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PubMed2004

A case of accessory parotid gland tumor.

We herein describe a case of accessory parotid gland tumor, including diagnosis and surgical approach. The accessory parotid gland is salivary tissue separated from the main parotid gland and lying on masseter muscle. It has secondary duct empting into the Stensen's duct. The accessory parotid gland exists in 21-61 % of individuals. However, the appearance of an accessory parotid tumor is rare, with a reported frequency of 1-7.7 % of all parotid gland tumors. Surgical resection is the treatment of choice for the accessory parotid gland tumor. It is important to identify the buccal branch of the facial nerve to avoid injury to the facial nerve. The tumor in our case was surgically resected without facial nerve injury. The histopathological diagnosis was pleomorphic adenoma.

Adenoma, Pleomorphic↗
PubMed1982

[Sebaceous cells in repeat biopsies of normal salivary glands and in sebaceous carcinoma of the parotid gland].

One-time examination of the normal tissue of the major salivary glands outside the pathologic foci revealed sebaceous cells in the glandular ducts in about 10% out of 433 patients. In 8 of 45 patients with salivary gland was examined for the second time in a new operation material in necropsy with a time delay of 18 days to 13 years. Sebaceous cells were found in 2 examination in 3 persons, i.e. in almost 38%, which is statistically significantly higher percentage than in the group in the first examination. All 3 observations were positive up to 5 years after repeating excision. Dependence on the patient's age or on the basic diagnosis was not found. In carcinoma of the parotid gland extensive colonies of the sebaceous cells were present in the carcinoma at autopsy of this woman aged 81 a solitary carcinomatous focus in the lung was found 13 years after the removal of the tumor of the parotid gland. Microscopically it revealed the structure of a bronchiologenic carcinoma.

Adenocarcinoma↗
PubMed1990

Benign cysts of the parotid gland.

Benign cysts of the parotid gland are not frequently diagnosed. They occur in any portion of the parotid gland and may be difficult to diagnose. They present with considerable histological variation in their linings. Three cases are presented of unilocular benign cystic lesions of the parotid gland that have been treated by superficial parotidectomy. Two of them were lined by a single or pseudostratified layer of cuboidal epithelium and were diagnosed as retention cysts. The third was a lympho-epithelial cyst and was lined by stratified squamous and partially by pseudostratified ciliated columnar epithelium. A review of the relevant literature is also presented.

Adolescent↗
PubMed2005

Basal cell adenoma and lymphoepithelial cyst as recurrent tumors of pleomorphic adenoma of the parotid gland.

Basal cell adenoma of the parotid gland is a rare benign tumor. Lymphoepithelial cyst of the parotid gland is also a rare benign tumor-like lesion. We report an elderly woman, who previously underwent a removal of pleomorphic adenoma, with multiple masses in the left parotid gland. Physical, MR and intra-operative examination suggested the masses as multiple recurrences of the previous pleomorphic adenoma. A total parotidectomy with facial nerve preservation was performed. The histological examination revealed that the masses were two basal cell adenomas and one lymphoepithelial cyst. These rare tumors should be considered in the differential diagnosis of recurrent masses after a removal of pleomorphic adenoma of the parotid gland.

Adenoma↗
PubMed2005

Lesions of the accessory parotid gland in children.

The accessory parotid gland, a little-known and seldom-mentioned anatomical variant, is a nodule of normal salivary tissue separate from the main parotid gland, located on the masseter muscle and connected to the Stensen duct at that level. It can be the site of both congenital and acquired lesions.

Child↗
PubMedDate not supplied

Primitive malignant melanoma of the parotid gland.

Melanoma of the parotid gland is a very rare event: it can occur as a primary disease or as spread of the intraglandular nodes. The authors report a case and review the few cases of primary melanoma of the parotid gland reported in the literature.

Diagnosis, Differential↗
PubMed2006

Lipomatous lesions of the parotid gland.

PURPOSE: Lipomatous lesions of the parotid gland are rare and seldom considered in the initial diagnosis of a parotid mass. We report our experience in the management of patients with lipomatous lesions affecting the parotid gland. PATIENTS AND METHODS: Retrospective analysis of all parotidectomies performed for neoplastic lesions in the maxillofacial unit between 1975 and 2003 and patients with lipomatous lesions involving the parotid gland were identified; 638 parotidectomies were performed in this period on 629 patients in which 660 neoplasms were identified. Eight patients were found to have lipomatous lesions and form the basis of this study. RESULTS: Lipomatous lesions accounted for only 1.3% of parotid tumors and occurred more frequently in males, at a ratio of 3 to 1. The most common presentation was that of a slowly enlarging, painless mass. Computed tomography scan was the most frequent imaging modality undertaken, and in 3 patients a diagnosis of a lipoma was made preoperatively. Seven patients underwent a superficial parotidectomy and 1 patient had a total conservative parotidectomy because of the deep lobe location of the mass. Five patients were found to have a focal lipoma and 3 patients had diffuse lipomatosis. There were no recurrences. Temporary facial nerve palsy and Frey's syndrome were the most frequent complications. CONCLUSION: Lipomatous lesions accounted for only 1.3% of all parotid tumors. There were no specific distinguishing clinical features in our patients, and an accurate preoperative diagnosis was made in 3 patients based on imaging investigations. A well-circumscribed lipoma was more common than diffuse lipomatosis. Superficial parotidectomy was the treatment of choice and there were no recurrences in our series.

