more conservative approach to parotid surgery. The parotid surgery commonly begins with a modified Blair or facelift incision. Although minor, the incision scar from these incisions is visible on the face and neck. I initially developed a retroauricular hairline incision (RAHI) for the removal of benign lesions in the upper neck with a more esthetic look. The RAHI approach also may be used for selected patients with benign parotid neoplasms. Mobile benign tumors arising in the inferior superficial part of the parotid gland may be removed by the RAHI approach without compromising surgical visualization. This surgery appears to show excellent cosmetic outcomes in addition to the benefits of extracapsular dissection, lower complication rates, and preservation of secretory function. The RAHI without a preauricular incision is a feasible technique in the surgical management of parotid tumors.

  20. 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.

  1. 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.

  2. Cystic Dilatation of the Parotid Duct of a Goat

    PubMed Central

    Slocombe, R. F.

    1980-01-01

    Cystic dilatation of the parotid duct of a goat was diagnosed by exploratory surgery and analysis of cyst contents. The cyst and its associated salivary gland were surgically removed. This case is compared with the more common salivary mucocele. ImagesFigure 1. PMID:7397617

  3. Cellular phone use and risk of benign and malignant parotid gland tumors--a nationwide case-control study.

    PubMed

    Sadetzki, Siegal; Chetrit, Angela; Jarus-Hakak, Avital; Cardis, Elisabeth; Deutch, Yonit; Duvdevani, Shay; Zultan, Ahuva; Novikov, Ilya; Freedman, Laurence; Wolf, Michael

    2008-02-15

    The objective of this nationwide study was to assess the association between cellular phone use and development of parotid gland tumors (PGTs). The methods were based on the international INTERPHONE study that aimed to evaluate possible adverse effects of cellular phone use. The study included 402 benign and 58 malignant incident cases of PGTs diagnosed in Israel at age 18 years or more, in 2001-2003, and 1,266 population individually matched controls. For the entire group, no increased risk of PGTs was observed for ever having been a regular cellular phone user (odds ratio = 0.87; p = 0.3) or for any other measure of exposure investigated. However, analysis restricted to regular users or to conditions that may yield higher levels of exposure (e.g., heavy use in rural areas) showed consistently elevated risks. For ipsilateral use, the odds ratios in the highest category of cumulative number of calls and call time without use of hands-free devices were 1.58 (95% confidence interval: 1.11, 2.24) and 1.49 (95% confidence interval: 1.05, 2.13), respectively. The risk for contralateral use was not significantly different from 1. A positive dose-response trend was found for these measurements. Based on the largest number of benign PGT patients reported to date, our results suggest an association between cellular phone use and PGTs.

  4. 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

  5. Fine needle aspiration biopsy of cystic benign lymphoepithelial lesion of the parotid gland in patients at risk for the acquired immune deficiency syndrome.

    PubMed

    Finfer, M D; Gallo, L; Perchick, A; Schinella, R A; Burstein, D E

    1990-01-01

    Cystic benign lymphoepithelial lesion (BLL), a previously rare lesion of the parotid gland consisting of marked lymphoid hyperplasia with accompanying squamous-lined cysts, has recently been described in patients with the acquired immune deficiency syndrome (AIDS) or AIDS risk factors. Thirteen fine needle aspiration (FNA) samples of parotid gland masses from patients with AIDS (one case), AIDS risk factors (five cases) or denial of AIDS risk factors (two cases) and a histopathologic diagnosis of BLL were examined. The FNA features that correlated best with the histopathologic findings were (1) a heterogeneous lymphoid population, (2) scattered single and/or clustered foamy macrophages and (3) superficial and/or anucleated squamous cells. Most aspirates showed some combination of these three components. The differential diagnostic considerations, the clinical and radiologic correlations and the relationship of this lesion to HIV infection are discussed. Patients with parotid masses whose aspirates consist of some combination of squamous cells, lymphocytes and foamy macrophages should be questioned for possible AIDS risk factors.

  6. Effects of biomaterial-derived fibroblast conditioned medium on the α-amylase expression of parotid gland acinar cells.

    PubMed

    Chou, Ya-Shuan; Young, Tai-Horng; Lou, Pei-Jen

    2015-11-01

    Salivary gland cells are surrounded by a complex stromal environment, in which fibroblasts are the main cells in proximity to the gland cells. In this study, the interaction between parotid gland acinar cells (PGACs), fibroblasts, and biomaterials was investigated. We prepared different biomaterials, including chitosan, polyvinyl alcohol (PVA), poly (ethylene-co-vinyl alcohol) (EVAL), polyvinylidene fluoride (PVDF), and tissue culture polystyrene (TCPS) to culture fibroblasts and then collect their conditioned media to culture PGACs. We observed no difference in AQP3, AQP5, and E-cadherin expression among different fibroblast conditioned medium treatments. Interestingly, α-amylase expression was obviously enhanced in PGACs cultured in the presence of conditioned medium from fibroblasts cultured on PVDF. Higher neurotrophin-4 (NT-4) expression was observed in PVDF-derived fibroblast conditioned medium using a growth factor protein array assay. In addition, directly adding NT-4 into the culture medium significantly promoted α-amylase expression by PGACs. Finally, nestin and βIII-tubulin expression by fibroblasts cultured on PVDF was also enhanced. Together, these results suggest that PVDF could promote α-amylase expression by PGACs via the NT-4 produced by fibroblasts. To date, there is no effective therapy for patients with dry mouth with persistent salivary hypofunction. The study made use of different biomaterials to culture fibroblasts and then collect their conditioned media to culture PGACs. It was found that the effect of fibroblast conditioned medium from PVDF on the α-amylase expression of PGACs was obviously enhanced and higher neurotrophin-4 (NT-4) expression was found in PVDF-derived fibroblast conditioned medium. In addition, directly adding NT-4 into the culture medium significantly promoted the expression of α-amylase by PGACs and the expression of nestin and βIII-tubulin of fibroblasts after being cultured on PVDF was enhanced. Therefore, the

  7. Isolated secretion granules from parotid glands of chronically stimulated rats possess an alkaline internal pH and inward-directed H/sup +/ pump activity

    SciTech Connect

    Arvan, P.; Castle, J.D.

    1986-10-01

    Secretion granules have been isolated from the parotid glands of rats that have been chronically stimulated with the ..beta..-adrenergic agonist, isoproterenol. These granules are of interest because they package a quantitatively different set of secretory proteins in comparison with granules from the normal gland. Polypeptides enriched in proline, glycine, and glutamine, which are known to have pI's >10, replace ..cap alpha..-amylase (pI's = 6.8) as the principal content species. The internal pH of granules from the treated rats changes from 7.8 in a potassium sulfate medium to 6.9 in a choline chloride medium. The increased pH over that of normal parotid granules (approx.6.8) appears to protect the change in composition of the secretory contents. Whereas normal mature parotide granules have practically negligible levels of H/sup +/ pumping ATPase activity, the isolated granules from isoproterenol-treated rats undergo a time-dependent internal acidification that requires the presence of ATP and is abolished by an H/sup +/ ionophore. Additionally, an inside-positive granule transmembrane potential develops after ATP addition that depends upon ATP hydrolysis. Two independent methods have been used that exclude the possibility that contaminating organelles are the source of the H/sup +/-ATPase activity. Together these data provide clear evidence for the presence of an H/sup +/ pump in the membranes of parotid granules from chronically stimulated rats. However, despite the presence of H/sup +/-pump activity, fluorescence microscopy with the weak base, acridine orange, reveals that the intragranular pH in live cells is greater than that of the cytoplasm.

  8. AAV2-mediated transfer of the human aquaporin-1 cDNA restores fluid secretion from irradiated miniature pig parotid glands

    PubMed Central

    Gao, Runtao; Yan, Xing; Zheng, Changyu; Goldsmith, Corinne M.; Afione, Sandra; Hai, Bo; Xu, Junji; Zhou, Jian; Zhang, Chunmei; Chiorini, John A.; Baum, Bruce J.; Wang, Songlin

    2010-01-01

    Previously (Shan et al, 2005), we reported that adenoviral vector-mediated transfer of the human aquaporin-1 (hAQP1) cDNA to minipig parotid glands following irradiation (IRti) transiently restored salivary flow to near normal levels. This study evaluated a serotype 2, adeno-associated viral (AAV2) vector for extended correction of IR (single dose; 20 Gy)-induced, parotid salivary hypofunction in minipigs. Sixteen weeks following IR, parotid salivary flow decreased by 85-90%. AAV2hAQP1 administration at week 17 transduced only duct cells and resulted in a dose-dependent increase in salivary flow to ∼35% of pre-IR levels (to ∼1ml/10min) after 8 weeks (peak response). Administration of a control AAV2 vector or saline, was without effect. Little change was observed in clinical chemistry and hematology values after AAV2hAQP1 delivery. Vector treated animals generated high anti-AAV2 neutralizing antibody titers by week 4 (∼1:1600) and significant elevations in salivary (∼15%), but not serum, GM-CSF levels. Following vector administration, salivary [Na+] was dramatically increased, from ∼10mM to ∼55 (at 4 weeks) and 39 mM (8 weeks). The findings demonstrate that localized delivery of AAV2hAQP1 to IR-damaged parotid glands leads to increased fluid secretion from surviving duct cells, and may be useful in providing extended relief of salivary hypofunction in previously irradiated patients. PMID:20882054

  9. Hyperglycemia simultaneously induces initial caries development and enhances spontaneous occlusal surface wear in molar teeth related to parotid gland disorder in alloxan-induced diabetic rats

    PubMed Central

    Nishimoto, Taiki; Kodama, Yasushi; Matsuura, Tetsuro; Ozaki, Kiyokazu; Taniguchi, Yoshihiko

    2016-01-01

    Diabetes and salivary gland dysfunction are major factors that induce dental caries in experimental animals, but there are no reports analyzing the association of dental caries and salivary glands in an animal model of diabetes mellitus (DM). To clarify the initial development of dental caries and preceding salivary gland disorder, we performed a histopathological analysis on teeth and salivary glands in diabetic Wistar rats 7 weeks after alloxan treatment (DM group) in comparison with nondiabetic rats (Non-DM group) and functional analysis on saliva secretion during the experimental period. Pilocarpine-induced salivary fluid secretion in diabetic rats gradually decreased with continuous hyperglycemia from immediately after alloxan treatment to the time of autopsy. Histopathologically, Oil Red O-positive lipid droplets accumulated in the acinar cells of the parotid gland. No tooth was stereoscopically defined as having dental caries in any of the rats in either group; however, the external appearance remarkably changed owing to occlusal wear in almost all molars in the DM group. The initial lesions of dental caries, appearing as micro-defects in dentin with bacterial colonization on the molar surface, were identified using histopathological analysis, and the incidence in the DM group was more than twice that in the Non-DM group. In conclusion, hyperglycemia simultaneously induces initial caries development and enhances spontaneous occlusal wear in molar teeth of Wistar rats 7 weeks after alloxan treatment. The parotid gland dysfunction caused by hyperglycemia may be mostly involved in the pathogenesis of occlusal wear as well as in dental caries in this diabetic model. PMID:28190924

  10. Improvement of anti-nutritional effect resulting from β-glucanase specific expression in the parotid gland of transgenic pigs.

    PubMed

    Guan, Li-Zeng; Cai, Jin-Shun; Zhao, Shuai; Sun, Yu-Ping; Wang, Jing-Lan; Jiang, Yong; Shu, Gang; Jiang, Qing-Yan; Wu, Zhen-Fang; Xi, Qian-Yun; Zhang, Yong-Liang

    2017-02-01

    β-Glucan is the predominant anti-nutritional factors in monogastric animal feed. Although β-glucanase supplementation in diet can help to eliminate the adverse effects, enzyme stability is substantially modified during the feed manufacturing process. To determine whether the expression of endogenous β-glucanase gene (GLU) in vivo can improve digestibility of dietary β-glucan and absorption of nutrients, we successfully produced transgenic pigs via nuclear transfer which express the GLU from Paenibacillus polymyxa CP7 in the parotid gland. In three live transgenic founders, β-glucanase activities in the saliva were 3.2, 0.07 and 0.03 U/mL, respectively, and interestingly the enzyme activities increased in the pigs from 178 days old to 789 days old. From the feed the amount of gross energy, crude protein and crude fat absorbed by the transgenic pigs was significantly higher than the non-transgenic pigs. Meanwhile the moisture content of the feces was significantly reduced in transgenic pigs compared with the non-transgenic pigs. Furthermore, in all positive G1 pigs, β-glucanase activity was detectable and the highest enzyme activity reached 3.5 U/mL in saliva. Also, crude protein digestion was significantly higher in G1 transgenic pigs than in control pigs. Taken together, our data showed that the transgenic β-glucanase exerted its biological catalytic function in vivo in the saliva, and the improved performance of the transgenic pigs could be accurately passed on to the offspring, indicating a promising alternative approach to improving nutrient availability was established to improve utilization of livestock feed through transgenic animals.

  11. Binding sites of Ulex europaeus-lectin I in human parotid gland. A light-microscopic and ultrastructural study using the immunoperoxidase technique and immunocryoultramicrotomy.

    PubMed

    Born, I A; Zimmer, K P; Schwechheimer, K; Maier, H; Möller, P

    1987-05-01

    Twenty non-neoplastic parotid glands (removed during neck dissection for regional tumours) were examined for cellular and subcellular binding sites of Ulex europaeus-lectin I (UEA-I), a lectin reported to be specific for alpha-L-fucose. For light microscopy, an extended peroxidase-antiperoxidase method was applied; for the evaluation of the subcellular localization of bound lectin, three of these glands were examined following immunocryoultramicrotomy and staining by the protein A-gold technique. In addition to the known cytoplasmic affinity of UEA-I for capillary endothelium, acinar cells bound the lectin within the cytoplasmic compartment; the number and distribution of stained acinar cells varied among individuals. Furthermore, cytomembrane-bound labelling that occurred most markedly at the luminar surface was observed in striated-duct epithelium. Using the electron microscope, protein A-gold particles were seen in zymogen granules and in Golgi cisternae of serous acinar cells; primary saliva secreted in the lumina exhibited strong labelling; serous acinar cells had binding sites on their cell membranes, striated-duct epithelium had binding sites on its surface membrane and in the vicinity of apical vesicles. Our results show that UEA-I is a useful tool for the study of the structure and functional states of the parotid gland epithelium and its associated pathological alterations.

  12. Use of a porcine dermal collagen graft (Permacol) in parotid surgery.

    PubMed

    Papadogeorgakis, Nikolaos; Petsinis, Vasilis; Christopoulos, Panagiotis; Mavrovouniotis, Nikolaos; Alexandridis, Constantinos

    2009-07-01

    Our aim was to present the results of the use of porcine dermal collagen graft (Permacol) in the prevention of Frey's syndrome and face-contouring aesthetic deformities after operations on the parotid. We treated 19 patients with parotid tumours. After resection, a Permacol sheet was applied to the perimeter of the tissue deficit so that it was fully covered, and was sutured firmly. This technique produced satisfactory aesthetic results with good facial contouring in all patients. It also protected the exposed parotid nerve plexus, and none of the patients developed Frey's syndrome. Permacol produced good results in both postoperative facial contouring and prevention of Frey's syndrome.

  13. P2Y purinoceptors mediate ATP-induced changes in intracellular calcium and amylase release in acinar cells of mouse parotid glands.

    PubMed

    Moriguchi-Mori, Kasumi; Higashio, Hironori; Isobe, Kanako; Kumagai, Miho; Sasaki, Kana; Satoh, Yoh-ichi; Kuji, Akiyoshi; Saino, Tomoyuki

    2016-01-01

    Adenosine 5'-triphosphate (ATP) can act as an extracellular signal that regulates various cellular functions. The present study aimed to determine which purinoceptors play a role in ATP-induced changes in intracellular Ca(2+) ([Ca(2+)]i) and amylase secretion in mouse parotid glands. ATP induced a steep increase in [Ca(2+)]i in acinar cells. The removal of extracellular Ca(2+) or the use of Ca(2+) channel blockers slightly inhibited this increase. Inhibition of PLCγ by U73122 and of IP3 by xestospongin C did not completely block this increase. The purinoceptor antagonists suramin and reactive blue-2 strongly inhibited the ATP-induced changes in [Ca(2+)]i. 2-MeSATP induced a strong increase in [Ca(2+)]i, while Bz-ATP induced a small [Ca(2+)]i increase, and UTP and α,β-MeATP had no effect. The potency order of ATP analogs (2-MeSATP > ATP > UTP) suggested that P2Y1 and P2Y12 play a significant role in the cellular response to ATP. RT-PCR revealed that P2X2,4,7 and P2Y1,2,10,12,14 were expressed in acinar cells. Ca(2+)-dependent exocytotic secretion of amylase was detected in parotid glands. These findings indicated that ATP activates P2Y receptors more than P2X receptors at low concentrations. Thus, P2Y receptors were found to be the main receptors involved in Ca(2+)-related cell homeostasis and amylase secretion in mouse parotid glands.

  14. 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.

  15. Evidence Suggesting that the Buccal and Zygomatic Branches of the Facial Nerve May Contain Parasympathetic Secretomotor Fibers to the Parotid Gland by Means of Communications from the Auriculotemporal Nerve.

    PubMed

    Tansatit, Tanvaa; Apinuntrum, Prawit; Phetudom, Thavorn

    2015-12-01

    The auriculotemporal nerve is one of the peripheral nerves that communicates with the facial nerve. However, the function of these communications is poorly understood. Details of how these communications form and connect with each other are still unclear. In addition, a reliable anatomical landmark for locating these communications during surgery has not been sufficiently described. Microdissection was performed on 20 lateral hemifaces of 10 soft-embalmed cadavers to investigate facial-auriculotemporal nerve communications with emphasis on determining their function. The auriculotemporal nerve was identified in the retromandibular space and traced towards its terminations. The communicating branches were followed and the anatomical relationships to surrounding structures observed. The auriculotemporal nerve is suspended above the maxillary artery in the dense retromandibular fascia behind the mandibular ramus. It forms a knot and fans out, providing multiple branches in all directions in the sagittal plane. Inferiorly, it connects the maxillary periarterial plexus, while minute branches supply the temporomandibular joint anteriorly. The larger branches mainly communicate with the branches of the temporofacial division of the facial nerve, and the auricular branches enter the fascia of the auricular cartilage posteriorly. The temporal branches and occasionally the zygomatic branches arise superiorly to distribute within the temporoparietal fascia. The auriculotemporal nerve forms the parotid retromandibular plexus through two types of communication. It sends one to three branches to join the zygomatic and buccal branches of the facial nerve at the branching area of the temporofacial division. It also communicates with the periarterial plexus of the superficial temporal and maxillary arteries. This plexus continues anteriorly along the branches of the facial nerve and the periarterial plexus of the transverse facial artery as the parotid periductal autonomic plexus

  16. Adamantinoma-like Ewing sarcoma mimicking basal cell adenocarcinoma of the parotid gland: a case report and review of the literature.

    PubMed

    Lezcano, Cecilia; Clarke, Martha R; Zhang, Lei; Antonescu, Cristina R; Seethala, Raja R

    2015-06-01

    Adamantinoma-like Ewing sarcoma (AES) is a rare variant of the Ewing family of tumors that resembles classic adamantinoma of bone. AES shows epithelial differentiation and a more complex immunohistochemical expression profile with keratin and basal marker immunoreactivity and can resemble a variety of carcinomas. We report an unusual case of an AES of the parotid gland that mimicked a basal cell adenocarcinoma. Like basal cell adenocarcinoma, this AES showed a nested basaloid proliferation with peripheral palisading in tumor nests with 'basaloid' epithelial differentiation as highlighted by cytokeratin AE1/3 and p40 positivity. However, unlike most basal cell adenocarcinomas, this tumor demonstrated high grade morphology, showed no true ductal or myoepithelial component, and also showed a tendency towards neuroectodermal phenotype with focal rosette formation, CD99 and weak synaptophysin immunoreactivity. EWSR1 and FLI1 fluorescence in situ hybridization confirmed the presence of a translocation supporting the diagnosis of AES. This is the first case of AES presenting as a primary parotid mass highlighting the potential to be mistaken for primary salivary gland carcinomas, which in addition to basal cell adenocarcinoma include other basaloid tumors such as adenoid cystic carcinoma.

  17. 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.

  18. Parotid angiofibroma

    PubMed Central

    Hallur, Neelakamal H; Zainab, Heena; Shah, Ashwin; Siddiqua, Aaisha

    2014-01-01

    Angiofibromas are rare, benign, locally invasive vascular tumors, which represent 0.05-0.5% of all head and neck tumors. Most frequent site of occurrence is the posterior nasopharynx, called as nasopharyngeal angiofibromas (NA), when these arise outside the nasopharyngeal region they are termed as extranasopharyngeal angiofibromas (ENA). Only 65 cases of ENA have been reported, and the most common site has been reported to be maxilla followed by ethmoids. Other unusual sites of occurrence reported so far in literature are nasal cavity, nasal septum, larynx, sphenoid sinus, pterygomaxillary fissure, infratemporal fossa, cheek, oropharynx, retromolar area, middle turbinate, inferior turbinate, and tonsil. ENA arising from the superficial lobe of parotid gland has not been reported in the literature so far and this case is the first to be reported. PMID:25328316

  19. 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

  20. Inositol 1,3,4,5-tetrakisphosphate and not phosphatidylinositol 3,4-bisphosphate is the probable precursor of inositol 1,3,4-trisphosphate in agonist-stimulated parotid gland.

