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The effect of sympathetic denervation on nerve growth factor (NGF) immunoreactivity in the submandibular and parotid glands of adult female rats using a two-site, enzyme-linked immunosorbent assay was investigated. Unilateral sympathetic denervation through the avulsion of the superior cervical ganglion resulted in elevated levels of total amounts (decreased from 40-20%) and concentrations (decreased from 45-32%) of NGF in the submandibular glands, but not in the parotid glands, on the operated side 7-28 days post-operatively. Sympathetic decentralisation had no effect. The present findings support the hypothesis that increased levels of NGF play an important part in the increased activity of the acetylcholine-synthesising enzyme, choline acetyltransferase, in the rat submandibular gland following sympathetic denervation.
Parotid gland acinar cells undergo marked hypertrophy and hyperplasia upon systemic exposure to the beta-adrenergic agonist, isoproterenol. This glandular enlargement is accompanied by substantial cellular changes including DNA synthesis, an increase in glandular protein synthesis, and differential changes in RNA transcription. To gain a more detailed understanding of the underlying changes induced by isoproterenol, we have examined the parotid gland gene expression profile of mice up to 24 h post-isoproterenol injection using high-density oligonucleotide arrays. Depending upon the exposure time, between 22 and 48 of the approximately 6,500 mouse genes and expressed sequence tags (ESTs) analyzed displayed significant changes in expression patterns. Genes that were previously shown to be repressed (alpha-amylase) or activated (proline-rich proteins) following isoproterenol exposure were found to be similarly affected in this experiment, validating this technique. This study demonstrates that the oligonucleotide array technology is a useful tool for examining isoproterenol-induced salivary gland gene expression changes. Using this as a starting point, we can begin to dissect the specific pathways involved in mediating isoproterenol action within the parotid gland.
Although the parotid glands are affected more frequently by cysts and congenital lesions than other salivary glands, the benign multigerminal cyst arising from a duplication anomaly of the first branchial cleft within the parotid gland is extremely rare. Forty-two cases of this unusual cause of parotid swelling have been reported in the literature. An example of a first branchial cleft anomaly appearing clinically as a parotid tumor is reported.
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Of the parotid gland tumors, benign pleomorphic adenomas are the most commonly encountered. Although occurring relatively frequently in the general population, it is rare for the surgical community to encounter one that weighs more than a few ounces. The authors report a woman who avoided early surgical intervention and eventually presented with an extraordinarily large parotid gland tumor. This is the largest solid (without cystic change), benign pleomorphic adenoma of the parotid gland in the English medical literature, weighing 8.03 kg.
BACKGROUND: The parotid lymph nodes represent an important group of nodes at risk for metastatic involvement from cutaneous malignancies of the head and neck. When treating patients with metastatic disease in the parotid gland it has been our custom to also remove the lymph nodes of the neck on the basis that these nodes represent other nodal groups at risk for metastatic involvement. The aim of this study is to determine the incidence of cervical node involvement among patients with clinical metastatic SCC or melanoma of the parotid to determine whether treatment of the clinically negative neck is warranted. METHODS: The study group consists of 123 prospectively accessioned patients with clinical metastatic cutaneous squamous cell carcinoma (SCC) (n = 73) or melanoma (n = 50) involving the parotid gland and a minimum of 2 years of follow up, irrespective of the clinical status of the neck. RESULTS: Among 73 patients with metastatic SCC in the parotid, 19 (26%) had clinical neck involvement, and 16 of these were pathologically positive (84%). A total of 37 patients had elective neck dissections, and 13 were pathologically positive, which is an overall rate of 52% neck involvement among patients having neck dissection. Among 50 patients with metastatic melanoma in the parotid, 19 (38%) patients were initially seen with clinical neck disease, and all were pathologically positive. Among 31 patients with clinically negative necks, 26 had neck dissections and seven had positive nodes (27%). Overall, 58% of patients with melanoma who had a neck dissection had positive nodes. CONCLUSION: Patients with metastatic cutaneous SCC and melanoma involving the parotid gland had a high incidence of clinical (26% and 38%, respectively) and occult neck disease (35% and 27%). Treatment of the clinically negative neck in the presence of clinical metastatic parotid cancer should be considered to reduce the likelihood of failure in cervical nodes, to define the extent of disease, and to assist with patient selection for adjuvant therapy.
The rat parotid gland produces a number of well-characterized secretory proteins. Relatively little is known, however, about the onset of their synthesis and cellular localization during gland development. Secretory protein expression was studied in parotid glands of fetal and postnatal rats using light and electron microscopic immunocytochemistry and Northern blotting. Amylase, parotid secretory protein (PSP), common salivary protein-1 (CSP-1), and SMGB were first detected by immunofluorescence in parotid glands of 18 day fetuses. By 5 days after birth, light and electron microscopic immunolabeling localized all of these proteins to the secretory granules of developing acinar cells. Labeling of acinar cells for DNAse I, however, was not observed until 18 days after birth. Between 9 and 25 days, CSP-1 and SMGB reactivity of acinar cells declined, but increased in intercalated duct cells. After 25 days, CSP-1 and SMGB were found only in intercalated ducts, and amylase, PSP, and DNAse I were restricted to acinar cells. Levels of CSP-1 and SMGB mRNA were relatively constant through 21 postnatal days, but declined significantly after that. Amylase and PSP mRNA increased rapidly and continuously from five days after birth to the adult stage. In contrast, DNAse I mRNA was not detectable until 18 days after birth. The immunocytochemical and molecular analyses define three basic patterns of protein expression in the rat parotid gland: proteins whose synthesis is initiated early in development and is maintained in the acinar cells, such as amylase and PSP; proteins that are initially synthesized by immature acinar cells but are restricted to intercalated ducts in the adult gland, such as CSP-1 and SMGB; and proteins that are synthesized only by mature acinar cells and first appear during the third postnatal week, such as DNAse I. The parotid gland exhibits four distinct developmental stages: prenatal, from initiation of the gland rudiment until birth; neonatal, from 1 day up to about 9 days postnatal; transitional, from 9 days to 25 days of age; and adult, from 25 days on. Although differences exist in timing and in the specific proteins expressed, these developmental stages are similar to those seen in the rat submandibular gland. Additionally, the results support the suggestion that intercalated ducts may differentiate from the neonatal acini.