Adult↗
PubMed2003

Lipomatosis of the parotid gland in children.

Parotid lipomatosis is extremely rare in children. Only 4 cases have previously been reported in the English language medical literature. Surgical excision is frequently complicated by recurrence. We report, a fifth case, on a 5-month-old girl with rapidly progressive parotid lipomatosis. Emphasis is laid on the importance of preserving the unusually delicate tumor capsule to prevent tissue spillage and recurrence. The creation of an appropriate cleavage between the mass and the expanded skin with sparse subcutaneous fat, safeguarding the tumor capsule on one side and the skin blood supply on the other, represents a rewarding technical challenge.

Biopsy, Needle↗
PubMed2005

Sonohistology for the computerized differentiation of parotid gland tumors.

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

Adenoma↗
PubMed2001

Morphological and histochemical changes in the secretory granules of mucous cells in the early postnatal mouse parotid gland.

It has previously been known that the developing parotid glands in humans and rats contain mucous cells in their terminal clusters and acini, but these cells disappear within a short period of time. Using rat parotid glands, IKEDA and AIYAMA (1997, 1999) suggested that the mucous cells might change into serous cells in the early postnatal period, but it is uncertain whether mucous cells appear only in the developing parotid gland of a few species such as humans and rats, or whether the cell transformation actually occurs. To clarify these points, the present study investigated the developing mouse parotid glands. Light microscopy showed cells with secretory granules that stained extensively with PAS and alcian blue in the terminal clusters of a 1-day-old mouse parotid gland. Mucous cell numbers in the terminal clusters and the acini reached a peak on day 5 and decreased on day 7. By day 10, the mucous cells had disappeared altogether. Thus, the presence of mucous cells in the developing mouse parotid gland was confirmed. Electron microscopy showed granules of low-electron-density and bipartite granules in the mucous cells. Bipartite granules and highly electron-dense granules sometimes co-existed in a single cell. Immuno-electron microscopy revealed a positive reaction for amylase to the low-electron-density granules and the low-electron-density portions of the bipartite granules, in addition to the highly electron-dense granules and the electrondense cores of the bipartite granules. No mucous cells with nuclei displaying characteristics of apoptosis were recognizable. Lectin histochemistry both at the light and electron microscopic levels showed that the secretory granules in the mouse parotid gland mucous cells had sugar residues similar to those of the mature serous granules. These findings demonstrate that mucous cells appear in the early postnatal mouse parotid gland, and that almost all of these cells may be converted into serous cells.

Amylases↗
PubMed2003

Synchronous bilateral mucoepidermoid carcinoma of the parotid gland.

It is rare for a parotid gland tumour to arise bilaterally, the most common example being Warthin's tumour. Furthermore, it is rare for a parotid gland cancer to occur bilaterally. Here, we describe a case of synchronous bilateral mucoepidermoid carcinoma arising in the parotid gland. A case of bilateral facial nerve dysfunction is presented in which aggressive surgery failed to save the life of a 48-year-old man. This is the first such case reported in the available English literature.

Carcinoma, Mucoepidermoid↗
PubMed1993

Primary lymphoma of mucosa associated lymphoid tissue (MALT) in the parotid gland.

Malignant lymphoma of the parotid gland is a rare condition. In a series of 365 malignant lymphomas of the head and neck seven cases (1.9%) presented with a stage I/II MALT lymphoma of the parotid gland, originating from Mucosa Associated Lymphoid Tissue (MALT) and exhibiting the histological criteria of a centrocyte-like cell proliferation, surrounding reactive B-cell follicles. There were six men and one woman with a mean age of 50.1 years. In four patients the parotid mass was present for more than one year. Complete remission was obtained by radiotherapy (40 Gy). Prognosis for this group was found to be favourable with a follow-up ranging from 1.5 to 10 years.

Adult↗
PubMed2003

A histological comparison of deep and superficial lobe pleomorphic adenomas of the parotid gland.

BACKGROUND: Excision of parotid superficial lobe pleomorphic adenomas requires removal of a surrounding cuff of normal parotid tissue. Less aggressive dissection in removing pleomorphic adenomas that occur in the deep lobe of the parotid gland does not seem to compromise prognosis in these patients. We attempted to define histologic characteristics, differentiating superficial and deep lobe tumors, in an attempt to explain this clinical phenomenon. METHOD: Thirty-one pleomorphic adenomas, 12 deep-lobe tumors, and 19 superficial lobe tumors were analyzed and compared, looking at tumor size, capsule thickness, penetration of tumor through capsule, and predominant cell types present. RESULTS: The superficial lobe tumors had significantly thinner capsules (p =.02). There was increased extracapsular extension of tumor in the superficial lobe group compared with the deep lobe group (79% and 58%, respectively). The tumors were larger in patients with deep lobe lesions (2.6 cm vs 3.6 cm). There was no difference in predominant cell types. CONCLUSIONS: The anatomic location of deep lobe tumors is a likely explanation for the histologic differences observed in this study. These important differences allow less aggressive dissection in deep lobe tumors without compromising prognosis.