    PubMed Central

    Downes, C P; Hawkins, P T; Irvine, R F

    1986-01-01

    When [3H]inositol-prelabelled rat parotid-gland slices were stimulated with carbachol, noradrenaline or Substance P, the major inositol trisphosphate produced with prolonged exposure to agonists was, in each case, inositol 1,3,4-trisphosphate. Much lower amounts of radioactivity were present in the inositol 1,4,5-trisphosphate fraction separated by anion-exchange h.p.l.c. Analysis of the inositol trisphosphate head group of phosphatidylinositol bisphosphate in [32P]Pi-labelled parotid glands showed the presence of phosphatidylinositol 4,5-bisphosphate, but no detectable phosphatidylinositol 3,4-bisphosphate. Carbachol-stimulated [3H]inositol-labelled parotid glands contained an inositol polyphosphate with the chromatographic properties and electrophoretic mobility of an inositol tetrakisphosphate, the probable structure of which was determined to be inositol 1,3,4,5-tetrakisphosphate. Since an enzyme in erythrocyte membranes is capable of degrading this tetrakisphosphate to inositol 1,3,4-trisphosphate, it is suggested to be the precursor of inositol 1,3,4-trisphosphate in parotid glands. PMID:2432882

  1. Immediate facial reanimation in oncological parotid surgery with neurorrhaphy of the masseteric-thoracodorsal-facial nerve branch.

    PubMed

    Biglioli, Federico; Tarabbia, Filippo; Allevi, Fabiana; Colombo, Valeria; Giovanditto, Federica; Latiff, Mahfuz; Lozza, Alessandro; Previtera, Antonino; Cupello, Silvia; Rabbiosi, Dimitri

    2016-06-01

    The extracranial facial nerve may be sacrificed together with the parotid gland during a radical parotidectomy, and immediate reconstruction of the facial nerve is essential to maintain at least part of its function. We report five patients who had had radical parotidectomy (two with postoperative radiotherapy) and immediate (n=3) or recent (n=2) reconstructions of the masseteric-thoracodorsal-facial nerve branch. The first mimetic musculature movements started 6.2 (range 4-8.5) months postoperatively. At 24 months postoperatively clinical evaluation (modified House-Brackmann classification) showed grade V (n=3), grade IV (n=1), and grade III (n=1) repairs. This first clinical series of masseteric-thoracodorsal-facial nerve neurorrhaphies has given encouraging results, and the technique should be considered as an option for immediate or recent reconstruction of branches of the facial nerve, particularly when its trunk is not available for proximal neurorrhaphy.

  2. 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.

  3. Effect of Capsaicin Cream on the Secretion of the Submandibular and Parotid Gland in the General Population with Different Chilli-eating Habits.

    PubMed

    Wang, Yang; Wang, Zhen; Yu, Guang Yan; Tang, Zhan Gui; Hu, Ji An

    2016-06-01

    To investigate the effect of capsaicin cream on the secretion of the submandibular gland (SMG) and the parotid gland (PG) in the general population, with different chilli-eating habits. In two groups with different chilli-eating habits, the salivary flow rate of the SMG and the PG was detected at statics and different times, after application of capsaicin cream. In both groups, the topical application of capsaicin cream could significantly increase the salivary secretion of SMG (P < 0.05), but the increase in the salivary flow rate of the SMG between the two groups had no significant difference (P > 0.05). On the other hand, although the salivary flow rate of PG also increased after stimulation, the increase had no statistical difference (P > 0.05). The application of capsaicin cream can effectively promote the secretion of the SMG and the PG, and its effect is independent of chilli-eating habits, which indicates that topical application of capsaicin cream can be considered as a potential treatment for the hypofunction of the salivary gland.

  4. Extravascular type of intravascular papillary endothelial hyperplasia mimicking parotid gland neoplasia and the possible role of ferritin in the pathogenesis: A case report

    PubMed Central

    Mignogna, Chiara; Barca, Ida; Di Vito, Anna; Puleo, Francesca; Malara, Natalia; Giudice, Amerigo; Giudice, Mario; Barni, Tullio; Donato, Giuseppe; Cristofaro, Maria Giulia

    2017-01-01

    Intravascular papillary endothelial hyperplasia (IPEH) is defined as a vascular lesion characterized by extensive proliferation of vascular endothelial cells. This lesion was first described by Pierre Masson in 1923 as intravascular hemangioendothelioma. The most frequent sites of involvement are the skin and subcutis. IPEH comprises ~2% of the vascular tumors of the skin and subcutaneous tissue and it has a predilection for the head, neck, trunk and the extremities. The diagnosis is based on histopathology. We herein present the second case of Masson's tumor of the parotid gland described in literature. The patient was a 70-year-old female. Magnetic resonance imaging revealed an irregular lesion with smooth margins, initially considered to be compatible with pleomorphic adenoma. Immunohistochemical analysis revealed positivity of the tumor cells for ferritin heavy and light chains, vimentin and CD31. The aim of the present study was to emphasize the immunohistochemical characteristics and briefly discuss the potential role of ferritin in the pathogenesis of IPEH. PMID:28357092

  5. 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.

  6. Comparing the RTOG/EORTC and LENT-SOMA scoring systems for the evaluation of late skin toxicity after (125)I seed brachytherapy for parotid gland cancer.

    PubMed

    Mao, Ming-Hui; Feng, Zhien; Li, Hua; Qin, Li-Zheng; Li, Jian-Hua; Huang, Xin; Xing, Ru-Dong; Zhang, Jie; Zhang, Jian-Guo; Han, Zheng-Xue

    The Radiation Therapy Oncology Group (RTOG) and Late Effects Normal Tissue Task Force-Subjective, Objective, Management and Analytic (LENT-SOMA) scoring systems were compared for grading late skin effects after iodine-125 seed brachytherapy in parotid gland cancer patients. A total of 109 patients diagnosed with parotid gland carcinoma were treated postoperatively with iodine-125 seed brachytherapy at a dose of 100-120 Gy. After 6-24 months of followup, telangiectasia, skin pigmentation, atrophy, fibrosis, and ulceration were scored according to both RTOG and LENT-SOMA scale criteria. The strength of correlation between the scores and the interobserver variability were calculated. Of 109 patients, 22.9% had telangiectasia; 78.9%, pigmentation; 28.4%, fibrosis; 4.6%, edema; 0.9%, ulceration; 37.6%, retraction and/or atrophy; 22.9%, sensation change; and 11%, scaliness and/or roughness. Compared with RTOG, LENT-SOMA criteria resulted in the upgrading of pigmentation in 17% of cases, the downgrading of all instances of telangiectasia and the downgrading of one instance of Grade 4 ulceration to Grade 3. Between the two scales, fibrosis and atrophy correlated well (Spearman ρ, 0.992, 0.986). An additional 229 side effects were observed using LENT-SOMA criteria. The LENT-SOMA scale was more accurate than the RTOG scale for the evaluation of late skin and subcutaneous toxicity. The downgrading of telangiectasia and upgrading of pigmentation with the LENT-SOMA scale reflected the patients' conditions better than the scores obtained with the RTOG scale. The assessment of fibrosis and atrophy correlated well between the two scales. The use of the sum of the individual scores of the LENT-SOMA is therefore advocated. The addition of decreased sweating and the removal of the alopecia (scalp) metric should be considered to standardize the reporting of late radiation morbidity. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  7. Comparison of TNM-based stage grouping versus UICC/AJCC stage grouping (7th edition) in malignant parotid gland tumors.

    PubMed

    Kreppel, Matthias; Scheer, Martin; Meyer, Moritz; Stenner, Markus; Wedemeyer, Inga; Drebber, Uta; Semrau, Robert; Odenthal, Margarete; Zöller, Joachim E; Guntinas-Lichius, Orlando; Büttner, Reinhard; Beutner, Dirk

    2013-09-01

    Although the UICC/AJCC's TNM staging of the 7th edition was improved in 2002, there are still shortcomings concerning the prognostic quality. Alternative TNM-based stage-groupings such as the T and N Integer Score (TANIS) where shown to have a better prognostic quality for various kinds of head and neck tumors in the past. The aim of the study was to compare the prognostic value of the 7th edition of the UICC/AJCC TNM-classification for carcinoma of the parotid gland with different TNM-based stage groupings. The retrospective analysis included 180 patients with carcinoma of the parotid gland diagnosed between 1986 and 2007. The stage grouping system of the 7th edition of the UICC/AJCC and TNM-based stage-groupings (TANIS-3, TANIS-8, Snyderman, Berg and Hart) were tested for their prognostic significance. Overall survival (OS) was plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. In univariate analysis all stage-groupings had a highly significant impact on overall survival (p<0.05), however in multivariate analysis, only the TANIS-8 scheme (p=0.008) and Snyderman scheme (p=0.047) predicted OS, while the UICC/AJCC-classification did not predict OS significantly (p=0.381). In comparison to other TNM-based stage groupings the UICC/AJCC-classification did not provide significant prediction of OS, while alternative stage-groupings such as the TANIS-8 had a higher prognostic value. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. [Epidemic parotiditis, a reportable disease].

    PubMed

    Boverhoff, J C; Baart, J A

    2013-01-01

    Three consecutive patients with an acute swelling of one of the cheeks, were diagnosed with epidemic parotiditis. The first phase of the diagnostic procedure for an acute cheek swelling is to eliminate the possibility of odontogenic causes. When odontogenic problems have been excluded, non-dentition-related causes may be considered. An acute, progressive swelling in the preauricular area can often be attributed to an inflammation of the parotid gland, but epidemic parotiditis should also be considered. Epidemic parotiditis, or mumps, is caused by the mumps virus. Contamination occurs aerogenically. In the Netherlands, mumps vaccine is an ingredient of the governmental combined mump-measles-rubella inoculation programme. However, in recent years several small-scale parotiditis epidemics have broken out, predominantly among young, inoculated adults. Oropharyngeal mucus and blood samples are needed to diagnose the disease. Each case of the disease should be reported to the community healthcare service.

  9. 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 ...

  10. Neurovascular free-muscle transfer for the treatment of established facial paralysis following ablative surgery in the parotid region.

    PubMed

    Takushima, Akihiko; Harii, Kiyonori; Asato, Hirotaka; Ueda, Kazuki; Yamada, Atsushi

    2004-05-01

    Neurovascular free-muscle transfer for facial reanimation was performed as a secondary reconstructive procedure for 45 patients with facial paralysis resulting from ablative surgery in the parotid region. This intervention differs from neurovascular free-muscle transfer for treatment of established facial paralysis resulting from conditions such as congenital dysfunction, unresolved Bell palsy, Hunt syndrome, or intracranial morbidity, with difficulties including selection of recipient vessels and nerves, and requirements for soft-tissue augmentation. This article describes the authors' operative procedure for neurovascular free-muscle transfer after ablative surgery in the parotid region. Gracilis muscle (n = 24) or latissimus dorsi muscle (n = 21) was used for transfer. With gracilis transfer, recipient vessels comprised the superficial temporal vessels in 12 patients and the facial vessels in 12. For latissimus dorsi transfer, recipient vessels comprised the facial vessels in 16 patients and the superior thyroid artery and superior thyroid or internal jugular vein in four. Facial vessels on the contralateral side were used with interpositional graft of radial vessels in the remaining patient with latissimus dorsi transfer. Cross-face nerve grafting was performed before muscle transfer in 22 patients undergoing gracilis transfer. In the remaining two gracilis patients, the ipsilateral facial nerve stump was used as the primary recipient nerve. Dermal fat flap overlying the gracilis muscle was used for cheek augmentation in one patient. In the other 23 patients, only the gracilis muscle was used. With latissimus dorsi transfer, the ipsilateral facial nerve stump was used as the recipient nerve in three patients, and a cross-face nerve graft was selected as the recipient nerve in six. The contralateral facial nerve was selected as the recipient nerve in 12 patients, and a thoracodorsal nerve from the latissimus dorsi muscle segment was crossed through the upper lip

  11. 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.

  12. Brooke-Spiegler syndrome presenting multiple concurrent cutaneous and parotid gland neoplasms: cytologic findings on fine-needle sample and description of a novel mutation of the CYLD gene.

    PubMed

    Malzone, Maria Gabriella; Campanile, Anna Cipolletta; Losito, Nunzia Simona; Longo, Francesco; Perri, Francesco; Caponigro, Francesco; Schiavone, Concetta; Ionna, Franco; Maiello, Francesco; Martinuzzi, Claudia; Nasti, Sabina; Botti, Gerardo; Fulciniti, Franco

    2015-08-01

    Multiple dermal cylindromas and membranous basal cell adenoma of parotid gland in a 67-year-old woman with Brooke-Spiegler syndrome (BSS) were examined by fine-needle cytology. Histology, immunochemistry, and CYLD germline mutation testing were also performed. Cytomorphology and immunochemistry of the two lesions showed basaloid neoplasms, remarkably similar, composed by proliferating epithelial cells of basal type accompanied by a smaller proportion of myoepithelial cells. CYLD gene showed a novel germline splice acceptor site mutation (c.2042-1G>C) with skipping of the entire exon 15. The occurrence of analogous tumors, dermal cylindromas, and membranous basal cell adenoma of the parotid gland, in the same patient may result from the action of a single gene on ontogenetically similar stem cells. Therefore, patients with BSS should be offered a genetic counselling for an early and correct diagnosis.

  13. Alcoholic parotid sialadenosis.

    PubMed

    Mandel, L; Hamele-Bena, D

    1997-10-01

    Alcoholism is a primary cause of sialadenosis, which is an asymptomatic, bilateral enlargement of the parotid glands. The authors outline the pathogenesis, symptoms and testing involved in diagnosing sialadenosis. Recognizing sialadenosis is important because it may point to the unsuspected presence of underlying systemic disease. Therefore, dental practitioners need to be able to differentiate sialadenosis from an inflammatory or neoplastic process to prevent unnecessary treatment.

  14. Electromyography monitoring of patients with salivary gland diseases.

    PubMed

    Vaiman, Michael; Nahlieli, Oded; Segal, Samuel; Eviatar, Ephraim

    2005-12-01

    To provide a description of surface electromyography (sEMG) of spontaneous saliva swallowing (SSS) and monitoring of swallow rate in patients with salivary gland diseases. Numbers of SSS obtained during 2 hours of sEMG monitoring were compared with sialometry data for healthy volunteers (n = 100), patients with Sjögren syndrome (n = 10), and patients after parotid gland (n = 15) and submandibular gland (n = 16) surgery. Normative: 1 SSS every 2 minutes and 15 seconds; Sjögren: 1 SSS every 13 minutes (P < 0.001); parotid gland surgery: 1 SSS every 3 minutes and 24 seconds (P = 0.26); submandibular gland surgery: 1 SSS every 5 minutes and 04 seconds (P < 0.05). Sjögren patients and patients after submandibular surgery had hyposalivation correlated with less SSS. The established normal rate of SSS makes this modality applicable for evaluating salivary flow for potentially identifying and ruling out abnormalities. Parotid gland surgery does not significantly affect salivary flow rate. Sialometry combined with sEMG monitoring give a clinician more reliable data to evaluate salivary gland disorders than sialometry alone.

  15. 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.

  16. [Laparoscopic adrenalectomy in surgery of the adrenal gland diseases].

    PubMed

    Nichitaĭlo, M E; Litvinenko, A N; Gul'ko, O N; Kvacheniuk, A N; Lukecha, I I

    2013-02-01

    In 2002-2012 yrs in The Department of Laparoscopic Surgery and Choledocholithiasis laparoscopic adrenalectomy (LA) for various adrenal gland diseases was done in 94 patients. The operation time while doing right-sided and left-sided LA have had constituted, accordingly, at average (73.6 +/- 12.1) and (121.6 +/- 11.9) min, intraoperative blood loss - (49.3 +/- 9.2) ml. Hemotransfusion was not applied. There was no need for conversion. In 1 (1,1%) patient hemoperitoneum have had occurred as a consequence of traumatic injury of spleen while performing left-sided LA. Nonspeciphic postoperative complications were absent.

  17. Parotid abscess: a five-year review--clinical presentation, diagnosis and management.

    PubMed

    Tan, V E S; Goh, B S

    2007-09-01

    Parotid abscess is an uncommon complication of suppurative infection of the parotid gland parenchyma, commonly bacterial or viral. Ductal ectasis, primary parenchymal involvement, or infection of the intraparotid or periparotid lymph nodes can result in abscess formation. Parotid abscess may arise from ductal ectasis, primary parenchymal involvement, or infection of the subcapsular lymph nodes. The operative records for all the patients who underwent surgeries in the Department of Otorhinolaryngology, Head and Neck Surgery of the National University Hospital, Kuala Lumpur, Malaysia between January 2001 and December 2005 were retrospectively reviewed. Our case series comprises 15 patients, with 10 males and five females with a median age at presentation of 51 years old. Diabetes mellitus is a significant comorbid factor, with six patients being diabetics. Among the diabetics, two patients presented with facial nerve palsy and one of them also died due to overwhelming septicaemia. Here, we discuss the presenting symptoms, predisposing factors, investigations, microbiology and complications of this condition.

  18. Synchronous unilateral parotid neoplasms. A case report.

    PubMed

    Herce-López, Javier; Salazar-Fernández, Clara I; Mayorga-Jiménez, Francisco; Gallana-Alvarez, Silvia; Pérez-Sánchez, Juan M

    2009-02-01

    The parotid gland is the most usual location of benign neoplasms affecting major salivary glands and quite often the recurrence of these tumours is noticed, specially in the case of pleomorphic adenoma. The occurrence of multiple tumours in the parotid glands is rare and the majority of these are multifocal Warthin's tumors (papillary cystadenoma lymphomatosum). The simultaneous development of tumours with different histological types is unusual and when it occurs, the most common combination is a pleomorphic adenoma and a Warthin's tumor. There are many articles about Multiple Parotid Tumors (MPT) but only a few of them are focused on unilateral synchronous benings tumors, being pleomorphic adenoma and Warthin's these tumors. The report describes a 55 year old female with a pleomorphic adenoma occurring synchronously with a Warthin's tumor within the superficial lobe of her left parotid gland.

  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. Intraglandular Transplantation of Adipose-Derived Stem Cells for the Alleviation of Irradiation-Induced Parotid Gland Damage in Miniature Pigs.

    PubMed

    Wang, Zhifa; Ju, Zhaoyu; He, Longlong; Li, Zhijin; Liu, Yanpu; Liu, Bin

    2017-08-01

    In a previous study, the authors verified the protective efficacy of adipose-derived stem cells (ADSCs) on the prevention of salivary gland (SG) damage induced by irradiation in mice. As a critical step before implementation in clinical practice, the present study investigated the protective effect of ADSCs in a miniature pig SG model, because miniature pigs share many characteristics with humans. Third-passage autologous ADSCs at a concentration of 4 × 10(6) cells/mL were transplanted by intraglandular injection into parotid glands (PGs) immediately after local irradiation at a single dose of 20 Gy. The injection process was repeated twice a week for 6 consecutive weeks. At 12 weeks after irradiation, functional and histologic evaluations were performed by measuring salivary flow rate (SFR) and hematoxylin and eosin and periodic acid-Schiff staining. Immunohistochemical and transmission electron microscopic examinations also were conducted to evaluate amylase (AMY) production, microvessel density (MVD), and microstructural changes. The irradiated PGs showed remarkable decreases in SFR, AMY production, and MVD. However, transplantation of ADSCs alleviated irradiated PG morphology and function by preserving more functional acinar cells and increasing SFR and AMY production. In addition, greater MVD was observed in the ADSC-treated group than in the irradiated group. These results indicated that intraglandular transplantation of autologous ADSCs is an effective method to protect PGs against damage from irradiation in miniature pigs, which might have clinic application in the future. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. 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. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Specific expression of an A-kinase anchoring protein subtype, AKAP-150, and specific regulatory mechanism for Na(+),K(+)-ATPase via protein kinase A in the parotid gland among the three major salivary glands of the rat.