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When rat parotid explants were cultured on siliconized lens paper floating on chemically defined 199 medium, all of sialagogues tested increased ornithine decarboxylase activity, which was roughly proportional to the amylase released into the culture medium. S-Adenosylmethionine decarboxylase and DNA synthesis were also induced by isoproterenol, methoxamine, carbachol and pilocarpine, but not by serotonin or substance P. The increases of the two decarboxylase activities and DNA synthesis were observed in vivo in mouse parotid gland after repeated injections of carbachol or pilocarpine. These results indicate that both adrenergic and cholinergic sialagogues stimulate the syntheses of polyamines and DNA in murine parotid gland.
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The metabolism of [4-14C]progesterone in the parotid salivary glands of nonpregnant female, pregnant female and male rats were investigated in vitro. The metabolic activity of the male rats was significantly lower than in either of the female groups. The pregnant group was metabolically more active than the nonpregnant female group, but his differences was not statistically significant. I homogenates and soluble fractions the main metabolite was 20-alpha-hydroxy- 4-pregnen-3-one in female rats. In male rats the main metabolites were 20-alpha-hydroxy-4- pregnen-3-one and 3-alpha-hydroxy-5-alpha-pregnan-20-one in homogenates and 20-alpha-hydroxy-4- pregnen-3-one in soluble fractions. In the microsomal fractions of both sexes polar compounds predominated. The results indicated the presence of at least the following progesterone metabolizing enzymes in art parotid salivary glands; 3-alpha-, 3-beta-, 20-alpha- and 20-beta-hydroxysteroid dehydrogenase, 5-alpha-and 5-beta-steroid hydrogenase and 17-alpha-steroid hydroxylase activities. Ind the homogenates and soluble fractions of female rats 20-alpha-hydroxysteroid dehydrogenase activity was significantly higher than in males.
In rat parotid glands, the involvement of the microfilament system in the cellular signal transmission mechanism was tested by measuring the effect of cytochalasin D (which disturbs the microfilament system) on the production of intracellular second messengers. Cytochalasin D (CD) did not affect unstimulated calcium movements (measured by the 45Ca efflux technique) or inositol phosphate production or cAMP accumulation. Neither did it modify the generation of intracellular second messengers induced by activation of the cholinergic muscarinic receptor (calcium and inositol phosphates). CD dit not affect the cAMP accumulation induced by the activation of the beta-adrenergic receptor whereas it strongly inhibited the calcium movements induced by activation of the same receptor. These data suggest that, in rat parotid glands, calcium movements, induced by beta-adrenergic receptor stimulation need an intact microfilament system to occur, whereas the muscarinic pathway (via IP3) does not.
Adenoid cystic carcinoma is the commonest malignant tumor of the submandibular and minor salivary glands; the parotid gland constitutes a small share of this neoplasm. We present a 30-year-old woman with solitary liver metastasis from an adenoid cystic carcinoma of the parotid gland, which had been surgically treated 10 years ago. The patient underwent successful resection of this metastasis.
BACKGROUND: Mycobacterial infection of the parotid gland is rare even in countries where the disease is rife. Because patients do not have specific symptoms of tuberculosis and tuberculosis of the parotid gland frequently presents as a neoplasm, most patients undergo parotidectomy. PATIENTS: In this text we present a case report and the review of 20 well documented cases from the literature. The problems of diagnosis and therapy, especially the problem of distinguishing tuberculous infection from another parotid swelling such as a benignoma or a granuloma, are analyzed. RESULTS: Eighty percent of the patients we reviewed in our investigation originated from Asian or African countries. In most cases the history of the parotid swelling was shorter than one year, often even shorter than six months. In 17 of the 20 patients tuberculosis presented as a solid mass corresponding to the infection of a parotid lymph node. In three cases a diffuse infection of the whole gland was described. It was frequently impossible to distinguish tuberculosis from swelling of the parotid gland due to other causes by clinical or sonographical investigations. History of tuberculosis was given in two cases: the patients underwent an antituberculous therapy one and five years ago. The chest radiograph was normal in all but one cases. In two cases pretherapeutic diagnosis was made by biopsy, in two cases by fine needle aspiration cytology, which was performed in a total of seven cases. CONCLUSION: Tuberculosis is a rare cause for parotid swelling. Nationality of the patient and a short history of the swelling may suggest a mycobacterial infection. Diagnosis by fine needle aspiration cytology may be difficult. Other investigations should be added, if necessary. Antituberculous therapy has to be done also in cases of organ tuberculosis after surgery. If the right diagnosis is known before therapy, parotictomy can be avoided.
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Multiple unilateral parotid gland tumors are very rare. A review of the literature shows only seven cases of coexisting unilateral parotid tumors. This patient had a benign mixed tumor and a mucoepidermoid carcinoma of the right parotid gland. This is the eighth reported case of multiple unilateral parotid tumors and the first to show such a combination of tumors.