Adenoma, Pleomorphic↗
PubMed1999

Enzyme histochemical localization of Na(+),K(+)-ATPase and NADH-DE in the developing rat parotid gland.

Information on ductal differentiation in the developing rat parotid gland is sparse. Striated and excretory ducts are rich in a number of enzymes related to ion movement. The objective of this investigation was to delineate histochemically the chronology of two of these, ouabain-sensitive Na(+),K(+)-ATPase and NADH-DE, in the developing rat parotid gland. Parotid glands were excised from rats at representative ages from 20 days in utero to 42 days. Enzyme histochemistry was performed on air-dried frozen sections. For Na(+), K(+)-ATPase, some sections also were fixed in phosphate-buffered formalin. Ouabain blocked Na(+),K(+)-ATPase activity, and neither enzyme reacted without substrate. Weak Na(+),K(+)-ATPase reactions were initially seen in unfixed sections at 1 day, and increased steadily to the adult pattern of strong (concentrated basolaterally) in striated ducts and excretory ducts, respectively, and weak to modest (diffuse) in acini and intercalated ducts at 28 days. In fixed sections, localization was sharper but the reaction was somewhat reduced. NADH-DE was modest in terminal buds and ducts before birth, then progressively changed to the adult pattern of weak in acini and intercalated ducts and strong (concentrated basally and luminally) in striated and excretory ducts at 28 days. As demonstrated by enzyme histochemistry of Na(+),K(+)-ATPase and NADH-DE, differentiation of rat parotid striated ducts and excretory ducts occurs mainly between birth and 28 days. Anat Rec 256:72-77, 1999. Published 1999 Wiley-Liss, Inc.

Animals↗
PubMed1987

Squamous cell carcinoma of the parotid gland.

Squamous cell carcinoma involving the parotid gland is an aggressive and rapidly advancing lesion which if not recognized and treated early will result in a high morbidity and mortality. We reviewed 30 patients with squamous cell carcinoma involving the parotid gland. Twenty-four patients had had previous epidermoid skin lesions in an area known to drain to the parotid gland and three resulted from direct extension into the gland from an overlying skin carcinoma, whereas only three were primary lesions of the gland. Patients who presented with involvement of the gland more than 4 months after excision of the skin lesion had a poor prognosis. Patients with epidermoid skin cancer in areas with a propensity to secondarily involve the parotid gland must be closely followed after treatment of the primary skin lesion.

Adult↗
PubMed1990

[Radionuclide study on the change of duct-ligated parotid gland].

Regressive changes of duct-ligated parotid glands in rabbits were examined by salivary gland scintigraphy with 99mTc O4-, subtraction sialography and soft X-ray radiography. Scintigram images were obtained with a pinhole collimator improved for small animal scintigraphy. Subtraction images were taken photographically. Contrast media were injected into extracted tissue for soft X-ray radiography. Radiological observations were carried out 3, 7, 14, 21, 28, 35 and 42 days after injection, and in the control rabbit. The images obtained by these three modalities were compared and discussed. Salivary gland scintigrams and subtraction sialograms clearly demonstrated the outlines of duct ligated parotid glands. Soft X-ray radiograms obtained from the extracted tissue showed the fine structure of the parotid glands. All of these images showed regressive changes in the duct-ligated parotid glands.

Animals↗
PubMed1983

[A combined method of sialography and CT scan of the parotid gland].

Computed tomography (CT) of parotid gland was performed on 40 patients, immediately following sialography. The results of the combined CT-sialography were compared with those of sialography alone and are presented here. We have come to the conclusion that the main indication for this method, in the study of the parotid gland, is the mass-pathology, particularly situated in deep-lobe and in the pharyngo-maxillary space.

Adenoma, Pleomorphic↗
PubMed1985

[A case of polymorphous adenocarcinoma in the right parotid gland].

The nature of adenocarcinomas of parotid gland origin seems to be still unclear because of the rarity of this lesion. A 65-year-old man with a "polymorphous adenocarcinoma" of the parotid gland is presented. This tumor is characterized by a marked diversity in the histologic manifestations, presenting dominantly solid, tubular, pseudoadenoid cystic sarcomatoid patterns. The tumor cells showed distinctive signs of high grade malignancy such as the occurrence of mitotic figures and involvements of lymphatic vessels and/or blood vessels. "Polymorphous adenocarcinoma" is a histologically distinctive neoplasm unlike other adenocarcinomas of parotid gland origin.

Adenocarcinoma↗