    PubMed

    Kurihara, Kinji; Nakanishi, Nobuo; Amano, Osamu; Yamamoto, Miyuki; Iseki, Shoichi

    2003-07-15

    We have examined the expression of A-kinase anchoring protein (AKAP) in the three major salivary glands, i.e. the parotid gland (PG), submandibular gland (SMG), and sublingual gland (SLG), of the rat to elucidate the functional relevance between saliva secretion and Na(+),K(+)-ATPase regulation by protein kinase A (PKA)-dependent phosphorylation, since an AKAP subtype, AKAP-150, is known to be involved in the regulation of the ATPase in PG. Although AKAP-150 and its mRNA were clearly detected in the PG, they were hardly detectable in either the SMG or SLG. The membrane-bound form of the RII regulatory subunit of PKA, an index for the total amount of AKAP subtypes and therefore of the anchored PKA holoenzyme, was also undetectable in membranes from the SMG and SLG but was found in the PG; though a substantial and comparable amount of Na(+),K(+)-ATPase was present in all of these membrane preparations. Incubation with [gamma-32P]ATP revealed that Na(+),K(+)-ATPase in the PG membranes was quickly phosphorylated upon the addition of cAMP, whereas the ATPases in the membranes from SMG and SLG were not; though they were readily and equally phosphorylated by the exogenously added PKA catalytic subunit. AKAP-150 in the basolateral membranes of PG acinar cells was co-immunoprecipitated with RII by an anti-RII antiserum; and AKAP-150 and Na(+),K(+)-ATPase were immunohistochemically co-localized predominantly on the basolateral membranes, suggesting a possibility that the ATPase might directly interact with the AKAP to form an ATPase/AKAP/PKA complex or associate with the AKAP, such association being mediated via some scaffolding molecule. Expression of AKAP-150 and quick down-regulation of Na(+),K(+)-ATPase by AKAP-anchored PKA in response to cAMP elevation are characteristics specific to PG among the three major salivary glands, suggesting the presence of PG-specific regulatory mechanisms for saliva production/secretion.

  3. Meibomian gland dysfunction and tear cytokines after cataract surgery according to preoperative meibomian gland status.

    PubMed

    Jung, Ji Won; Han, Soo Jung; Nam, Sang Min; Kim, Tae-Im; Kim, Eung Kweon; Seo, Kyoung Yul

    2016-09-01

    To investigate the possible mechanisms by which cataract surgery aggravates meibomian gland dysfunction (MGD), we evaluated the changes in tear cytokines and ocular surface parameters after cataract surgery according to the preoperative MGD grade. Prospective, observational case series. A total of 50 eyes from 50 patients who underwent cataract surgery were included. Patients were classified into two groups: Group I had no or minimal MGD, and group II had grades 2-4 MGD. Ocular surface parameters were measured, including tear film break-up time, Schirmer I test, ocular surface staining and Ocular Surface Disease Index, and tear cytokine levels were measured. The main outcomes were changes in ocular surface parameters and inflammatory tear cytokine concentrations. In group II, preoperative MGD grade, ocular surface staining, tear film break-up time and Ocular Surface Disease Index were worse, and mean interleukin (IL)-2, IL-6 and TNF-α levels were higher than those of group I. MGD and ocular surface parameters were worsened to a greater degree after surgery in group II than in group I (P < 0.050). In group II, IL-6 and TNF-α levels significantly increased at postoperative 1 month, and there were significant correlations between changes in ocular surface parameters and tear cytokines (IL-2, IL-6 and TNF-α; P < 0.050). The extent to which the MGD grade was aggravated following cataract surgery differed based on preoperative MGD grade. Preoperative MGD and ocular surface status should be carefully evaluated. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  4. Endoscope-assisted transoral accessory parotid mass excision.

    PubMed

    Woo, Seung Hoon

    2016-01-01

    Accessory parotid gland tissue is salivary tissue adjacent to Stensen's duct that is distinctly separate from the main body of the parotid gland. Surgical removal of an accessory parotid mass is usually accomplished through an external neck incision. However, this procedure inevitably results in a neck scar. We report the case of a 55-year-old man with an accessory parotid mass. We applied a modified approach to accessory parotid mass removal through the mouth with an endoscope system. The patient, who was diagnosed with a benign pleomorphic adenoma, underwent endoscope-assisted transoral accessory parotid mass excision. The follow-up time was 6 months. The patient experienced no serious postoperative complications or recurrence. Resection of an accessory parotid mass can be performed via an endoscope-assisted transoral approach. In this study, we describe the procedure of the endoscope-assisted transoral resection. © 2015 Wiley Periodicals, Inc.

  5. [Morphometric studies of the parotid gland of rats after bilateral gonadectomy and after gonadectomy and administration of mesterone].

    PubMed

    Zarebska, A

    1989-01-01

    The influence of bilateral gonadectomy on the secretory segments of the partoid gland in male rats was investigated. The changes in the section area of cell nuclei, secretory cells, serous vesicles as well as in the mean number of cells in the vesicles were statistically analyzed. Eleven-day gonadectomy caused a statistically significant increase of the mean section area of cell nuclei, secretory vesicles and cells. Eight-day mesterone treatment in the dose of 2 mg/kg of body mass does not eliminate the changes caused by gonadectomy but results in the further increase of the mean section area of cell nuclei and secretory vesicles, as well as in the increase of cells in the vesicles.

  6. 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.

  7. Does the ultrasound dissector improve parathyroid gland preservation during surgery?

    PubMed

    Pelizzo, M R; Sorgato, N; Isabella Merante Boschin, I; Marzola, M C; Colletti, P M; Rubello, D

    2014-07-01

    The most common complication of thyroid surgery is hypoparathyroidism, usually temporary. Ischemic injury or parathyroid avulsion are the causes of surgical hypoparathyroidism. We assessed the value of an ultrasound scalpel, the Harmonic Focus(®) (HF), could prevent surgical-related hypoparathyroidism. Patients consecutively undergoing total thyroidectomy using the HF from November 2009 to February 2011 were recruited and their clinical characteristics, type of operation, histology, and postoperative calcium levels (normal range: 2.10-2.55 mMol/l) were recorded. The prevalence of transient and permanent hypocalcemia was calculated for benign vs. malignant diseases and compared with a control group of 147 patients treated surgically in 2005 using manual technique. 139 patients treated by the same surgeon with a total thyroidectomy (41.7% for a malignant disease) were considered. Prevalence of transient hypoparathyroidism (THP) was 45.2% and of definitive hypoparathyroidism (DHP) 1.4%. None of the patients with malignancies were hypocalcemic at 1-year follow-up. In the control group THP was found in 51.7% of cases and DHP in 5.4% (p < 0.001). Use of the ultrasound scalpel improved the likelihood of the parathyroid glands preservation during thyroid surgery. Paradoxically, the HF appears to be more effective in treating malignant disease, i.e. when central node dissection is required. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. [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.

  9. Sialadenosis of the salivary glands.

    PubMed

    Pape, S A; MacLeod, R I; McLean, N R; Soames, J V

    1995-09-01

    Sialadenosis (sialosis) is an uncommon, non-inflammatory condition which usually causes bilateral, diffuse enlargement of the salivary glands, particularly the parotid. We present a series of 7 patients with sialadenosis. Two had bilateral and 4 unilateral parotid involvement. One patient had unilateral submandibular gland sialadenosis. One patient had bilateral parotid and bilateral submandibular gland sialadenosis. The clinicopathological features and management of the condition are reviewed.

  10. [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.

  11. 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

  12. 3D-FIESTA MRI at 3 T demonstrating branches of the intraparotid facial nerve, parotid ducts and relation with benign parotid tumours.

    PubMed

    Li, Chuanting; Li, Yan; Zhang, Dongsheng; Yang, Zhenzhen; Wu, Lebin

    2012-11-01

    To investigate the usefulness of three-dimensional (3D) fast imaging employing steady state precession (FIESTA) magnetic resonance imaging (MRI) at 3 T in evaluating the intraparotid components of the facial nerve and parotid ducts, and to compare the MRI images with surgical findings. Thirty-one cases of benign parotid tumours were studied with conventional and 3D FIESTA MRI sequences at 3T using a head coil. The most clinically useful 3D FIESTA images were acquired at parameters of 4.9 ms repetition time (TR); 1.5 effective echo time (TEeff); a flip of 55°, a field of view of 18 to 20 cm, a matrix of 512 × 320, an axial plane, no gaps, and a section thickness of 1 mm. Post-processed multiplanar images were obtained with an Advantage Windows (AW sdc 4.3) workstation. Parotid ducts, facial nerves, and tumours were identified on these images. The relationship of the tumours to the facial nerves and parotid ducts was confirmed at surgery. The facial nerves appeared as linear structures of low intensity. The main trunk of the facial nerve was identified bilaterally in 93.5% of the 3D-FIESTA sequence images. Parotid ducts appeared as structures of high intensity on multiplanar 3D-FIESTA images (100%). The relationships of the tumours with the cervicofacial and temporofacial divisions of the facial nerve were correctly diagnosed in 26 of 31 cases (83.9%) using 3D-FIESTA sequence images. 3D-FIESTA MRI at 3 T depicted the main trunk, cervicofacial and temporofacial divisions of the facial nerve, and the main parotid duct. It is useful for preoperative evaluation of parotid gland tumours. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  13. Preservation of hormonal function by identifying pituitary gland at endoscopic surgery.

    PubMed

    Linsler, Stefan; Hero-Gross, Renate; Friesenhahn-Ochs, Bettina; Sharif, Salman; Lammert, Frank; Oertel, Joachim

    2017-09-01

    The endonasal endoscopic approach has been established for perisellar tumor surgery with a higher resection rate and reduced complications. We analyzed the potential to identify the pituitary gland under endoscopic view, at surgery and see its relation to postoperative hormonal insufficiency in endonasal endoscopic procedures. Between January 2011 and January 2014, 70 cases of pituitary adenomas with preoperative intact pituitary function underwent endoscopic endonasal transsphenoidal procedures for intrasellar pathologies. Endocrinologists and neurosurgeons followed these patients prospectively. Special attention was paid to intraoperative identification of gland tissue, surgical complications, degree of resection and postoperative hormonal insufficiency. The pituitary gland was identified in 57 out of 70 procedures (81.4%). Eleven percent (8 of 70 patients) had persistent pituitary insufficiency. Two of these 8 patients belonged to the group with pituitary gland identification (2 out of 57); thus, when the pituitary gland was identified during the procedure postoperative hormonal insufficiency was seen in 3.5% of cases. Failure of pituitary gland identification presented with hormonal insufficiency of 46.2%. In analysis with Fisher's exact test, there was a high significant correlation between the identification of the pituitary gland intraoperatively and normal pituitary function postoperatively (p<0.005). On follow up radical tumor resection was seen in 88% (62 of 70 patients). This study indicates that identification and preservation of pituitary gland tissue and function is possible in endoscopic transsphenoidal surgery. This preservation of gland tissue is a positive predictor of postoperative normal pituitary function. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. 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.

  15. Probabilistic Multiple-Bias Modeling Applied to the Canadian Data From the Interphone Study of Mobile Phone Use and Risk of Glioma, Meningioma, Acoustic Neuroma, and Parotid Gland Tumors.

    PubMed

    Momoli, F; Siemiatycki, J; McBride, M L; Parent, M-É; Richardson, L; Bedard, D; Platt, R; Vrijheid, M; Cardis, E; Krewski, D

    2017-10-01

    We undertook a re-analysis of the Canadian data from the 13-country case-control Interphone Study (2001-2004), in which researchers evaluated the associations of mobile phone use with the risks of brain, acoustic neuroma, and parotid gland tumors. In the main publication of the multinational Interphone Study, investigators concluded that biases and errors prevented a causal interpretation. We applied a probabilistic multiple-bias model to address possible biases simultaneously, using validation data from billing records and nonparticipant questionnaires as information on recall error and selective participation. In our modeling, we sought to adjust for these sources of uncertainty and to facilitate interpretation. For glioma, when comparing those in the highest quartile of use (>558 lifetime hours) to those who were not regular users, the odds ratio was 2.0 (95% confidence interval: 1.2, 3.4). After adjustment for selection and recall biases, the odds ratio was 2.2 (95% limits: 1.3, 4.1). There was little evidence of an increase in the risk of meningioma, acoustic neuroma, or parotid gland tumors in relation to mobile phone use. Adjustments for selection and recall biases did not materially affect interpretation in our results from Canadian data. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. 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.

  17. Horner's syndrome associated with parotid duct obstruction in a sheep.

    PubMed

    Loste, Araceli; Ramos, Juan J; Ferrer, Luis M; Climent, Salvador; Latre, Maria V

    2006-12-01

    A 9-year old, Rasa Aragonesa ewe was presented with a left-sided, facial, soft fluctuant swelling. The postmortem examination showed grass awns filling the entire length of the parotid gland duct. The presence of parotid duct obstruction with Horner's syndrome, previously unreported in sheep, is discussed.

  18. Epstein-barr virus-associated extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT Lymphoma) arising in the parotid gland of a child with ataxia telangiectasia.

    PubMed

    Bennett, Jennifer A; Bayerl, Michael G

    2015-03-01

    Hematologic malignancies, in particular T-cell lymphomas/leukemias, are prevalent in patients with ataxia telangiectasia (AT), with most reported cases being clinically aggressive and high grade. Epstein-Barr virus (EBV) is often associated with lymphoid proliferations/neoplasms arising in immunodeficient patients. Reports of low-grade B-cell neoplasms in the ataxia telangiectasia population are extremely rare. Here, we describe a case of EBV-associated extranodal marginal zone lymphoma (mucosa-associated lymphoid tissue lymphoma) of the parotid gland in a 16-year-old boy with AT. In addition, we review the literature of hematologic malignancies in the AT population as well as the occurrence of EBV in mucosa-associated lymphoid tissue lymphoma.

  19. Intraparotid ductal ectasia: rare cause of parotid swelling.

    PubMed

    Chahed, Houda; Meherzi, Samia; Mediouni, Azza; Ben Amor, Mohamed

    2017-07-27

    A 41-year-old patient was hospitalised for a chronic right parotid mass. A cervical ultrasound revealed a cystic mass of the parotid. Cervical MRI found a ductal ectasia of the parotid and submandibular glands associated with a retention cyst of the right parotid. He had a right total parotidectomy. Histopathological examination of the lesion revealed a multilocular cystic mass with a diffuse glandular ectasia of salivary ducts. The patient had an uneventful postoperative course without any recurrence of symptoms. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Parotid-sparing intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma: Preserved parotid function after IMRT on quantitative salivary scintigraphy, and comparison with historical data after conventional radiotherapy

    SciTech Connect

    Hsiung, C.-Y. . E-mail: hsiungcy@hotmail.com; Ting, H.-M.; Huang, H.-Y.; Lee, C.-H.; Huang, E.-Y.; Hsu, H.-C.

    2006-10-01

    Purpose: To evaluate the parotid function after parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). Methods and Materials: From March 2003 to May 2004, 16 patients with nonmetastatic NPC underwent parotid-sparing IMRT. Eight of these patients had Stage III or IV NPC based on the 1997 American Joint Committee on Cancer staging system. The post-IMRT parotid function was evaluated by quantitative salivary scintigraphy and represented by the maximal excretion ratio (MER) of the parotid gland after sialogogue stimulation. The parotid function of 16 NPC patients who were previously treated with conventional radiotherapy was reviewed as the historical control. Results: In the parotid-sparing IMRT group, all 16 patients were alive and without cancer at the end of follow-up period (median, 24.2 months). The mean parotid MER was 53.5% before radiotherapy, 10.7% at 1 month post-IMRT, and 23.3% at 9 months post-IMRT. In the conventional radiotherapy group, the mean parotid MER was 0.6% at 6 to 12 months postradiotherapy. The difference was statistically significant (23.3% vs. 0.6%, p < 0.001, Mann-Whitney test). In the IMRT group, the mean parotid doses ranged from 33.2 Gy to 58.8 Gy (average, 43.9 Gy). The correlation between the mean parotid dose and the percentage decrease of parotid MER at 9 months post-IMRT (dMER) was statically significant (p = 0.008, Pearson correlation). Conclusions: Although the mean parotid doses are relatively high, the significant preservation of parotid function is achieved with IMRT for NPC patients. The significant correlation between mean parotid dose and parotid dMER demonstrates the dose-function relationship of the parotid gland.

  1. [Acrylamid- and immunelectrophoretic separations of human parotid secretions from individuals with parotid tumors, chronic parotitis and sialadenosis (author's transl)].

    PubMed

    Eichner, H

    1976-11-01

    After previous examinations in normal parotid glands in this paper secretion of proteins in parotid glands with pleomorphic adenomas, Whartin tumors, parotid carcinomas, chronic parotitis and sialadenosis should be studied. Different discelectrophoretic and immunelectrophoretic runs were done. Thereby we got the following changes in electrophoreses: Pleomorphic adenomas generally show a more palid pattern in band-structure, caused by the diminished proteinconcentration in the secretions. Most remarkable are thereby the c1 and d1-4-bands. Immunelectrophoretic separations are normal. Whartin tumors show a different bandpattern in the anodal near gel region, which is enpowered by immunelectrophoretic runs. Secretions from parotid carcinomas show a characteristic change in bandstructure. There are found added bands which result from serumproteins as immunelectrophoretic examinations proof. The same is found in glands with parotitis in contrary to glands with sialadenosis.

  2. Microscopic surgery for pituitary adenomas to preserve the pituitary gland and stalk

    PubMed Central

    Li, Hao-Yu; Feng, Cheng-Yuan; Zhang, Chi; Su, Jun; Yuan, Jian; Xie, Yuanyang; Liao, Yiwei; Yuan, Xianrui; Liu, Qing

    2017-01-01

    Surgery is the primary treatment of choice for all symptomatic pituitary adenomas except prolactinomas. Common postoperative complications include endocrinopathies, vision impairment and cerebrospinal fluid leak. The present study assessed 153 continuous microscopic surgeries for pituitary adenomas performed by an author of the present study between 2010 to 2014. Patients underwent either transphenoidal or transcranial surgery depending on their individual tumor characteristics. Five typical cases are presented in the present study and intraoperative identification and preservation of the gland and stalk were discussed. Postoperative complications were analyzed and compared with the literature. In the present analysis, 90.2% patients received transphenoidal surgery, and the rest underwent transcranial operation. Gross total resection was achieved in 81.2% patients in the transphenoidal group and 46.7% patients in the transcranial group. No new hypopituitarism or worsening of the pre-existing pituitary dysfunctions was detected. The most common postoperative endocrinopathy was diabetes insipidus (transphenoidal group, 4.3%; transcranial group, 26.7%). All patients were fully recovered prior to discharge. The findings indicated the importance of pituitary gland and stalk preservation during the microscopic surgery to minimize postoperative morbidity and mortality, without compromising the extent of tumor resection. Based on preoperative imaging characteristics and intraoperative observations, surgeons should try all possible means to preserve the pituitary stalk and gland during surgery in order to minimize postoperative endocrinopathies and improve quality of life. PMID:28450934

  3. Microscopic surgery for pituitary adenomas to preserve the pituitary gland and stalk.

    PubMed

    Li, Hao-Yu; Feng, Cheng-Yuan; Zhang, Chi; Su, Jun; Yuan, Jian; Xie, Yuanyang; Liao, Yiwei; Yuan, Xianrui; Liu, Qing

    2017-03-01

    Surgery is the primary treatment of choice for all symptomatic pituitary adenomas except prolactinomas. Common postoperative complications include endocrinopathies, vision impairment and cerebrospinal fluid leak. The present study assessed 153 continuous microscopic surgeries for pituitary adenomas performed by an author of the present study between 2010 to 2014. Patients underwent either transphenoidal or transcranial surgery depending on their individual tumor characteristics. Five typical cases are presented in the present study and intraoperative identification and preservation of the gland and stalk were discussed. Postoperative complications were analyzed and compared with the literature. In the present analysis, 90.2% patients received transphenoidal surgery, and the rest underwent transcranial operation. Gross total resection was achieved in 81.2% patients in the transphenoidal group and 46.7% patients in the transcranial group. No new hypopituitarism or worsening of the pre-existing pituitary dysfunctions was detected. The most common postoperative endocrinopathy was diabetes insipidus (transphenoidal group, 4.3%; transcranial group, 26.7%). All patients were fully recovered prior to discharge. The findings indicated the importance of pituitary gland and stalk preservation during the microscopic surgery to minimize postoperative morbidity and mortality, without compromising the extent of tumor resection. Based on preoperative imaging characteristics and intraoperative observations, surgeons should try all possible means to preserve the pituitary stalk and gland during surgery in order to minimize postoperative endocrinopathies and improve quality of life.

  4. [Application of water jet ERBEJET 2 in salivary glands surgery].

    PubMed

    Gasiński, Mateusz; Modrzejewski, Maciej; Cenda, Paweł; Nazim-Zygadło, Elzbieta; Kozok, Andrzej; Dobosz, Paweł

    2009-09-01

    Anatomical location of salivary glands requires from surgeon high precision during the operation in this site. Waterjet is one of the modern tools which allows to perform "minimal invasive" operating procedure. This tool helps to separate pathological structures from healthy tissue with a stream of high pressure saline pumped to the operating area via special designed applicators. Stream of fluid is generated by double piston pummp under 1 to 80 bar pressure that can be regulated. This allows to precise remove tumors, spare nerves and vessels in glandular tissue and minimize use of electrocoagulation. Waterjet is a modern tool that can help to improve the safety of patients and comfort of surgeon's work.

  5. Parotid salivary duct sialocele associated with glandular duct stenosis in a cat.

    PubMed

    Vallefuoco, Rosario; Jardel, Nicolas; El Mrini, Meryem; Stambouli, Fouzia; Cordonnier, Nathalie

    2011-10-01

    Feline parotid salivary duct sialocele is an uncommon disorder that has been previously reported in association with traumatic rupture of the duct in only two cats. Both cases were successfully treated by proximal duct ligation. We describe the successful surgical treatment of a parotid duct sialocele, secondary to spontaneous salivary duct stenosis, in an adult domestic shorthair cat. The cat was referred for assessment of a recurrent fluid-filled swelling on the left side of the face. Cytology of the aspirated fluid was consistent with serous saliva. The anatomical localisation of the lesion and the nature of the fluid were indicative of parotid gland/duct involvement. Retrograde sialography by parotid duct cannulation was unsuccessful because the left parotid duct opening was stenosed and obstructed by scar tissue. Surgical exploration revealed a parotid salivary duct sialocele, which was completely removed along with the parotid gland without complications.

  6. Fistulectomy of the parotid fistula secondary to suppurative parotitis: a case report.

    PubMed

    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.

  7. 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

  8. Hyposalivation: the roles of radioactive iodine and stapes surgery.

    PubMed

    Mandel, Louis

    2013-02-01

    The aim of this study is to call attention to the role that radioactive iodine ((131)I) and stapes surgery may play in causing hyposalivation. The manner in which (131)I and stapes surgery can cause salivary damage was reviewed. A case report is presented to illustrate the involved pathophysiology. The case report clearly shows the significant injury to the parotid glands caused by the (131)I. However, subjective symptoms of oral dryness only developed after injury to the chorda tympani nerve (CTN) during stapes surgery. The loss of function of both parotid glands after (131)I therapy for thyroid cancer was initially compensated by the secretions of the more radiation-resistant submandibular and sublingual salivary glands (SMSG/SLSG). Damage to the CTN's secretory fibers in one SMSG/SLSG complex led to subjective oral dryness by accentuating an existing objective hyposalivation. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Influence of amplitude-related perfusion parameters in the parotid glands by non-fat-saturated dynamic contrast-enhanced magnetic resonance imaging

    SciTech Connect

    Chiu, Su-Chin; Cheng, Cheng-Chieh; Chang, Hing-Chiu; Chung, Hsiao-Wen; Chiu, Hui-Chu; Liu, Yi-Jui; Hsu, Hsian-He; Juan, Chun-Jung

    2016-04-15

    Purpose: To verify whether quantification of parotid perfusion is affected by fat signals on non-fat-saturated (NFS) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and whether the influence of fat is reduced with fat saturation (FS). Methods: This study consisted of three parts. First, a retrospective study analyzed DCE-MRI data previously acquired on different patients using NFS (n = 18) or FS (n = 18) scans. Second, a phantom study simulated the signal enhancements in the presence of gadolinium contrast agent at six concentrations and three fat contents. Finally, a prospective study recruited nine healthy volunteers to investigate the influence of fat suppression on perfusion quantification on the same subjects. Parotid perfusion parameters were derived from NFS and FS DCE-MRI data using both pharmacokinetic model analysis and semiquantitative parametric analysis. T tests and linear regression analysis were used for statistical analysis with correction for multiple comparisons. Results: NFS scans showed lower amplitude-related parameters, including parameter A, peak enhancement (PE), and slope than FS scans in the patients (all with P < 0.0167). The relative signal enhancement in the phantoms was proportional to the dose of contrast agent and was lower in NFS scans than in FS scans. The volunteer study showed lower parameter A (6.75 ± 2.38 a.u.), PE (42.12% ± 14.87%), and slope (1.43% ± 0.54% s{sup −1}) in NFS scans as compared to 17.63 ± 8.56 a.u., 104.22% ± 25.15%, and 9.68% ± 1.67% s{sup −1}, respectively, in FS scans (all with P < 0.005). These amplitude-related parameters were negatively associated with the fat content in NFS scans only (all with P < 0.05). Conclusions: On NFS DCE-MRI, quantification of parotid perfusion is adversely affected by the presence of fat signals for all amplitude-related parameters. The influence could be reduced on FS scans.

  10. Influence of amplitude-related perfusion parameters in the parotid glands by non-fat-saturated dynamic contrast-enhanced magnetic resonance imaging.

    PubMed

    Chiu, Su-Chin; Cheng, Cheng-Chieh; Chang, Hing-Chiu; Chung, Hsiao-Wen; Chiu, Hui-Chu; Liu, Yi-Jui; Hsu, Hsian-He; Juan, Chun-Jung

    2016-04-01

    To verify whether quantification of parotid perfusion is affected by fat signals on non-fat-saturated (NFS) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and whether the influence of fat is reduced with fat saturation (FS). This study consisted of three parts. First, a retrospective study analyzed DCE-MRI data previously acquired on different patients using NFS (n = 18) or FS (n = 18) scans. Second, a phantom study simulated the signal enhancements in the presence of gadolinium contrast agent at six concentrations and three fat contents. Finally, a prospective study recruited nine healthy volunteers to investigate the influence of fat suppression on perfusion quantification on the same subjects. Parotid perfusion parameters were derived from NFS and FS DCE-MRI data using both pharmacokinetic model analysis and semiquantitative parametric analysis. T tests and linear regression analysis were used for statistical analysis with correction for multiple comparisons. NFS scans showed lower amplitude-related parameters, including parameter A, peak enhancement (PE), and slope than FS scans in the patients (all with P < 0.0167). The relative signal enhancement in the phantoms was proportional to the dose of contrast agent and was lower in NFS scans than in FS scans. The volunteer study showed lower parameter A (6.75 ± 2.38 a.u.), PE (42.12% ± 14.87%), and slope (1.43% ± 0.54% s(-1)) in NFS scans as compared to 17.63 ± 8.56 a.u., 104.22% ± 25.15%, and 9.68% ± 1.67% s(-1), respectively, in FS scans (all with P < 0.005). These amplitude-related parameters were negatively associated with the fat content in NFS scans only (all with P < 0.05). On NFS DCE-MRI, quantification of parotid perfusion is adversely affected by the presence of fat signals for all amplitude-related parameters. The influence could be reduced on FS scans.

  11. [Parotid pneumocele in Down's syndrome].

    PubMed

    Hervás Núñez, María J; Benito Navarro, Juan R; Rodríguez Fernández-Freire, Antonio; Rodríguez Pérez, Miguel A

    2008-01-01

    Pneumoparotiditis is related to the cause of an infrequent increase in the size of the parotid gland due to the entrance of air through the Stenon duct following an increase in the pressure in the oral cavity. It is observed in musicians who play wind instruments, glass blowers, patients undergoing diagnostic or therapeutic techniques, in adolescents that provoke it intentionally, and in mentally handicapped people as found in the clinical case reported here. The symptoms are usually non-specific and the diagnosis is confirmed with an axial tomography. The interest in this clinical case lies in the peculiar form of presentation and its diagnostic confirmation through the use of CT imaging.

  12. Lymphoepithelial carcinoma of the salivary glands

    PubMed Central

    Kim, Yeun J.; Hong, Hyun S.; Jeong, Sun H.; Lee, Eun H.; Jung, Min J.

    2017-01-01

    Abstract Rationale: Lymphoepithelial carcinoma (LEC) is a rare malignancy with the histopathological feature of undifferentiated carcinoma and an intermixed reactive lymphoplasmacytic infiltration. Although clinically significant because of its malignant nature, it is difficult to make a differential diagnosis by preoperative imaging. Here, we report 3 cases of primary LEC arising in the major salivary glands, which showed unusual imaging features unlike other malignant tumors. Patient concerns: Our first case is a 44-year-old man with LEC in the right parotid gland, the second case is a 71-year-old woman with LEC in the right submandibular gland, and the third case is a 35-year-old woman with LEC in the right parotid gland. All of the patients presented with a palpable mass of variable duration. Diagnoses: Computed tomography (CT) scans revealed a relatively well-defined, slightly hyperattenuated exophytic solid mass that had homogeneous well-enhanced regions. Ultrasonography (US) in the first 2 cases showed well-defined, hypoechoic solid masses with posterior enhancement. The CT findings seem to be benign tumors, but US features are compatible with highly cellular and hypervascular tumors. Interventions: The resection of the involved salivary gland with postoperative radiation therapy was performed. Outcomes: There was no evidence of recurrence or metastasis after 5 years in all 3 patients. Lessons: Understanding these unusual imaging findings may be helpful in detecting LEC, and may also help clinicians provide adequate management to patients, such as surgery with adjuvant radiotherapy, because of its malignant entity. PMID:28207533

  13. [Surgery of the thymus gland, normal, atrophied or cancerous].

    PubMed

    Limet, R; Rogister, B

    2000-10-01

    Thymoma is the most frequently resected mediastinal tumor. Its malignancy is related more to macroscopical findings than to microscopical analysis. All thymomas should be resected, in order to prevent malignant degeneration. Furthermore, for the treatment of myasthenia, several centers recommend resection of the thymus, either tumoral (thymoma) or atrophied. Although the role of surgery in this regard is controversial, all authors unanimously stress that complete resection of all thymic remnants is essential to achieve adequate results.

  14. Association of Parathyroid Gland Biopsy Excision Technique With Ex Vivo Radiation Counts During Radioguided Parathyroid Surgery.

    PubMed

    Hinson, Andrew M; Lawson, Bradley R; Franco, Aime T; Stack, Brendan C

    2017-06-01

    Parathyroid biopsy represents a means for normal and hyperfunctional glands to be distinguished intraoperatively. However, no data exist to guide surgeons regarding how much of a parathyroid gland must be biopsied to satisfy the 20% rule. To quantify the relative proportion of a hyperfunctional parathyroid gland that must be evaluated with the gamma probe to satisfy the 20% rule. A retrospective review of surgical data for 24 consecutive patients (16 women, 18 men; mean [SD] age, 66.6 [10] years; range, 51-83 years) who underwent surgery for primary hyperparathyroidism between May and October, 2015, in a tertieary academic medical center. Extirpated parathyroid glands were sectioned into parallel or pie-shaped biopsies and evaluated ex vivo with a gamma probe to determine what percentage of a hyperfunctional gland must be sampled to meet the Norman 20% rule. The hypothesis was formulated during data collection. In total, 253 ex vivo biopsy specimens were obtained from 33 surgically removed parathyroid glands. Parathyroid biopsies satisfied the 20% rule with an accuracy that depended on the relative proportion of the parent gland represented: half or more (96.6%; 95% CI, 91.7%-100.0%), a quarter to one-half (87.0%; 95% CI, 79.3%-94.7%), less than a quarter (63.6%; 95% CI, 54.5%-72.8%). When less than a quarter of the gland was removed, pie-shaped biopsies were more likely to satisfy the 20% rule compared with parallel biopsies of the same weight (78.4% vs 56.2%; absolute difference, 22.2%; 95% CI, 4.7%-39.7%). Unless half of a parathyroid gland is biopsied during radioguided parathyroidectomy, the 20% rule cannot reliably rule out the presence of a hyperfunctional parathyroid lesion. Pie-shaped biopsies originating from the center of the gland are associated with a lower rate of false-negative results compared with peripheral biopsies of similar size. Pie-shaped biopsies and biopsy of half or more of each nonexcised parathyroid gland for ex vivo counts may increase

  15. Oxidative stress in alcohol-induced rat parotid sialadenosis.

    PubMed

    Campos, Sara Cristina Gonçalves; Moreira, Denise Aparecida Corrêa; Nunes, Terezinha D'Avila e Silva; Colepicolo, Pio; Brigagão, Maísa Ribeiro Pereira Lima

    2005-07-01

    This study evaluated the effect of chronic ethanol consumption on the oxidative status of rat parotid and submandibular glands. To identify the endogenous response to ethanol ingestion, the activities of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were determined. In addition, the antioxidant alpha-tocopherol was supplied to the animals in order to estimate its action in ethanol-associated glandular damage. The thiobarbituric acid reactive substances (TBARS), and the protein carbonyl (PC) content, both markers of cellular oxidative stress on lipid and protein structures, respectively, were recorded. Animals subjected to alcohol ingestion showed a low body growth rate with concomitant enlargement of absolute and relative parotid wet weight, compared with pair-fed calorie-controlled rats. Parotid glands of ethanol-treated animals showed increased SOD and GPx activity, and alpha-tocopherol was able to reduce their activities to the control levels. TBARS and PC were enhanced after chronic ethanol treatment in rat parotids. Supplemental alpha-tocopherol suppressed the oxidative ethanol-induced damage in lipid without affecting induced protein oxidation. Submandibular glands revealed no alterations in the weight, enzymatic and oxidative parameters tested due to ethanol and/or alpha-tocopherol ingestion. These findings indicate the involvement of oxidative stress in parotid gland sialadenosis due to ethanol consumption and the capability of alpha-tocopherol to halt lipid damage, although this low-molecular antioxidant compound leads to neither increased glandular weight nor protein oxidation in ethanol-induced parotid alterations.

  16. [Flow rate, amylase and protein content of parotid saliva in sialadenosis (author's transl)].

    PubMed

    Chilla, R; Opaitz, M; Arglebe, C

    1978-03-01

    Flow rate, protein concentration and amylase activity of parotid saliva were investigated in 17 patients with sialadenosis. The results were compared with the data obtained from 90 healthy controls. Total protein and amylase concentrations of saliva did not change although, under the influence of sialadenosis, the parotid gland clearly shows ultrastructural signs of disturbed protein secretion. Also the flow rates of parotid saliva were the same in sialadenosis patients and the control group. This can be explained by the patho-physiology of parotid secretion from the sialadenotic gland.

  17. Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery.

    PubMed

    Vidal Fortuny, J; Belfontali, V; Sadowski, S M; Karenovics, W; Guigard, S; Triponez, F

    2016-04-01

    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. Angiography with the fluorescent dye indocyanine green (ICG) was performed in patients undergoing total thyroidectomy, to visualize vascularization of identified parathyroid glands. 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. 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. © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

  18. Reconstructive Surgery of the Upper Eyelid Using the Residual Tarsus after Excision of Sebaceous Gland Carcinoma

    PubMed Central

    Yunoki, Tatsuya; Nakamura, Yasuhisa; Fuchizawa, Chiharu; Hayashi, Atsushi

    2016-01-01

    Purpose To report a successful eyelid reconstruction performed using the residual tarsus after excision of a sebaceous gland carcinoma. Case Report An 86-year-old woman presented with a sebaceous gland carcinoma of the upper eyelid margin. After excision of the tumor, she underwent reconstructive surgery of the superior eyelid performed using the residual tarsus. Because the tumor was localized on the upper lid margin, a tarsus of about 4–5 mm in height remained after the excision; we therefore used the residual tarsus to reconstruct the upper eyelid. No functional or cosmetic problems arose as a result of this method. Conclusions Reconstructive surgery of the upper eyelid using the residual tarsus may be a viable option provided that surgeons can ensure a sufficient safety margin, and that more than 4 mm of the tarsus remains. PMID:28203187

  19. Cyclical hypofractionated radiotherapy also known as "QUAD Shot" alone using intensity-modulated radiotherapy for squamous cell carcinoma of the parotid gland in an 85-year-old patient with multiple comorbidities.

    PubMed

    Kil, Whoon Jong; Camphausen, Kevin

    2017-04-01

    Palliative radiotherapy (RT) is not commonly offered to patients with head and neck cancer because of the belief that toxicity from the RT would not provide great palliative benefits. The purpose of this study was for us to report the advantages of cyclical hypofractionated RT (QUAD Shot) using intensity-modulated RT (IMRT) for an elderly comorbid patient with head and neck cancer. An 85-year-old multiple comorbid man with squamous cell carcinoma in the left parotid gland with left facial pain received the IMRT-QUAD Shot (14 Gy/4 fractions, twice-daily treatment with 6 hours interval, on 2 consecutive days) to lesions, which were repeated every 4 weeks 3 times. With the IMRT-QUAD Shot, he achieved complete left facial pain relief without acute toxicity. At 12 months after the first IMRT-QUAD Shot, he remained without left facial pain, late toxicity, or disease recurrence impacting positively on his quality of life. The IMRT-QUAD shot is reasonable and safe to apply for symptom palliation in elderly multiple comorbid patients with head and neck cancer. 2017 Wiley Periodicals, Inc. Head Neck 39: E55-E60, 2017. © 2017 Wiley Periodicals, Inc.

  20. [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.

  1. Intraoperative detection of parathyroid gland perfusion during endocrine surgeries (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Mannoh, Emmanuel; Thomas, Giju; Solorzano, Carmen C.; Mahadevan-Jansen, Anita

    2017-02-01

    As many as 80,000 patients a year in the US undergo thyroidectomies or parathyroidectomies for diseased glands. About 21% of these surgeries result in disruption of blood supply to health parathyroid glands, which, if unaddressed, may result in long-term hypocalcemia. Surgeons need to know as soon as possible whether or not the blood supply to a parathyroid gland has been disrupted, as this informs their decision on whether or not to excise and reimplant the gland. There is a non-trivial failure rate involved in this transplantation process, and in the absence of an objective gold-standard surgeons often rely on subjective visual inspection in making this decision. Here we present Laser Speckle Imaging as a real-time objective method to assess parathyroid viability. Our device consists of a 785 nm laser source and a near-infrared camera with a zoom lens, positioned above the surgical field with an articulated arm. With the laser diffusing light onto the tissue, the camera acquires images which are processed in real-time and displayed on a monitor. These speckle contrast images are then averaged and the relative difference in speckle contrast between the parathyroid gland and surrounding thyroid tissue is calculated and correlated with the surgeon's assessment of viability. Preliminary findings from in vivo measurement of 9 diseased glands show 100% agreement with the surgeon when taking a greater than 5% relative difference to indicate devascularization. This device has the potential to be used as an intraoperative tool for assessing parathyroid viability.

  2. Combination of Hot-Hypertonic Saline and Pressure Dressing in the Management of Parotid Fistula.

    PubMed

    Aisha; Fatima, Saira; Memon, Aijaz Ahmed

    2015-12-01

    Parotid fistula is a rare complication of surgical or non-surgical trauma on or in the vicinity of parotid gland. Many pharmacological agents and surgical methods are used to treat it with their own merits, demerits and patient preferences. Injection of hypertonic hot saline along with compression dressing is an economical, patient-preferred and almost complication-free method to deal parotid fistula with promising results.

  3. Parotid salivary secretory pattern in bulimia nervosa.

    PubMed

    Riad, M; Barton, J R; Wilson, J A; Freeman, C P; Maran, A G

    1991-01-01

    Parotid gland enlargement occurs in about 25% of patients with the binge eating syndrome of bulimia nervosa. The parotid salivary secretory patterns in 28 bulimics were determined in order to investigate the functional abnormality in the glands. Bulimia patients had a reduced resting flow rate. Bulimics who developed sialadenosis (4 patients) had reduced resting and stimulated flow rates. The salivary amylase activity was increased in both the resting and stimulated states in bulimics and the sialadenosis group. The resting total protein levels were greater in the bulimics. The electrolyte and immunoglobulin levels were within normal limits. The possibility of protein and enzymatic secretory disturbances due to autonomic nerve disorders as an explanation for the development of sialadenosis in bulimia nervosa is discussed.

  4. Role of parotid amylase in starch digestion in the gastro-intestinal tracts of diabetic rats.

    PubMed

    Kurahashi, M; Inomata, K

    1989-09-01

    In order for the role of parotid amylase in starch digestion in the gastro-intestinal tracts of diabetic rats to be clarified, this study investigated the effect of parotid-duct ligation on both amylase secretion from the parotid glands and pancreas into the gastro-intestinal tract and on starch digestion in the gastro-intestinal contents during feedings. In both diabetic rats and control rats, parotid-duct ligation reduced amylase activity in both the parotid glands during fasting and in the gastric contents after feeding. The amylase activity in the intestinal contents after feeding was reduced by parotid-duct ligation in the diabetic rats. Starch digestion in the gastro-intestinal tract after feeding was reduced by parotid-duct ligation in the diabetic rats. The results suggest that most of the amylase activity in the gastric contents and a large part of the amylase activity in the intestinal contents are derived from the parotid glands, and that parotid amylase plays an important role in starch digestion in the gastro-intestinal tracts of diabetic rats.

  5. Pleomorphic Adenoma Of Minor Salivary Glands.

    PubMed

    Khan, Mohammad Naeem; Raza, Syed Shahmeer; Hussain Zaidi, Syed Aizaz; Haq, Ihtisham Ul; Hussain, Amer Kamal; Nadeem, Muhammad Daniyal; Farid, Khayyam

    2016-01-01

    Pleomorphic adenoma is the most common benign tumour of salivary glands which is Known for its wide pleomorphic architecture. It accounts for 45-75% of all salivary gland neoplasm. It can involve major as well as minor salivary glands. Among minor salivary glands (5-10% of cases) the palate lip, nasal cavity, pharynx, larynx and trachea are the most common sites. Diagnosis is made with biopsy along with histopathology. Wide excision with biopsy and removal of underlying extension of tumour is the treatment of choice. Sixty years old farmer presented with painless swelling in the upper lip for the last 8 years. History revealed recurrent mass in the midline of upper lip with no other complaints. He was operated 3 times for this complaint in the past. Belonging to poor socioeconomic status no biopsy records were found. On examination 3×4 cm hard and mobile mass was found. Lymph nodes of head and neck and parotid gland revealed no enlargement. Surgery by wide excision was planned. After baseline investigation surgery was done and the mass sent for histopathology. Biopsy reports showed pleomorphic adenoma on unusual site. Dissection of salivary gland tumour is important as they have propensity to metastasize. Wide local excision along with biopsy is the method of choice. Proper surgical techniques are required to avoid recurrence.

  6. Bilateral parotid enlargement as a presenting feature of bulimia nervosa in a post-adolescent male.

    PubMed Central

    Buchanan, J. A.; Fortune, F.

    1994-01-01

    An unusual case of bulimia nervosa in a post-adolescent male is reported. The clinical presentation was one of painless parotid swelling of 3 years duration with marked weight loss and underlying metabolic alkalosis. The diagnostic significance of parotid salivary gland swellings is discussed. Images Figure 1 Figure 2 PMID:8140014

  7. Horner’s syndrome associated with parotid duct obstruction in a sheep

    PubMed Central

    Loste, Araceli; Ramos, Juan J.; Ferrer, Luis M.; Climent, Salvador; Latre, María V.

    2006-01-01

    A 9-year old, Rasa Aragonesa ewe was presented with a left-sided, facial, soft fluctuant swelling. The postmortem examination showed grass awns filling the entire length of the parotid gland duct. The presence of parotid duct obstruction with Horner’s syndrome, previously unreported in sheep, is discussed. PMID:17217091

  8. A successful treatment strategy for clozapine-induced parotid swelling: a clinical case and systematic review.

    PubMed

    Immadisetty, Vyasa; Agrawal, Pradeep

    2012-12-01

    Parotid gland swelling is a less frequently reported side effect of clozapine and has no licensed treatment. A 58-year-old man treated with clozapine for treatment-resistant schizophrenia developed bilateral painful parotid swellings and hypersalivation. Initial trials of dose alteration and antihypersalivatory medication had limited success. A combination of benzatropine and terazosin was successful in treating the parotid hyperplasia. Clozapine was the probable cause of parotid swelling in our case, as established using the Naranjo adverse drug reaction probability scale and World Health Organization causality categories. Literature for treatments of clozapine-induced parotid gland swellings was reviewed. None of the published articles suggested a treatment regimen for clozapine-induced parotid hyperplasia. Most reports only highlighted the occurrence of salivary gland swelling with clozapine. Others mentioned management strategies, which included spontaneous resolution, or resolution on discontinuing clozapine. One report, a trial with benzatropine and ipratropium, had variable success. In this case the re-emergence of parotid swelling when terazosin and benzatropine doses were missed followed by a quick resolution upon recompliance, goes some way in proving that this combination is indeed effective. The combination of terazosin and benzatropine appears to have a role in treating parotid gland swellings induced by clozapine.

  9. Management of salivary gland tumors in a Nigerian tertiary institution.

    PubMed

    Fomete, Benjamin; Adebayo, E T; Ononiwu, C N

    2015-01-01

    The salivary glands consist of three major paired glands (the parotid, submandibular and sublingual) as well as numerous minor salivary glands, situated mostly in the oral cavity but also found in the pharynx, larynx, trachea, and sinuses. Tumours of salivary glands show a wide variety of pathologic types varying from benign to malignant. More salivary gland tumours are benign than malignant. Data for this study were obtained from retrospective survey of case notes of all patients with Salivary gland tumours seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Shika, Zaria between January 2003 and August 2013. There were 135 patients 73 (54.1%) females and 62 (45.9%) males within the age range of 2.5 to 80 years (41.85 years). Thirty nine (28.9%) were benign while 96 (71.1%) were malignant. Major salivary glands were involved in 60.7% of tumours; the rest 39.3% involved minor salivary glands. Pleomorphic adenoma (86.7%) formed the bulk of benign tumours while adenoid cystic carcinoma (47.5%) was the predominant malignant tumour of salivary glands. Of 135 patients (n=,57.1% had surgery in our institution and were followed up. Those with malignancy also benefited from radiotherapy, chemotherapy or palliative oncology treatment. Management of salivary glands tumours in our environment is a challenge due to late presentation and the size of the tumour.

  10. 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

  11. Cytological features of mammary analogue secretory carcinoma of the parotid gland in a 15-year-old girl: a case report with review of the literature.

    PubMed

    Inaba, Takako; Fukumura, Yuki; Saito, Tsuyoshi; Yokoyama, Junkichi; Ohba, Shinichi; Arakawa, Atsushi; Yao, Takashi

    2015-01-01

    Mammary analogue secretory carcinoma (MASC) is a recently recognized tumor of salivary glands characterized by the ETV6-NTRK3 fusion gene. This tumor is very rare in children and adolescents. We report a case of MASC in a 15-year-old girl, the fifth youngest case so far reported. The patient complained of a left infra-auricular mass that gradually enlarged for a year. Fine-needle aspiration cytology/imprint cytology showed individual tumor cells that had faintly eosinophilic granular cytoplasm with secretion granules sometimes seen adjacent to the tumor cells. These cytological features overlapped between those of zymogen granule-poor acinic cell carcinoma (AciCC) and MASC. In addition to the case report, we present a review of the related literature with a focus on the cytological features of MASC. The differential diagnostic clues are also discussed.

  12. 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.

  13. Intraoperative parathyroid hormone as an indicator for parathyroid gland preservation in thyroid surgery.

    PubMed

    Ezzat, Waleed Farag; Fathey, Hanaa; Fawaz, Samya; El-Ashri, Alaa; Youssef, Tamer; Othman, Hala Badr

    2011-11-08

    Intra-operative parathyroid hormone (PTH) levels have successfully been used to assess surgical ablation of parathyroid adenomas, the use of this same test to predict preservation of viable gland has not been widely used. to test the sensitivity and specificity of intraoperative rapid PTH assay test in predicting permanent postoperative hypoparathyroidism, and applicability to guide the search for inadvertently removed parathyroid glands for possible auto transplantation. 52 patients undergoing total thyroidectomy for non-malignant thyroid diseases were included. Intraoperative rapid PTH assay test was performed. If levels were reduced, or less than 3 parathyroid glands were detected, removed thyroid gland was examined for unintentionally removed parathyroid tissue for possible auto transplantation. There was a strong correlation between intraoperative rapid PTH assays and those taken 24 hours after surgery, 16 out of 52 patients had reduction of the PTH intraoperatively to levels below 25 pg/ml, of them, 11 patients (who had values between 15-24 pg/ml) recovered to normal PTH levels within 4 weeks, while the 5 patients with intraoperative PTH levels below 15 pg/ml failed to regain normal PTH levels up to 12 weeks postoperatively, even in those patients where parathyroid tissue was auto transplantated. The 4 patients who had parathyroid tissue reimplanted intraoperatively restored some of their parathyroid function as indicated by relative rise of their PTH levels, but did not reach even the low normal levels. (ROC) curve for prediction of early hypoparathyroidism using intraoperative rapid PTH assay was statistically highly significant with optimal cutoff value for predicting early hypocalcaemia level <27 pg/ml, (sensitivity 100%, specificity 68.2%). (ROC) curves for predicting permanent hypoparathyroidism using intraoperative rapid PTH assay or standard PTH assay taken 24 hours after surgery were statistically significant with optimal cutoff value PTH level <12

  14. [Diagnostic accuracy of fine needle aspiration cytology in parotid tumours].

    PubMed

    Zerpa Zerpa, Vanessa; Cuesta Gonzáles, Maria Teresa; Agostini Porras, Gabriela; Marcano Acuña, Martin; Estellés Ferriol, Enrique; Dalmau Galofre, José

    2014-01-01

    Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007-2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. The mean age of the studied sample was 52.9 years (range: 11 to 88 years); 55.9% were men. The FNAC showed significant sensitivity of 57.1%, with a specificity of 95.1%, for detecting malignancy in parotid gland tumours. The positive and negative predictive values for malignancy were 50 and 96.3%, respectively. FNAC is considered a simple test but of limited use for diagnostic guidance in tumour pathology of the parotid gland in our environment, mainly because of its low sensitivity. However, the high specificity and high negative predictive value of FNAC makes it a more accurate test in benign or negative result cases. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  15. Canalicular adenoma: a case report of an unusual parotid lesion

    PubMed Central

    Butler, Colin; Kulendra, Kevin N; Menon, Gopind; D’Souza, Alwyn R

    2009-01-01

    The present report describes a case of an 85-year-old woman who underwent an excisional biopsy of a preauricular lesion centred over the zygoma and subsequently developed an immediate iatrogenic facial palsy. Histopathological diagnosis revealed a canalicular adenoma of the parotid gland. PMID:21686469

  16. Differential Diagnosis of Parotid Lipoma in a Breast Ca Patient

    PubMed Central

    2017-01-01

    Lipomas are common benign tumors usually detected on the torso, neck, upper thighs, and upper arms. However, they are rarely found in the parotid gland region. Because of their rarity at this site, they are not often considered in the differential diagnosis of parotid tumors. This report describes a rare case of a lipoma in the superficial lobe of parotid gland. A 71-year-old female patient admitted to our department complaining about swelling and pain in the posterior area of the left mandibular region since one month. Her medical history included mastectomy after breast CA fifteen years ago. Clinical examination revealed a smooth-surfaced, soft, and painful mass, with well-defined margins in the left mandibular region. Differential diagnosis of metastasis, inflammatory neck swellings, and benign salivary gland tumors were considered for the patient. Advanced imaging methods such as ultrasonography and contrast tomography revealed that the lesion was a lipoma of parotid gland. A surgical intervention under general anesthesia was planned for the removal of the mass; however patient refused the surgical treatment. Patient was placed on six-month periodic recall. This article reviews the radiographic appearance and differential diagnoses of lipoma in this rare location. PMID:28255469

  17. [A case of parotid pleomorphic adenoma metastasis to multiple organs].

    PubMed

    Kessoku, Hisashi; Yoshimura, Tsuyoshi; Iino, Takashi; Tanaka, Yasuhiro

    2014-01-01

    In January 2011, a 64-year-old woman who had undergone tumor resection for pleomorphic adenoma of the left parotid gland four times since her first operation in 1996 visited an orthopedist in our hospital complaining of pain in her right lower limb. Computed tomography (CT) of the whole body showed multiple tumors on the left parotid gland, right kidney, the sacrum, and both lungs. Biopsy of the sacral region and right nephrectomy were performed based on a clinical diagnosis of sacral and pulmonary metastases from renal cell carcinoma, and palliative radiation therapy was immediately begun on the sacral region. Given the definitive pathological diagnosis of metastasis of pleomorphic adenoma of the parotid gland, the recurrent tumor of the left parotid gland and the surrounding lymph nodes were first removed. Postoperative findings demonstrated that the pleomorphic adenoma had metastasized to the lymph nodes. The lung tumors were resected subsequently, and postoperative findings led to the diagnosis of pleomorphic adenoma. Metastasis of pleomorphic adenoma is known to be extremely rare, and to our knowledge this case of metastasis to a kidney is the first reported in Japan.

  18. Comparative Analysis of an Image-Guided Versus a Non-Image-Guided Setup Approach in Terms of Delivered Dose to the Parotid Glands in Head-and-Neck Cancer IMRT

    SciTech Connect

    Duma, Marciana Nona; Kampfer, Severin; Wilkens, Jan Jakob; Schuster, Tibor; Molls, Michael; Geinitz, Hans

    2010-07-15

    Purpose: To assess the impact of interfractional variations of shape and setup uncertainties on the dose to the parotid glands (PGs) in head-and-neck cancer intensity-modulated radiotherapy and image-guided radiotherapy (IGRT). Methods and Materials: Two scenarios were analyzed retrospectively for 10 head-and-neck cancer patients, treated with helical TomoTherapy (TomoTherapy Inc., Madison, WI): the IGRT scenario and the non-IGRT scenario. The initial dose-volume histograms derived from the planning computed tomography (PCT) scan and 120 recalculated dose-volume histograms of the PGs of each scenario and of corresponding fractions were compared. Setup errors, cumulative median doses (CMDs) for 6 fractions, overall volumes of the PGs, and volumes that received less than 1 Gy or more than 1.6 Gy per fraction were analyzed. Results: The mean decrease in the PG volume was 0.13 cm{sup 3}/d. There was a significantly higher CMD than initially predicted (mean increase for 6 fractions, 1.13 Gy for IGRT and 0.96 Gy for non-IGRT). The volume that received less than 1 Gy per fraction decreased (mean difference to PCT, 1.36 cm{sup 3} for IGRT [p = 0.003] and 1.35 cm{sup 3} for non-IGRT [p = 0.003]) and the volume that received more than 1.6 Gy per fraction increased with increasing fraction number (mean difference to PCT, 1.14 cm{sup 3} for IGRT [p = 0.01] and 1.16 cm{sup 3} for non-IGRT [p = 0.006]). There was no statistically significant difference between the two scenarios (CMD, p = 0.095; volume that received <1 Gy per fraction, p = 0.896; and volume that received >1.6 Gy per fraction, p = 0.855). Conclusions: In the analyzed group the actual delivered dose to the PGs does not differ significantly between an IGRT and a non-IGRT approach. However, IGRT in head-and-neck cancer intensity-modulated radiotherapy is strongly recommended to improve patient setup.

  19. Margins for Benign Salivary Gland Neoplasms of the Head and Neck.

    PubMed

    Carlson, Eric R; McCoy, James Michael

    2017-08-01

    The proper ablation of any neoplasm of the head and neck requires the inclusion of linear and anatomic barrier margins surrounding the neoplasm. Extirpative surgery of the major and minor salivary glands is certainly no exception to this surgical principle. To this end, the selection and execution of the most appropriate ablative surgical procedure for a major or minor benign salivary gland neoplasm is an essential exercise in oral and maxillofacial surgery. Of equal importance is the intraoperative identification and preservation of the pseudocapsule surrounding the benign neoplasm. This article reviews these important elements specifically related to ablative surgery of benign neoplasms of the parotid, submandibular and minor salivary glands with strict attention to observed nomenclature. Copyright © 2017 Elsevier Inc. All rights reserved.

  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. Adrenal Gland Disorders

    MedlinePlus

    ... adrenal gland disorders include Genetic mutations Tumors including pheochromocytomas Infections A problem in another gland, such as the pituitary, which helps to regulate the adrenal gland Certain medicines Treatment depends on which problem you have. Surgery or ...

  2. [Lupus erythematosus panniculitis presenting as palpebral edema and parotiditis].

    PubMed

    Pérez-Pastor, G; Valcuende, F; Tomás, G; Moreno, M

    2007-10-01

    Lupus erythematosus panniculitis or lupus erythematosus profundus is characterized by inflammation of the deep dermis and subcutaneous tissue. It can occur in isolation or associated with chronic systemic or discoid lupus erythematosus. It usually consists of nodules and hardened subcutaneous plaques on the forehead, cheeks, proximal extremities, and buttocks. Periorbital and parotid involvement are rare and can lead to misdiagnosis. We present the case of a patient with lupus erythematosus panniculitis who presented with palpebral edema and involvement of the periocular fat and parotid gland.

  3. Patterns of lymph node metastasis of parotid cancer.

    PubMed

    Shinomiya, Hitomi; Otsuki, Naoki; Yamashita, Daisuke; Nibu, Ken-Ichi

    2016-08-01

    To define the incidence and pattern of spread of lymph node metastasis from parotid cancers and to clarify the risk factors and appropriate extent of neck dissection (ND) for individual patient with parotid cancer. A total of 72 patients with parotid gland cancer treated by surgery between 1994 and 2013 were analyzed retrospectively by reference to medical records. In line with our protocol, patients with clinically positive lymph nodes and/or cT3/T4 disease were generally selected to undergo ND. Pathological examinations revealed mucoepidermoid carcinoma in 23 patients, carcinoma ex pleomorphic adenoma in 11, adenoid cystic carcinoma in 9, salivary duct carcinoma in 9, acinic cell carcinoma in 8, squamous cell carcinoma in 5, adenocarcinoma NOS in 4, epithelial myoepithelial carcinoma in 2, and basal cell carcinoma in 1. Thirty-three patients underwent neck dissection: modified radical ND (MRND) in 13, and elective ND (END) in 20. Postoperative RT (PORT) was performed in 33 patients. Among 13 cN+ patients, 10 were pN+ and lymph node metastasis was distributed mainly in levels I, II, III and V. Among 59 cN- patients, clinical T1, T2, T3 and T4 classifications accounted for 10, 24, 10 and 15 patients, respectively. The incidence of occult lymph node metastasis was 22%. Occult lymph node metastasis was mostly seen in the intraparotid, levels I and II of patients with cT4 disease. Among the ND group, 12 necks were pathologically negative for cancer (pN0). Relapse of neck lymph node metastasis occurred only in two patients treated by MRND with pathologically positive lymph nodes (pN+). These patients developed local and distant metastasis within 1 year after neck lymph node recurrence, and subsequently died of the cancer. pN+ was found in 19/30 high grade (63%), 1/10 intermediate grade (10%), and 3/32 low grade (9.4%). Among 33 patients who received PORT, only 1 patient relapsed neck lymph node. For patients with clinically positive lymph nodes, ipsilateral modified

  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. Sclerosing mucoepidermoid carcinoma of the sublingual gland.

    PubMed

    Lee, D H; Kim, J H; Lee, J K; Lim, S C

    2017-10-01

    Sclerosing mucoepidermoid carcinoma of the salivary gland is a rare subtype of mucoepidermoid carcinoma. The most common site of sclerosing mucoepidermoid carcinoma of the salivary glands is the parotid gland, followed by the submandibular gland, and the minor salivary glands. Here we report the first case of sclerosing mucoepidermoid carcinoma of the sublingual gland. Clinicians should consider sclerosing mucoepidermoid carcinoma in the differential diagnosis of salivary gland neoplasm. Surgical excision with clear margins seems to be a sufficient initial treatment option for sclerosing mucoepidermoid carcinoma of the salivary gland. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery.

    PubMed

    Chittiboina, Prashant; Lalith Talagala, S; Merkle, Hellmut; Sarlls, Joelle E; Montgomery, Blake K; Piazza, Martin G; Scott, Gretchen; Ray-Chaudhury, Abhik; Lonser, Russell R; Oldfield, Edward H; Koretsky, Alan P; Butman, John A

    2016-12-01

    OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing's disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC. The ESC (a double-turn, 12-mm-diameter surface coil made from 1-mm-diameter copper wire) was developed to obtain images in a 1.5-T MR scanner. The ESC was placed (via a standard sublabial TSS approach) on the anterior sella face. Clinical MR scans were obtained using the 8-channel head coil and ESC as the receiver coils. Using the ESC, ultra-high-resolution, 3D, balanced fast field echo (BFFE) and T1-weighted imaging were performed at resolutions of 0.25 × 0.25 × 0.50 mm(3) and 0.15 × 0.15 × 0.30 mm(3), respectively. RESULTS Region-of-interest analysis indicated a 10-fold increase in the signal-to-noise ratio (SNR) of the pituitary when using the ESC compared with the 8-channel head coil. ESC-related improvements (p < 0.01) in the SNR were inversely proportional to the distance from the ESC tip to the anterior pituitary gland surface. High-resolution BFFE MR imaging obtained using ESC revealed a number of anatomical features critical to pituitary surgery that were not visible on 8-channel MR imaging, including the pituitary capsule, the intercavernous sinus, and microcalcifications in the pars intermedia. These ESC imaging findings were confirmed by the pathological correlation with whole-mount pituitary sections. CONCLUSIONS ESC can significantly improve SNR in the sellar region intraoperatively using current 1.5-T MR imaging platforms. Improvement in SNR can provide images of the sella and surrounding structures with unprecedented

  7. Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery

    PubMed Central

    Chittiboina, Prashant; Talagala, S. Lalith; Merkle, Hellmut; Sarlls, Joelle E.; Montgomery, Blake K.; Piazza, Martin G.; Scott, Gretchen; Ray-Chaudhury, Abhik; Lonser, Russell R.; Oldfield, Edward H.; Koretsky, Alan P.; Butman, John A.

    2016-01-01

    OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing’s disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC. The ESC (a double-turn, 12-mm-diameter surface coil made from 1-mm-diameter copper wire) was developed to obtain images in a 1.5-T MR scanner. The ESC was placed (via a standard sublabial TSS approach) on the anterior sella face. Clinical MR scans were obtained using the 8-channel head coil and ESC as the receiver coils. Using the ESC, ultra–high-resolution, 3D, balanced fast field echo (BFFE) and T1-weighted imaging were performed at resolutions of 0.25 × 0.25 × 0.50 mm3 and 0.15 × 0.15 × 0.30 mm3, respectively. RESULTS Region-of-interest analysis indicated a 10-fold increase in the signal-to-noise ratio (SNR) of the pituitary when using the ESC compared with the 8-channel head coil. ESC-related improvements (p < 0.01) in the SNR were inversely proportional to the distance from the ESC tip to the anterior pituitary gland surface. High-resolution BFFE MR imaging obtained using ESC revealed a number of anatomical features critical to pituitary surgery that were not visible on 8-channel MR imaging, including the pituitary capsule, the intercavernous sinus, and microcalcifications in the pars intermedia. These ESC imaging findings were confirmed by the pathological correlation with whole-mount pituitary sections. CONCLUSIONS ESC can significantly improve SNR in the sellar region intraoperatively using current 1.5-T MR imaging platforms. Improvement in SNR can provide images of the sella and surrounding structures with unprecedented

  8. [Biochemical findings in proteincomposition of secretions of human malignant parotid tumours, chronic parotitis and sialadenoses (author's transl)].

    PubMed

    Eichner, H; Bretzel, G; Hochstrasser, K

    1977-01-01

    In comparison to former investigations in pleomorphic adenoms and Wharthin tumours in the present paper secretion of IgA, lysozyme in correlation to flowrate and total secretion in glands with malignant tumours, inflammations and Sialadenosis were estimated. Thereby 12 patients with malignomas of the parotid gland, 11 patients with chronic parotitis and 12 with sialadenoses were examined. The following results were found: 1. The concentration of protein, IgA and Lysozym is significantly higher than in normal glands and in glands with pleomorphic adenomas and Wharthin tumours. 2. Differentialdiagnosis of Sialadenitis and Sialadenosis of parotid glands is possible by estimating the examined parameters. Thereby in glands with sialadenosis flowrate is higher than in normal glands, and significant lower in glands with sialadenitis. Moreover concentrations of IgA and Lysozyme and protein in glands with sialadenitis are evaluated.

  9. Diffusion weighted magnetic resonance imaging in the diagnosis of parotid masses. Preliminary results

    PubMed Central

    Yologlu, Zeynel; Aydin, Hasan; Alp, Nalan A.; Aribas, Bilgin K.; Kizilgoz, Volkan; Arda, Kemal

    2016-01-01

    Objective To demonstrate the diagnostic potentials of MRI, diffusion weighted imaging (DWI), and apparent diffusion coefficient (ADC) mapping in the detection of parotid masses correlated to the histopathological results. Methods Study design was retrospective. Fifteen patients with parotid gland masses were included as the study group and contralateral normal parotis glands of same patients were taken as the control group. Patients with bilateral parotid gland tumors were excluded, 7 right-sided and 8 left-sided parotid masses were included in the research. The study took place at the Department of Radiology, Ankara, Turkey, between May 2012 and September 2014. Results Apparent diffusion coefficient measurements of 15 parotis tumors in 1000 and 750 sec/mm2 b-values with comparison to the contralateral normal gland parenchyma were demonstrated. Neurofibromas was predicted as the highest, and lipomas as the lowest ADC values. Pleomorphic adenomas, Warthin’s tumor, and normal parotid parenchyma indicate significant statistical differences from each other on the basis of mean ADC values (p<0.05). Conclusion The DWI and ADC mapping of parotis gland could aid in the differential diagnosis of benign and malignant masses. PMID:27874161

  10. Structural differences between alcoholic and diabetic parotid sialosis.

    PubMed

    Carda, Carmen; Carranza, Miriam; Arriaga, Adriana; Díaz, Anselmo; Peydró, Amando; Gomez de Ferraris, Maria Elsa

    2005-01-01

    Between the sialosis' etiologic agents, we can find the chronic alcoholism and diabetes. Both nosologic entities are described using a similar histopathologic pattern. The purpose of this work has been analyzing and comparing the histopathological differences between the diabetic and alcoholic sialosis. We studied 7 parotid glands samples of diabetic patients and 4 samples of normal glands obtained from surgical material were used as a control. For the comparative study, we used 12 parotid glands from chronic alcoholic patients with clinical diagnosis of cirrhosis and 6 autopsies on individuals who had died from alcoholic hepatic cirrhosis. This material was fixed in formaline, processed for embedding in paraffin, standard coloration techniques and immunotechnique for cytokeratin EA/1 y EA/3. In the cases of diabetics, the parotid gland was characterised by the presence of small acini, a bigger number of lipid intracytoplasmic droplets in the acinar and ductal cells, as well as an abundant adipose infiltration in the stroma when compared to the alcoholics. We observed that the cytokeratins' expression was heterogeneous at the acinar level, and very positive in the hyperplasic ducts, compared to the alcoholic and control groups. These qualitative valorations indicate the differences between the histopathologic pattern of sialosis with different origins.

  11. Implications of improved treatment of malignant salivary gland tumors by fast neutron radiotherapy

    SciTech Connect

    Catterall, M.; Errington, R.D.

    1987-09-01

    The conventional treatment for cancer of the salivary glands is surgery, with or without X ray therapy. In advanced tumors (Stage III and IV), local control and 5-year survival rates are less than 35%. Radical surgery severs the facial nerve in the majority of operations on parotid gland tumors. Local control of unresectable salivary gland tumors was achieved, in 74% of cases, by fast neutron therapy. From the MRC cyclotron at Hammersmith Hospital neutrons were given to 65 patients, with locally advanced or recurrent tumors, 89% of which were Stage IV. Local control and 5-year survival rates were 72% and 50%, respectively. The facial nerve was not damaged by neutron therapy. In patients with parotid gland tumors, 77% regained or maintained function. Function was lost in 14% through recurrence and 9% remained paralyzed. The results were achieved using beams from primitive machines with serious disadvantages. The results from neutrons implicate improvements for locally advanced tumors of non-epidermal origin in other sites of the body, especially with the high energy neutrons now available from modern cyclotrons.

  12. Controversies in Parotid Defect Reconstruction.

    PubMed

    Tamplen, Matthew; Knott, P Daniel; Fritz, Michael A; Seth, Rahul

    2016-08-01

    Reconstruction of the parotid defect is a complex topic that encompasses restoration of both facial form and function. The reconstructive surgeon must consider facial contour, avoidance of Frey syndrome, skin coverage, tumor surveillance, potential adjuvant therapy, and facial reanimation when addressing parotid defects. With each defect there are several options within the reconstructive ladder, creating controversies regarding optimal management. This article describes surgical approaches to reconstruction of parotid defects, highlighting areas of controversy.

  13. Interventional sialendoscopy for parotid ductal calculi: our preliminary experience.

    PubMed

    Singh, P P; Gupta, Neelima; Goyal, Arun; Tomar, Sanjeev

    2012-09-01

    With this article we present our initial experience with interventional sialendoscopy of the parotid duct for the parotid calculi. We carried out a prospective study of patients of parotid calculi in a tertiary referral centre. Diagnostic and interventional sialendoscopy was performed in five cases of parotid calculi. The outcome was classified on the basis of clearance of the lumen of the duct and resolution of symptoms. Diagnostic sialendoscopy was able to diagnose the calculus in all cases. Interventional sialendoscopy was done under general anesthesia in all cases and calculus was successfully removed. The average size of sialolith was 8.2 mm. No complications occurred in any of the cases. Check sialendoscopy was done in all cases after a minimum follow up of 6 months, which showed the duct lumen to be free of stone with no stricture of the duct. Sialendoscopy is an optimal technique for removal of intraductal parotid calculi and avoids removal of the gland. In our series there was no associated morbidity and complication.

  14. Cell deletion by apoptosis during regression of rat parotid sialadenosis.

    PubMed

    Chisholm, D M; Adi, M M; Ervine, I M; Ogden, G R

    1995-01-01

    Enlargement of the rat parotid salivary glands was induced by repeated administration of isoproterenol. Mean wet weights of the treated glands increased steadily to 240% of control values. Following withdrawal of the drug, quantitative histological techniques were used to investigate the balance between hypertrophy, hyperplasia and apoptosis. The volume occupied by acinar cells relative to the total gland volume together with cytoplasmic magnitude of nuclear area ratios as measures of hypertrophy increased during the early experimental period. Similarly, serous acinar cell mitotic counts increased, indicating that hyperplasia had occurred. Apoptosis was demonstrated at light microscopical level to be the main mechanism for cell deletion as the glands returned to normal size and weight. The results indicate that hypertrophy and hyperplasia of serous acinar cells contribute to isoproterenol-induced sialadenosis. The experimental animal model demonstrates that these proliferative changes are completed by 48 h and thereafter are balanced by apoptosis as the glands recover their normal size and weight.

  15. SMAS fold flap and ADM repair of the parotid bed following removal of parotid haemangiomas via pre- and retroauricular incisions to improve cosmetic outcome and prevent Frey's syndrome.

    PubMed

    Chen, Weiliang; Li, Jingsong; Yang, Zhaohui; Yongjie, Wang; Zhiquan, Wang; Wang, Youyuan

    2008-08-01

    The growth of parotid haemangiomas during the proliferative phase may be rapid and unpredictable. Involution often takes many years, with attendant psychological sequelae to the child. Although conservative management is usually proposed for parotid haemangiomas occurring in infancy, this may not be particularly helpful and the haemangioma difficult to conceal. The purpose of this study was to evaluate the reliable and aesthetic benefit of using a superficial musculoaponeurotic system (SMAS) fold flap and allograft dermal matrix (ADM) repair of the parotid bed following parotid haemangiomas via pre- and retroauricular incision. Forty-three paediatric patients (33 boys and 10 girls) with haemangiomas involving the parotid gland underwent total parotidectomy using a pre- and retroauricular approach with intraoperative placement of ADM within the parotid bed. They further underwent repair of the parotid bed with SMAS fold flaps. A panel of three plastic surgeons assessed the cosmetic outcomes. All of the patients were evaluated using a short questionnaire; postoperative gustatory sweating was assessed using a modification of Minor's starch-iodine test.

  16. 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.

  17. Adequacy and accuracy of salivary gland fine needle aspiration cytology.

    PubMed

    Mohammed Nur, M; Murphy, M

    2016-08-01

    Fine needle aspiration cytology (FNAC) is a widely utilized procedure in the preoperative assessment of salivary gland mass lesions. The aim of this study was to determine the adequacy of salivary gland FNA specimens and the accuracy of the cytological diagnoses made at a single institution over a 13-year period. All salivary gland FNAs performed at University Hospital Waterford between 2000 and 2013 were reviewed. Specimens were categorized into those performed by pathologists, radiologists or surgeons and adequacy determined for each. Cases with subsequent surgery had their histology reviewed and compared with cytology for concordance. Of 262 salivary gland FNAs 93.1 % were from parotids and 6.9 % from submandibular glands. Thirty-four FNAs (13 %) were inadequate. The inadequacy rates for pathologists, radiologists and surgeons were 11, 9.1 and 20 %, respectively (p = 0.101). Pleomorphic adenoma was the most frequent cytological diagnosis (53.5 %) followed by primary and secondary malignancies (15.8 %), inflammatory conditions (11.4 %) and Warthin tumour (10.1 %). The histology and cytology were discordant in 13.3 % of 143 cases. The sensitivity and specificity for malignancies were 80.7 and 98.2 %, respectively. Salivary gland FNAC has good sensitivity and specificity. Radiologists and pathologists have the best adequacy rates and image guidance makes radiologists good aspirators.

  18. Acute neonatal parotid abscess: A rare case report

    PubMed Central

    Kolekar, Shreesh; Chincholi, Tejas S.; Kshirsagar, Ashok; Porwal, Narendra

    2016-01-01

    Acute suppurative parotitis is uncommon in children and is very rare in neonates. Most common organism isolated is Staphylococcus aureus. We present a 15-day-old full-term breast-fed female neonate with left-sided acute parotid abscess. The baby presented with a left preauricular swelling, pain and redness. Pus was exuded from left Stensen's duct on compression of the gland externally. Early diagnosis and proper intravenous antibiotics are the keys to the treatment. PMID:28051052

  19. 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.

  20. 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.

  1. Morphological Changes of Myoepithelial Cells in the Rat Submandibular Gland Following the Application of Surgical Stimuli

    PubMed Central

    Kawabe, Yoshihiro; Mizobe, Kenich; Bando, Yasuhiko; Sakiyama, Koji; Taira, Fuyoko; Tomomura, Akito; Araki, Hisao; Amano, Osamu

    2016-01-01

    Myoepithelial cells (MECs) exist on the basal surface of acini in major exocrine glands, include myofilaments and various constructive proteins, and share characteristics with smooth muscle and epithelial cells. MECs project several ramified processes to invest acini, and possibly contract to compress acini to support the secretion by the glandular cells. However, the functional roles of MECs in salivary secretion are still unclear. We investigated morphological changes in immunostained MECs using the anti-α-smooth muscle actin (αSMA) antibody in operated or non-operated contralateral (NC) submandibular glands after partial or total resection. Furthermore, we investigated and discuss other salivary glands of rats. MECs in the parotid, sublingual and submandibular gland of adult rats exhibited different shapes and localizations. After surgery, in both operated and NC glands, the number of MECs and αSMA-immunopositive areas increased significantly. Three-dimensional analysis using a confocal laser-scanning microscope revealed that substantial and significant enhancement became evident in the number, length, and thickness of MEC-processes covering acini of the operated and NC submandibular glands. The preset findings indicate that MECs alter the morphology of their processes in operated and NC glands after surgery of the partial or total resection. It is suggested that MECs promote salivary secretion using elongated, thickened, and more ramified processes. PMID:28127104

  2. Mantle irradiation of the major salivary glands

    SciTech Connect

    Kaplan, P.

    1985-11-01

    Radiation given to the mantle field for treatment of Hodgkin's disease impinges on the submandibular and parotid glands at levels that have been both measured and calculated to be the complete tumor dose. This dosage is above the level of irradiation that has been shown to cause partial or complete loss of salivary gland function.

  3. 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

  4. Wegener's granulomatosis: parotid involvement and associated pancreatitis with C.T. findings.

    PubMed

    Stuckey, S L; Smart, P J

    1992-11-01

    Parotid enlargement is an uncommon physical sign and even less commonly the reason for referral for computerised tomography (CT) as the aetiology is usually self-evident. In cases referred for CT examination Wegener's granulomatosis should be considered, particularly if the pathology appears bilateral. This diagnosis may be confirmed by biopsy and/or supported by Anti-Neutrophil Cytoplasmic Antibody (ANCA) assay. A case of Wegener's granulomatosis with parotid gland involvement and temporally related pancreatitis with pseudocyst formation is reported. This is the second reported case of possible pancreatic involvement in Wegeners granulomatosis and approximately the tenth reported case of salivary gland involvement.

  5. 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.

  6. Dysgenetic polycystic disease of the minor and submandibular salivary glands.

    PubMed

    Koudounarakis, Eleftherios; Willems, Stefan; Karakullukcu, Baris

    2016-06-01

    Dysgenetic polycystic salivary gland disease is a rare pathology. No case of minor salivary gland involvement has been reported in the literature. A female patient presented with bilateral tumors of the parotid glands, bilateral submandibular gland enlargement, and multiple cystic lesions of the oral mucosa. MRI of the neck was performed along with fine-needle aspiration (FNA) of the parotid tumors and excisional biopsy of an oral lesion. Imaging and FNA findings of the parotid glands were suggestive of bilateral Warthin tumors. Excisional biopsy of the oral lesion revealed a minor salivary gland with histopathological features of dysgenetic polycystic salivary gland disease. Submandibular gland enlargement was also attributed to this rare entity based on the imaging characteristics. This is the first report of dysgenetic polycystic salivary gland disease of the minor salivary glands, combined with involvement of the submandibular glands and bilateral Warthin tumors of the parotid gland. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2437-E2439, 2016. © 2016 Wiley Periodicals, Inc.

  7. Parotid mass: a 5-year review of parotid surgery.

    PubMed

    Chew, Y K; Noorizan, Y; Khir, A; Brito-Mutunayagam, S

    2007-12-01

    This study is to analyze the incidence of facial nerve paralysis after parotidectomy and the type of pathologic condition involved in Hospital Pakar Sultanah Fatimah, Muar between 2002 and 2006. There were 20 parotidectomies done on 20 patients over this period of time. Fourteen were done for tumour and six for inflammatory conditions. The pathology involved were pleomorphic adenoma 9 (45%) cases, Kimura disease 2 (10%) cases, carcinoma 5 (25%) cases and inflammatory condition 4 (20%) cases. Out of 20 parotidectomies done (13 for superficial and 7 for total), 4 (20%) patients had complication of facial nerve paralysis, 2 Malignant tumour, 1 benign tumor and 1 was inflammatory condition. In conclusion, preservation of the facial nerve and its function, wherever possible, is very important to reduce social and functional morbidity.

  8. Effects of dopamine on adenylyl cyclase activity and amylase secretion in rat parotid tissue.

    PubMed

    Hatta, S; Amemiya, N; Takemura, H; Ohshika, H

    1995-06-01

    Several previous studies have shown that dopamine causes amylase secretion from rat parotid tissue. However, the mechanism of this dopamine action is still unclear. The present study was designed to characterize dopamine action in rat parotid gland tissue by examining the effects of dopamine on cyclic AMP accumulation, adenylyl cyclase activity, and amylase release. Dopamine significantly enhanced accumulation of cyclic AMP in parotid slices and stimulated adenylyl cyclase activity in parotid membrane preparations. It also significantly stimulated amylase release from parotid slices. The stimulatory effects of dopamine on cyclic AMP accumulation, adenylyl cyclase activity, and amylase release were effectively blocked with propranolol, a beta-adrenergic antagonist, but not by either SCH 23390, a preferential D1 antagonist, or butaclamol, a preferential D2 antagonist. No substantial specific binding sites for D1 receptors were detectable by [3H]SCH 23390 binding in parotid membranes. These results suggest that the stimulatory effect of dopamine on amylase secretion in rat parotid tissue is not mediated through specific D1 dopamine receptors but rather through beta-adrenergic receptors.

  9. Surgical management of parotid salivary duct rupture secondary to non-iatrogenic trauma in a dog

    PubMed Central

    YOON, Hun-Young; MIN, Byong-Su; KIM, Sun-Young; LEE, Da-Eun; KIM, Jung-Hyun

    2016-01-01

    A 3-year-old French bulldog presented for evaluation of recurrent swelling and a fistula on the right cheek after a dog fight. A large volume of serous fluids was identified on the wound immediately after atropine drops. A diagnosis of parotid salivary duct rupture secondary to trauma was made. On surgical exploration, the thickened proximal segment of the severed duct was identified and circumferentially double ligated with 3–0 silk. No evidence of swelling and normal appearance of the parotid salivary gland were identified 4 months postoperative recheck. No further problems were noted 10 months postoperatively phone-call. To the author’s knowledge, this is the first reported case of successful proximal parotid duct ligation of parotid salivary duct rupture secondary to non-iatrogenic trauma. PMID:27666341

  10. 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.

  11. Clinical evaluation of salivary carbohydrate antigen 125 and leptin in controls and parotid tumours.

    PubMed

    Zhang, K-Y; Liu, C-Y; Hua, L; Wang, S-L; Li, J

    2016-10-01

    We determined the correlation between saliva and serum for CA125 and leptin, and evaluated their clinical screening potential for parotid tumours. Serum, acid-stimulated bilateral parotid saliva and chewing-stimulated whole saliva were collected and measured the levels of CA125 and leptin with electrochemiluminescence immunoassay and enzyme-linked immunosorbent assay for healthy controls and patients with unilateral parotid tumour. Intra- and intergroup comparisons were made among them. Correlations and receiver operating curve analyses were also conducted. There was no correlation between salivary and serum CA125 (r = -0.157-0.265, P > 0.05), while significant correlation was found for leptin (r = 0.219-0.761, P < 0.05). Leptin levels in tumour parotid saliva and CA125 levels in whole saliva were elevated significantly (P < 0.001) and showed screening potential for parotid tumours. Salivary and serum leptin levels were significantly higher in women than in men (P < 0.001). Salivary CA125 might originate primarily from salivary gland and tumour rather than from blood, while salivary leptin might originate from both blood and salivary gland. Multiple sources might contribute to the significantly elevated CA125 in whole saliva. Whole saliva CA125 and parotid saliva leptin reflected the occurrence of parotid tumours, while serum CA125 and leptin did not. Salivary CA125 and leptin could not distinguish malignant parotid tumours. When detecting leptin level, the influence of subjects' sex must be considered. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Use of Botox (OnabotulinumtoxinA) for the Treatment of Parotid Sialocele and Fistula After Extirpation of Buccal Squamous Cell Carcinoma With Immediate Reconstruction Using Microvascular Free Flap: A Report of 3 Cases.

    PubMed

    Melville, James C; Stackowicz, Daniel J; Jundt, Jonathon S; Shum, Jonathan W

    2016-08-01

    Buccal squamous cell carcinoma is an aggressive form of oral carcinoma with a high recurrence rate. Injury to the parotid duct is often unavoidable when surgically treating buccal squamous cell carcinoma because of the intimate anatomic relation among the buccal mucosa, Stensen duct, and parotid gland. It is often difficult to achieve negative margins and preserve the integrity of the parotid duct. Sialocele formation is a frequent and untoward complication owing to extravasation of saliva into the surgical defect, which delays healing, creates fistulas, and produces painful facial swelling. Currently, no consensus exists regarding the management of a parotid sialocele. Multiple investigators have described different modalities of treatment, such as repeated percutaneous needle aspiration, pressure dressings, antisialagogue therapy, radiotherapy, botulinum toxin, and surgical techniques, including duct repair, diversion, ligation, drain placement, and parotidectomy. With approval from the institutional review board of the University of Texas Health Sciences Center at Houston, 3 cases of parotid sialocele and nonhealing fistulas successfully treated with Botox (onabotulinumtoxinA) after tumor extirpation, neck dissection, and reconstruction with a microvascular free flap are presented. At the University of Texas Health Sciences Center at Houston, the radiation oncologist prefers not to start adjunctive radiation treatment with a nonhealing wound or a drain in the field of radiation. Ideally, a standard timing of adjuvant radiotherapy is 6 to 8 weeks after surgery and 60 cGy should be completed before 7 months. With the use of Botox, the nonhealing wound resolved and the drain was removed at least 2 weeks before the initiation of adjunctive radiotherapy, thus minimizing the delay in adjuvant treatment. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Pretreatment Neutrophil-Lymphocyte Ratio in Salivary Gland Tumors Is Associated with Malignancy.

    PubMed

    Damar, Murat; Dinç, Aykut Erdem; Erdem, Duygu; Aydil, Utku; Kizil, Yusuf; Eravcı, Fakih Cihat; Bişkin, Sultan; Şevik Eliçora, Sultan; Işik, Hüseyin

    2016-12-01

    To assess pretreatment levels in the counts and percentages of leukocytes and the neutrophil-lymphocyte ratio (NLR) in benign and malignant salivary gland tumors (SGTs) while investigating whether NLR is an inflammatory marker for distinguishing low- from high-grade parotid gland tumors. Case series with chart review. Tertiary referral center. This study was performed on 182 patients with SGTs (age range: 16-87 years; 93 male and 89 female) who were treated between January 2010 and May 2015. Pretreatment counts and percentages of leukocytes and NLR were measured preoperatively in benign and malignant tumors. Mean neutrophil percentage (63.50% ± 12.11% vs 58.76% ± 8.20%, P = .008) and NLR (3.29 ± 3.13 vs 2.13 ± 1.26, P = .008) were significantly higher in patients with malignant SGTs than in patients with benign SGTs. Mean lymphocyte count (2.42 ± 0.72 10(3)/mm(3) vs 1.97 ± 0.87 10(3)/mm(3), P < .001) and percentage (30.67% ± 7.68% vs 26.86% ± 10.15%, P = .011) were lower in patients with malignant SGTs than in patients with benign SGTs. Mean lymphocyte percentage and NLR were significantly different between low- and high-grade malignant parotid gland tumors (P = .026 and P = .030, respectively). Elevated NLR could be an inflammatory marker to distinguish low- from high-grade malignant parotid gland tumors. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. Recurrent Parotid Carcinosarcoma in an Asymptomatic Patient

    PubMed Central

    Mansour, Joshua; Mangaonkar, Abhishek; Kota, Vamsi

    2016-01-01

    In this article, we present the case of a 52-year-old male with a history of parotid carcinosarcoma with initial diagnosis being 18 months prior. Initial treatment included a combination of gamma knife surgery coupled with high dosage chemotherapy and X-ray radiation therapy. At the time of follow-up, the patient presented with no complaints and had a nearly normal physical exam with the exception of some facial nerve weakness on the same side as the initial surgery. Despite being asymptomatic, the patient had a significant progression of disease that was manifested with intracranial lesions, multiple pathologic fractures, and a dramatic increase in overall tumor burden. Ultimately, the patient decided to pursue comfort measures only and succumbed to the disease peacefully soon thereafter. PMID:27847832

  15. Possible involvement of parotid beta-adrenergic receptors in the etiology of sialadenosis.

    PubMed

    Chilla, R; Witzemann, V; Opaitz, M; Arglebe, C

    1981-01-01

    The concentration of beta-adrenergic receptors was determined in rat and human parotid glands, in normal tissue as well as after sympathetic denervation of the rat, and in human sialadenosis. Receptor levels were clearly elevated after denervation of the rat and in sialadenosis. The possible implications of these findings for the etiology of human sialadenosis are discussed.

  16. Robotic assisted versus pure laparoscopic surgery of the adrenal glands: a case-control study comparing surgical techniques.

    PubMed

    Morelli, Luca; Tartaglia, Dario; Bronzoni, Jessica; Palmeri, Matteo; Guadagni, Simone; Di Franco, Gregorio; Gennai, Andrea; Bianchini, Matteo; Bastiani, Luca; Moglia, Andrea; Ferrari, Vincenzo; Fommei, Enza; Pietrabissa, Andrea; Di Candio, Giulio; Mosca, Franco

    2016-11-01

    The role of the da Vinci Robotic System (®) in adrenal gland surgery is not yet well defined. The goal of this study was to compare robotic-assisted surgery with pure laparoscopic surgery in a single center. One hundred and 16 patients underwent minimally invasive adrenalectomies in our department between June 1994 and December 2014, 41 of whom were treated with a robotic-assisted approach (robotic adrenalectomy, RA). Patients who underwent RA were matched according to BMI, age, gender, and nodule dimensions, and compared with 41 patients who had undergone laparoscopic adrenalectomies (LA). Statistical analysis was performed using the Student's t test for independent samples, and the relationship between the operative time and other covariates were evaluated with a multivariable linear regression model. P < 0.05 was considered significant. Mean operative time was significantly shorter in the RA group compared to the LA group. The subgroup analysis showed a shorter mean operative time in the RA group in patients with nodules ≥6 cm, BMI ≥ 30 kg/m(2) and in those who had previous abdominal surgery (p < 0.05). Results from the multiple regression model confirmed a shorter mean operative time with RA with nodules ≥6 cm (p = 0.010). Conversion rate and postoperative complications were 2.4 and 4.8 % in the LA group and 0 and 4.8 % in the RA group. In our experience, RA shows potential benefits compared to classic LA, in particular on patients with nodules ≥6 cm, BMI ≥ 30 kg/m2, and with previous abdominal surgery.

  17. Pleomorphic adenoma of submandibular gland: A case report with review of literature

    PubMed Central

    Patil, Preeti; Burde, Krishna; Naikmasur, Venkatesh G.; Thorawat, Amit

    2014-01-01

    Neoplasms that arise in the salivary glands are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes. Approximately 70% of the salivary gland tumors affect parotid gland with the submandibular gland being affected in 5-10% of the cases, sublingual gland in 1% and minor glands in 5-15% of the cases. Submandibular gland tumors are relatively rare and very few studies have been reported in the literature that is exclusively conducted on tumors affecting submandibular gland. In this paper, we describe a case of pleomorphic adenoma affecting submandibular gland with brief review of current literature on submandibular gland tumors. PMID:25097655

  18. Effect of (131)I 'clear residual thyroid tissue' after surgery on the function of parathyroid gland in differentiated thyroid cancer.

    PubMed

    Zhao, Zhi-Hua; Li, Feng-Qi; Han, Jian-Kui; Li, Xian-Jun

    2015-12-01

    Thyroid cancer is a common malignant tumor of the endocrine glands. Although surgery is the optimal treatment utilized, the disease is characterized by recurrence and metastasis. The aim of the present study was to determine the effect of iodine-131 ((131)I) 'clear residual thyroid tissue' following surgery on the treatment of differentiated thyroid cancer (DTC) and its effect on the function of the parathyroid gland. A total of 160 patients diagnosed with DTC, who were consecutively admitted to our Hospital between June 2012 and June 2014 and underwent total thyroidectomy or subtotal resection, were included in the present study. After three months, the patients were administered (131)I 'clear residual thyroid tissue' treatment and underwent a whole body scan after 1 week to determine whether 'clear residual thyroid tissue' treatment was successful or not. The treatment was repeated within 3 months if not successful. Of the 160 patients, 24 patients had cancer metastasis (15.0%). The average dose of (131)I used for the first time was 6.4+1.2 GBq and the treatment was successful in 66 cases (41.3%). The average treatment time was 2.8±0.6 therapy sessions. The results showed that, prior to and following the first treatment and at the end of the follow up, levels of the parathyroid hormone, serum calcium and phosphorus were compared, and no statistically significant difference (P>0.05) was observed. There were 5 patients with persistent hypothyroidism and 8 patients with transient hypothyroidism. The levels of thyroglobulin were significantly decreased, and the difference was statistically significant (P<0.05). A total of 48 patients (30%) with hypothyroidism were identified. In conclusion, the results have shown that DTC resection and (131)I 'clear residual thyroid tissue' treatment did not significantly impair the parathyroid function, thereby improving the treatment effect.

  19. Parotid or carotid? Misled by site.

    PubMed

    Tyagi, Ruchita; Munjal, Manish; Kaur, Pavneet; Kaur, Harpreet; Sood, Neena

    2017-03-06

    We present an interesting scenario where a 64 years old male presented with a long standing painless, infra-auricular swelling, which had progressively increased in size. Based on the site, the clinical impression was of a salivary gland lesion and FNAC was performed. The smears were unusually cellular and had necrotic background. The cytological diagnosis was a cystic neoplasm of salivary gland, possibly mucoepidermoid carcinoma. Warthin's tumor was also kept in differential. However, the radiological investigations, which were made available after the FNAC report were conflicting with cytological diagnosis of a malignancy and were characteristic of a carotid body tumor, generally a benign neoplasm. Surgical excision of the tumor with regional lymph node sampling was done and histopathological examination solved the puzzle by revealing metastasis of paraganglioma to right posterior triangle lymph nodes. This case is unique because of the unusual presentation of a malignant paraganglioma as an infra-auricular swelling, which was clinically considered as a parotid tumor. The clinician as well as the pathologist need to be aware of such diagnostic pitfall. Diagn. Cytopathol. 2017. © 2017 Wiley Periodicals, Inc.

  20. Parotid Sebaceous Carcinoma in Patient with Muir Torre Syndrome, Caused by MSH2 Mutation.

    PubMed

    Neelakantan, Iyer Vishwas; Di Palma, Silvana; Smith, C E T; McCoombe, A

    2016-09-01

    Sebaceous carcinoma of parotid gland are extremely rare with only 29 cases reported so far. The development of parotid sebaceous carcinoma in association with mutation in the mismatch repair gene that causes Muir Torre Syndrome (MTS), a subset of Lynch Syndrome, is still unclear. This study describes such a case and reviews the literature to see if an association between parotid sebaceous carcinoma and multiple visceral malignancies seen in Lynch Syndrome has ever been described. MTS represents a small subset of the Hereditary Non Polyposis Colorectal Carcinoma family, thought to be a subtype of Lynch Syndrome, where patients are prone to develop multiple visceral cancers involving gastrointestinal and genitourinary tract along with sebaceous and non-sebaceous tumours of the skin. MTS is a rare hereditary, autosomal dominant cancer syndrome caused by Microsatellite Instability and defect in DNA mismatch repair protein. The germline mutation involves mostly hMSH2 and hMLH1 genes. In MTS the skin of the head and neck area with the periocular region in particular, is affected but sebaceous carcinomas of the parotid associated with visceral malignancies has not yet been reported in literature. Here we report an index case of sebaceous carcinoma of parotid gland in a patient with MTS.

  1. [Salivaly gland tumors in childhood: importance of an early diagnosis and treatment].

    PubMed

    Gander, R; Guillén, G; García Vaquero, J A; Molino, J A; Marhuenda, C; Lloret, J

    2014-04-15

    Review of our series of salivaly gland tumors at pediatric age, given its low frequency and their higher rate of malignancy compared with the adult population. Retrospective study of the medical records of all pediatric patients with salivaly gland tumors treated in our center between 1998 and 2013. We identified 12 patients. The most common site of tumor location was the parotid gland in 11 patients followed by the sublingual gland in 1 patient. Three patients had previous cancer and radiotherapy history. The diagnosis (histological or radiological) were: 4 hemangiomas, 2 pleomorphic adenomas, 4 mucoepidermoid carcinomas, one acinar cell carcinoma and 1 primitive neuroectodermal tumor (PNET). No patient had metastasis at diagnosis. Preoperative fine needle aspiration (FNA) was performed in 6 patients with solid masses, being diagnostic in all cases. Eight patients underwent surgery. In two cases of total parotidectomy initial neuroapraxia appeared but none had permanent facial paralysis. There were no cases of Frey syndrome. The aesthetic results were good. There was only one tumor recurrence and all patients, except one who died of leukemia relapse, survive today. Salivaly gland tumors are uncommon in pediatric age but their high rate of malignancy makes it necessary to establish a rapid diagnosis. In our experience, FNA showed a high sensitivity. For malignant tumors, definitive treatment is surgical excision, preserving the facial nerve whenever possible. For vascular tumors, surgery is reserved for cases refractory to medical treatment.

  2. Clinicopathologic factors associated with recurrence in parotid carcinoma.

    PubMed

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

    2017-08-25

    Parotid carcinomas have varying histological types and diverse biologic behaviors. Establishing an adequate treatment plan and predicting recurrence is important. To analyze the risk factors associated with recurrence in our 5 year experience with 30 cases of primary parotid carcinoma undergoing surgery at a single institute. From January 2009 to December 2013, 30 patients with surgical treatment of parotid carcinoma were identified based on their medical records. The 30 patients were comprised of 17 males and 13 females. Among 11 patients with T4 tumors, seven patients had recurrence. Among seven patients with cervical nodal metastasis, all patient except one had recurrence. Clinically late stages (stage III and IV) showed more common recurrence than early stage (stage I and II) lesions. Lymphovascular invasion was seen in 5 patients, and all patients had recurrence. Among 11 patients with extracapsular spread, 7 patients had recurrence. In 17 patients with high grade carcinomas, ten patients had recurrence. In 13 patients with low grade carcinomas, no patients experienced recurrence. T- and N-stage, clinical stage, lymphovascular invasion, extracapsular spread, and histopathologic grade correlate significantly with recurrence in parotid carcinoma. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. 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.

  4. Isolated Langerhans cell histiocytosis of the sublingual gland in an adult.

    PubMed

    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.

  5. 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

  6. [Sialendoscopy: endoscopic approach to obstructive salivary gland disease].

    PubMed

    van der Meij, E H; Pijpe, J; van Ingen, J M; de Visscher, J G A M

    2013-09-01

    Sialendoscopy: endoscopic approach to obstructive salivary gland defects Obstructive defects of the parotid and the submandibular gland often present themselves clinically by mealtime-related swelling of the affected salivary gland, the so-called 'mealtime syndrome'. Salivary ductal obstruction of the parotid and submandibular gland is predominantly caused by the presence of a salivary stone, a mucous plug, or by ductal stenosis. Until recently, diagnostic and treatment options for these obstructive salivary gland defects were restricted. Surgical removal of the affected salivary gland was often the treatment of choice. By applying sialendoscopy, a minimally invasive, semi rigid optical technique, it is possible to diagnose and treat obstructions which are found in the salivary ductal system. In many cases, therefore, the surgical removal of the salivary gland becomes unnecessary.

  7. Oncocytic papillary cystadenoma of major salivary glands: Three rare cases with diverse cytologic features.

    PubMed

    Chin, Susie; Kim, Hee Kyung; Kwak, Jeong Ja

    2014-01-01

    Oncocytic papillary cystadenoma (OPC) in the major salivary glands is extremely rare. We report three cases of these cystadenomas arising in major salivary glands, with varied cytologic features. Case 1: A 38-year-old man presented with a right parotid gland mass that showed papillary clusters of oncocytic cells on cytologic examination. Case 2: An 84-year-old man presented with a left parotid gland mass. Cytology revealed an acellular smear. Case 3: A 57-year-old man presented with a mass in the right submandibular gland. Cytology revealed irregular sheets of epithelial cells. Histologic diagnoses of OPC were made for all three cases.

  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

    2014-11-28

    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. Relationship between parotid amylase secretion and osmolality in the gastric contents of rats fed a pelleted or liquid diet.

    PubMed

    Kurahashi, M; Inomata, K

    1999-12-01

    The relationship between parotid amylase secretion and the osmolality in the gastric contents of rats fed a pelleted or liquid diet was investigated. In sham-operated rats fed a pelleted diet, amylase activity in the parotid glands decreased, amylase activity in the plasma increased, and there was strong amylase activity in the gastric contents. As a result, both reducing sugar concentration and osmolality in the gastric contents increased. In parotid duct-ligated rats, the feeding of a pelleted diet affected neither parotid nor plasma amylase activity and there was little amylase activity in the gastric contents; this resulted in decreased starch digestion. The amylase activity in the gastric contents of rats fed a liquid diet was lower than that of rats fed the pelleted diet. Both the reducing sugar concentration and osmolality in the gastric contents of rats fed the liquid diet were lower than those of rats fed the pelleted diet. However, both the reducing sugar concentration and osmolality in the gastric contents of rats fed the liquid diet were higher than those in the liquid diet itself. A small quantity of parotid amylase seems to effectively digest a large part of the starch in the stomaches of rats fed the liquid diet. These findings suggest that amylase secreted from parotid glands increases osmolality in the gastric contents via the production of reducing sugars from starch in rats when fed either pelleted or liquid diets.

  11. Electrophysiological properties of AQP6 in mouse parotid acinar cells.

    PubMed

    Ichikawa, Hideki; Shibukawa, Yoshiyuki; Sahara, Yoshinori; Tsumura, Maki; Qi, Bing; Satoh, Keitaro; Narita, Takanori; Hashimoto, Sadamitsu; Momose, Yasunori; Tazaki, Masakazu; Shimono, Masaki; Sugiya, Hiroshi

    2009-01-01

    Salivary gland acinar cells secrete large amounts of water and electrolytes, where aquaporins (AQPs) are thought to be involved in the secretion. In the present study, we investigated expression/localization of AQP6, and the anion transporting properties of AQP6 in mouse parotid acinar cells. RT-PCR, western blotting and immunohistochemical analyses revealed expression of AQP6 in acinar cells, localized in apical membrane. Voltage ramp from -100 mV to +100 mV at a holding potential of -60 mV elicited outwardly-rectifying currents, in the presence of extracellular Cl(-) channel blockers and intracellular solution with 150 mM Cs(+). These outward currents were increased when extracellular Cl(-) was replaced by Br(-), NO(3)(-), I(-), or SCN(-), accompanying a negative shift of reversal potentials. The outward current was enhanced by extracellular Hg(2+). These results were consistent with the biophysical properties of transfected AQP6 oocytes or HEK cells, which indicate that the AQP6 channel is functionally expressed in parotid acinar cells, and suggest that AQP6 contributes to secretion of anions in parotid acinar cells.

  12. Salivary Gland Scintigraphy in Patients with Sjogren's Syndrome: A local Experience with Dual-tracer.

    PubMed

    Luk, Wing Hang; Yeung, Jessie Tse Hang; Fung, Eliza Po Yan; Lok, Chiu Ming; Ng, Yuet Ming

    2017-01-01

    To review the findings of the patients with Sjögren's syndrome (SS) having technetium99-m-pertechnetate ((99m)Tc-pertechnetate) and gallium67- citrate (Ga-67) salivary gland scintigraphy in the past eight years. The patients with SS, who were referred to our department for salivary gland scintigraphy during January -2008December 2015 were studied using both (99m)Tc-pertechnetate and Ga-67 citrate scintigraphy. Eighteen patients were included in the study, 17 of whom had positive findings on (99m)Tc-pertechnetate salivary gland scintigraphy. One patient had negative parotid glands findings on (99m)Tc-pertechnetate, but positive findings in Ga-67 study. Four patients had asymmetric involvement of the parotid glands, and one patient had asymmetric involvement of the submandibular glands in (99m)Tc-pertechnetate salivary gland scintigraphy. On the other hand, one patient had only submandibular gland involvement in the (99m)Tc-pertechnetate scan. Nine patients (18/9) had positive parotid gland findings on Ga-67 study. The involvements of the parotid glands were all symmetrical, except for one patient. No abnormal gallium uptake in the submandibular glands in our patients was noted. (99m)Tc-pertechnetate salivary gland scintigraphy is sufficient for the assessment in the majority of patients with SS. Ga-67 scintigraphy may be a useful supplementary test, especially if the result of (99m)Tc-pertechnetate scintigraphy is not conclusive.

  13. [Hypertrophy of the salivary glands in bulimia].

    PubMed

    Herrlinger, P; Gundlach, P

    2001-07-01

    We report a case of bulimia nervosa with bilateral swelling of the parotid and submandibular glands. It was the only symptom of the behavioral disorder. Sjögren's disease was excluded histologically. In our case, the parotomegaly as a symptom of sialadenosis was found at the same time as the eating disorder. MRI or ultrasound are important diagnostic tools to confirm the diagnosis.

  14. 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.

  15. 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

  16. UNUSUAL FORMATIONS OF ERGASTOPLASM IN PAROTID ACINOUS CELLS OF MICE

    PubMed Central

    Parks, Harold F.

    1962-01-01

    The ergastoplasm (granular endoplasmic reticulum) of parotid acinous cells of the mouse is described with special emphasis on unusual forms of this membranous system. In the majority of the acinous cells the ergastoplasm appeared in sections to consist of a large number of separate flattened cisternae. In some acinous cells, however, the ergastoplasm was disposed as a very small number of large membranous formations. Although extensive and complicated in form, these latter formations could be seen, from the examination of a single section, to consist of a single expanse of membrane continuous with the nuclear envelope. Certain acinous cells exhibited ergastoplasmic formations which appeared to represent intermediate stages of a fragmentation or metamorphosis of the larger formations toward the more usual form of ergastoplasm. These observations suggest the possibility that the early elaboration of ergastoplasm consists in the production, in relation to the nuclear envelope, of large, complicated membranous formations that subsequently sever their connection with the nuclear envelope and form a large number of separate, or tenuously connected, cisternae. The majority of the large, complicated ergastoplasmic formations were seen in parotid glands of mice that had been starved for 4 days and subsequently fed for a variable number of hours, but some were found in glands that were not subjected to experimental treatment. The tissues studied were prepared for electron microscopic examination by fixation in osmium tetroxide, dehydration in alcohol, imbedding in butyl methacrylate, sectioning with a glass knife, staining with lead hydroxide, and sandwiching with formvar. PMID:14483961

  17. Evaluation of Parotid Salivary Glucose Level for Clinical Diagnosis and Monitoring Type 2 Diabetes Mellitus Patients.

    PubMed

    Wang, Beibei; Du, Juan; Zhu, Zhao; Ma, Zhihong; Wang, Songlin; Shan, Zhaochen

    2017-01-01

    Background. To investigate the relationships among blood glucose, mixed saliva glucose, and parotid glucose in type 2 diabetes patients and to evaluate the diagnostic and monitoring value of salivary gland glucose in patients with type 2 diabetes (type 2DM). Material and Methods. Thirty patients with type 2DM and 30 healthy age- and sex-matched individuals were included in this study. Glucose levels in unstimulated mixed saliva and in unstimulated parotid saliva were measured by the glucose oxidase peroxidase method. Results. The blood glucose and parotid salivary glucose levels in type 2DM patients were significantly higher than those in the controls (P < 0.05). The blood glucose, parotid salivary glucose, and mixed salivary glucose were 7.46 ± 1.44 mmol/L, 0.18 ± 0.19 mmol/L, and 3.17 × 10(-2) ± 2.84 × 10(-2) mmol/L, respectively, in the type 2DM group; the corresponding glucose levels in the control group were 5.56 ± 0.71 mmol/L, 7.70 × 10(-2) ± 6.02 × 10(-2) mmol/L, and 3.47 × 10(-2) ± 2.79 × 10(-2) mmol/L. The parotid salivary and blood glucose levels in type 2DM patients were strongly correlated; the linear regression equation for blood glucose and parotid salivary glucose was Y = 6.267X + 6.360, with r = 0.810. However, mixed salivary glucose levels were not significantly different in the type 2 diabetes group compared with the control group. Conclusion. Our results suggest that parotid salivary glucose has potential as a biomarker to monitor type 2DM and as a painless, noninvasive method for the management of type 2DM.

  18. Evaluation of Parotid Salivary Glucose Level for Clinical Diagnosis and Monitoring Type 2 Diabetes Mellitus Patients

    PubMed Central

    Wang, Beibei; Du, Juan; Zhu, Zhao; Ma, Zhihong; Wang, Songlin

    2017-01-01

    Background. To investigate the relationships among blood glucose, mixed saliva glucose, and parotid glucose in type 2 diabetes patients and to evaluate the diagnostic and monitoring value of salivary gland glucose in patients with type 2 diabetes (type 2DM). Material and Methods. Thirty patients with type 2DM and 30 healthy age- and sex-matched individuals were included in this study. Glucose levels in unstimulated mixed saliva and in unstimulated parotid saliva were measured by the glucose oxidase peroxidase method. Results. The blood glucose and parotid salivary glucose levels in type 2DM patients were significantly higher than those in the controls (P < 0.05). The blood glucose, parotid salivary glucose, and mixed salivary glucose were 7.46 ± 1.44 mmol/L, 0.18 ± 0.19 mmol/L, and 3.17 × 10−2 ± 2.84 × 10−2 mmol/L, respectively, in the type 2DM group; the corresponding glucose levels in the control group were 5.56 ± 0.71 mmol/L, 7.70 × 10−2 ± 6.02 × 10−2 mmol/L, and 3.47 × 10−2 ± 2.79 × 10−2 mmol/L. The parotid salivary and blood glucose levels in type 2DM patients were strongly correlated; the linear regression equation for blood glucose and parotid salivary glucose was Y = 6.267X + 6.360, with r = 0.810. However, mixed salivary glucose levels were not significantly different in the type 2 diabetes group compared with the control group. Conclusion. Our results suggest that parotid salivary glucose has potential as a biomarker to monitor type 2DM and as a painless, noninvasive method for the management of type 2DM. PMID:28251153

  19. Bilateral isolated submandibular gland mumps.

    PubMed

    Cheung, Linnea; Henderson, Arthur Harry; Banfield, Graham; Carswell, Andrew

    2017-06-05

    Isolated submandibular swellings pose a diagnostic challenge to the practising otolaryngologist. We report an unusual case of mumps isolated to bilateral submandibular glands. We discuss the case and the literature surrounding this condition and remind clinicians that mumps should be considered as a diagnosis in the presence of submandibular gland swelling in the absence of typical parotid swelling associated with mumps. Early consideration of this differential diagnosis, serological testing and a multidisciplinary approach may help to clinch the diagnosis earlier and prevent spread of the virus. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  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.

  1. Cytological spectrum of salivary gland lesions and their correlation with epidemiological parameters.

    PubMed

    Sandhu, Vaneet Kaur; Sharma, Upender; Singh, Navtej; Puri, Arun

    2017-01-01

    The role fine-needle aspiration (FNA) in the diagnosis of salivary gland lesions has evolved over the years. Although clinical and radiological parameters help to narrow the differential diagnosis the tissue diagnosis still remains the gold standard. This study is from January 2013 to December 2015 in our Department of Pathology where 170 salivary gland lesions were aspirated. The aim of the present study was to analyze adequacy rate in relation to the size of lesion and to evaluate varied cytological spectrum of salivary gland lesions with emphasis on differential diagnosis and to correlate cytological diagnosis with age, gender and anatomical site. The 170 cytological smears were categorized into two groups: Group 1 adequate aspirations (88.2%), Group 2 inadequate aspirations (11.7%). The adequate aspirations were subdivided as neoplastic (53.33%) and nonneoplastic (46.66%). The distribution of the various neoplastic lesions (80; 53.33%) were 66 (82.5%) benign, 12 (15%) were malignant and 2 (2.5%) were suspicious of malignancy. Among benign neoplasms, the pleomorphic adenoma (62; 93.3%) was the most frequent followed by Warthins tumor (4; 6%). The most common malignant neoplasms were adenoid cystic carcinoma (6; 50%), followed by mucoepidermoid carcinoma (4; 33.3%), malignant lymphoma (1; 8.3%) and metastatic carcinomatous deposits (1; 8.3%). In two cases, cytological picture indicated suspicion for malignancy however specific tumor typing could not be done. The neoplasms occurred more frequently in the parotid gland (65%), followed by submandibular gland (21.3%) and minor salivary glands (13.8%). The nonneoplastic lesions (70) included 68.6% cases of chronic sialadenitis, 17.1% cases were reported as mucocele, 11.4% cases of acute sialadenitis 2.9% cases as tubercular granulomas. FNA cytology provides useful information on the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy

  2. Basal cell adenocarcinoma of the major salivary glands: A population-level study of 509 cases.

    PubMed

    Zhan, Kevin Y; Lentsch, Eric J

    2016-05-01

    We sought to better characterize patient, tumor, and long-term survival characteristics of basal cell adenocarcinoma (BCAC) of the major salivary glands with the National Cancer Database (NCDB). Retrospective database review of the NCDB (1998-2012). We retrospectively reviewed the NCDB for all cases of major salivary gland BCAC with histologic code 8147/3. Relevant demographic, tumor, and survival variables were extracted and analyzed. COX multivariate regression was performed to identify prognosticators. Out of 36,224 major salivary gland cancers in the NCDB, we found 509 cases of BCAC (1.4%), 88% of which were in the parotid glands, 11.2% in the submandibular glands, and 0.8% in the sublingual glands. Age at diagnosis ranged from 18 to 92 years (average 64). No gender preference was found (50.7% male). Most tumors were 2 to 4 cm in size (47.3%). Regional (11.9%) and distant metastasis (1.8%) were uncommon. Overall survival at 5 and 10 years was 79% and 62%, respectively. Although numerous variables were found to significantly impact survival on univariate regression analysis, only age ≥ 65 (hazard ratio [HR] 2.55; 95% confidence interval [CI], 1.56-4.19; P < 0.001) and high primary tumor (T)-stage (HR 1.85; 95% CI, 1.16-2.95; P = 0.010) remained significant prognosticators in our multivariate model. For high T-stage disease, surgery with radiation had significantly better survival than surgery alone. Basal cell adenocarcinoma is a rare salivary malignancy with a good prognosis. Regional and distant metastasis were uncommon. Radiation with surgery may help for higher T-stage disease. Old age and high T-stage were significant predictors of worse survival. 4. Laryngoscope, 126:1086-1090, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Anorexia/bulimia-related sialadenosis of palatal minor salivary glands.

    PubMed

    Mignogna, M D; Fedele, S; Lo Russo, L

    2004-08-01

    In patients affected by alimentary disorders sialadenosis is frequently observed. This non-inflammatory condition is described to affect major salivary glands, leading to the characteristic parotid and/or submandibular swelling. Thus fine-needle aspiration cytology or parotid open biopsy are generally required to diagnose histologically the disorder. We report the case of a 28-year-old patient affected by bulimia/anorexia nervosa who presented, in addition to parotid enlargement, a bilateral symmetric painless soft swelling of the hard palate. The lesion was biopsied and histopathological examination showed the classical features of sialadenosis. To our knowledge, this is the first case of sialadenosis affecting palatal minor salivary glands. It underlines that when sialadenosis is clinically suspected, clinicians could check also patients' oral cavity for minor salivary glands involvement, in order to potentially avoid invasive extra-oral procedures and to easily confirm diagnosis with an intra-oral biopsy.

  4. Chymotrypsin with sialendoscopy-assisted surgery for the treatment of chronic obstructive parotitis.

    PubMed

    Sun, H-J; Xiao, J-Q; Qiao, Q-H; Bao, X; Wu, C-B; Zhou, Q

    2017-03-06

    Chronic obstructive parotitis (COP) is a common disease of the parotid gland. A total of 104 patients with COP were identified and randomized into a treatment group (52 cases) and a control group (52 cases). All patients underwent sialography and salivary gland scintigraphy (SGS) examinations before surgery. The patients in the treatment group received chymotrypsin combined with gentamicin via interventional sialendoscopy to irrigate the duct, and the control group received gentamicin alone. All patients were asked to record their pain on a visual analogue scale (VAS) before treatment and at 1 week, 2 weeks, 1 month, 3 months, and 6 months after surgery. The VAS score for pain intensity was decreased at 1 week post-treatment in both groups (P<0.05). Compared to the control group, the VAS score was lower in the treatment group at 1 week, 2 weeks, and 1 month post-treatment (P<0.05). The 6-month postoperative SGS results showed improved uptake and excretion in both groups (P<0.05). The treatment group exhibited higher scores for postoperative SGS excretion than the control group (P<0.05). The administration of chymotrypsin combined with gentamicin by sialendoscopy is effective for the treatment of non-stone-related COP and specifically improves the excretion function of the parotid gland.

  5. Outcomes of temporal bone resection for locally advanced parotid cancer.

    PubMed

    Mehra, Saral; Morris, Luc G; Shah, Jatin; Bilsky, Mark; Selesnick, Samuel; Kraus, Dennis H

    2011-11-01

    This study was conducted to report outcomes and identify factors predictive of survival and recurrence in patients undergoing lateral temporal bone resection (LTBR) as part of an extended radical parotidectomy for parotid cancer. This is a retrospective cohort study which includes all patients undergoing LTBR for parotid cancer between 1994 and 2010 at two affiliated academic centers. Survival and recurrence rates were analyzed using the Kaplan-Meier method and Cox multivariate regression. A total of 12 patients with median follow-up duration of 30.6 months were included: 6 de novo cases and 6 patients referred after local recurrence. Actuarial locoregional control at 2 years was 73%. Most patients (11; 92%) developed disease recurrence with distant metastases the most common site of first failure (83%). Overall and disease-specific survival rates were 80% at 2 years and 22.5% at 5 years. Recurrence-free survival (RFS) was 67% at 2 years and 8.3% at 5 years. On multivariate analysis, surgical margin status was an independent predictor of RFS (hazard ratio = 3.85, p = 0.045). In advanced parotid cancer, LTBR with a goal of gross total resection offers good locoregional control with an acceptable complication rate. The benefits of this surgery must be balanced with the morbidity and low likelihood of long-term survival, with most patients ultimately experiencing disease recurrence and death.

  6. Outcomes of Temporal Bone Resection for Locally Advanced Parotid Cancer

    PubMed Central

    Mehra, Saral; Morris, Luc G.; Shah, Jatin; Bilsky, Mark; Selesnick, Samuel; Kraus, Dennis H.

    2011-01-01

    This study was conducted to report outcomes and identify factors predictive of survival and recurrence in patients undergoing lateral temporal bone resection (LTBR) as part of an extended radical parotidectomy for parotid cancer. This is a retrospective cohort study which includes all patients undergoing LTBR for parotid cancer between 1994 and 2010 at two affiliated academic centers. Survival and recurrence rates were analyzed using the Kaplan-Meier method and Cox multivariate regression. A total of 12 patients with median follow-up duration of 30.6 months were included: 6 de novo cases and 6 patients referred after local recurrence. Actuarial locoregional control at 2 years was 73%. Most patients (11; 92%) developed disease recurrence with distant metastases the most common site of first failure (83%). Overall and disease-specific survival rates were 80% at 2 years and 22.5% at 5 years. Recurrence-free survival (RFS) was 67% at 2 years and 8.3% at 5 years. On multivariate analysis, surgical margin status was an independent predictor of RFS (hazard ratio = 3.85, p = 0.045). In advanced parotid cancer, LTBR with a goal of gross total resection offers good locoregional control with an acceptable complication rate. The benefits of this surgery must be balanced with the morbidity and low likelihood of long-term survival, with most patients ultimately experiencing disease recurrence and death. PMID:22547966

  7. The impact of dose on parotid salivary recovery in head and neck cancer patients treated with radiation therapy

    SciTech Connect

    Li Yun; Taylor, Jeremy . E-mail: jmgt@umich.edu; Haken, Randall K. ten; Eisbruch, Avraham

    2007-03-01

    Purpose: A common side effect experienced by head and neck cancer patients after radiation therapy (RT) is impairment of the parotid glands' ability to produce saliva. Our purpose is to investigate the relationship between radiation dose and saliva changes in the 2 years after treatment. Methods and Materials: The study population includes 142 patients treated with conformal or intensity-modulated radiotherapy. Saliva flow rates from 266 parotid glands are measured before and 1, 3, 6, 12, 18, and 24 months after treatment. Measurements are collected separately from each gland under both stimulated and unstimulated conditions. Bayesian nonlinear hierarchical models were developed and fit to the data. Results: Parotids receiving higher radiation produce less saliva. The largest reduction is at 1-3 months after RT followed by gradual recovery. When mean doses are lower (e.g., <25 Gy), the model-predicted average stimulated saliva recovers to pretreatment levels at 12 months and exceeds it at 18 and 24 months. For higher doses (e.g., >30 Gy), the stimulated saliva does not return to original levels after 2 years. Without stimulation, at 24 months, the predicted saliva is 86% of pretreatment levels for 25 Gy and <31% for >40 Gy. We do not find evidence to support that the overproduction of stimulated saliva at 18 and 24 months after low dose in 1 parotid gland is the result of low saliva production from the other parotid gland. Conclusions: Saliva production is affected significantly by radiation, but with doses <25-30 Gy, recovery is substantial and returns to pretreatment levels 2 years after RT.

  8. [Immunoglobulin and electrolyte levels in sialadenosis of the parotid (author's transl)].

    PubMed

    Proescher, H J

    1975-03-01

    A comparison of 15 patients with sialadenosis of the parotid gland and 15 control patients was made of their levels of immunoglobulins A, G and M, sodium, potassium, calcium, chloride, albumin, inorganic phosphate, cholesterin, uric acid and creatinin. Those patients with sialadenosis, in comparison with the control group and the findings in other reports, show reduced immunoglobulin A and increased potassium in the parotic secretion. The disturbance of function of the acinic cell is discussed.

  9. Aquaporins in Salivary Glands: From Basic Research to Clinical Applications.

    PubMed

    Delporte, Christine; Bryla, Angélic; Perret, Jason

    2016-01-27

    Salivary glands are involved in saliva secretion that ensures proper oral health. Aquaporins are expressed in salivary glands and play a major role in saliva secretion. This review will provide an overview of the salivary gland morphology and physiology of saliva secretion, and focus on the expression, subcellular localization and role of aquaporins under physiological and pathophysiological conditions, as well as clinical applications involving aquaporins. This review is highlighting expression and localization of aquaporins in human, rat and mouse, the most studied species and is pointing out possible difference between major salivary glands, i.e., parotid, submandibular and sublingual glands.

  10. Aquaporins in Salivary Glands: From Basic Research to Clinical Applications

    PubMed Central

    Delporte, Christine; Bryla, Angélic; Perret, Jason

    2016-01-01

    Salivary glands are involved in saliva secretion that ensures proper oral health. Aquaporins are expressed in salivary glands and play a major role in saliva secretion. This review will provide an overview of the salivary gland morphology and physiology of saliva secretion, and focus on the expression, subcellular localization and role of aquaporins under physiological and pathophysiological conditions, as well as clinical applications involving aquaporins. This review is highlighting expression and localization of aquaporins in human, rat and mouse, the most studied species and is pointing out possible difference between major salivary glands, i.e., parotid, submandibular and sublingual glands. PMID:26828482

  11. Bilateral parotid swelling: a radiological review

    PubMed Central

    Gadodia, A; Bhalla, A S; Sharma, R; Thakar, A; Parshad, R

    2011-01-01

    Bilateral parotid swelling is not an uncommon occurrence and may pose a challenge for clinicians and radiologists. Numerous causes of bilateral parotid swellings have been identified. The purpose of this pictorial review is to display this wide array with a focus on multimodality approach. PMID:21960397

  12. Parotid dermoid cyst: a case report.

    PubMed

    Birsan, Christina; Raza, Anwar; Cobb, Camilla

    2013-04-01

    A dermoid cyst arising in the parotid is rare and usually represents the rare first branchial cleft type II anomaly, which can have morphology similar to a dermoid cyst. This study reports the case of a 20-year-old woman who presented with a parotid mass, which on histologic review was consistent with a dermoid cyst. This appears to be the first case report of a parotid dermoid cyst with focus on the gross and histopathologic findings and to be presented in a histopathology focused journal. The discussion includes the clinical presentation, imaging findings, gross pathology, histologic features, and differential diagnosis of parotid dermoid cysts. Although there was no prior fine needle aspiration (FNA) of the lesion in this case, parotid masses are commonly subject to FNA prior to excision. Therefore, a brief review of the FNA findings in dermoid cysts is also included.

  13. Viruses and Salivary Gland Disease (SGD)

    PubMed Central

    Jeffers, L.; Webster-Cyriaque, J.Y.

    2011-01-01

    Viral infections are often associated with salivary gland pathology. Here we review the pathogenesis of HIV-associated salivary gland disease (HIV-SGD), a hallmark of diffuse infiltrative lymphocytosis syndrome. We investigate the presence and contributions of viral diseases to the pathogenesis of salivary gland diseases, particularly HIV-SGD. We have detected BK viral shedding in the saliva of HIV-SGD patients consistent with viral infection and replication, suggesting a role for oral transmission. For further investigation of BKV pathogenesis in salivary glands, an in vitro model of BKV infection is described. Submandibular (HSG) and parotid (HSY) gland salivary cell lines were capable of permissive BKV infection, as determined by BKV gene expression and replication. Analysis of these data collectively suggests the potential for a BKV oral route of transmission and salivary gland pathogenesis within HIV-SGD. PMID:21441486

  14. Adrenal glands