Sialadenoma papilliferum of the parotid gland

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

Sialadenoma papilliferum of the parotid gland

A case of sialadenoma papilliferum of the parotid gland in a 35-year-old woman is described. The tumor was locally excised and no recurrence was evident after a follow-up period of 30 months.     

Hyalinizing clear cell carcinoma arising from the base of the tongue

Hyalinizing clear cell carcinoma is a low-grade indolent and rare salivary gland tumor originally described by Milchgrub et al. in 1994. We herein report a case of this tumor of the base of the tongue. A 66-year-old Japanese woman presented with a large painless mass in the throat. Computed tomography and magnetic resonance imaging revealed a 40×30-mm well-defined ovoid tumor arising from the base of the tongue. She underwent tracheostomy followed by a resection of the tumor via the transmandibular approach combined with a right-sided supra-omohyoid neck dissection. Because the tumor invasion of the surrounding tissue was limited, the surgical defect at the base of the tongue was relatively small, and no reconstructive procedure needed to be performed. The tumor was histopathologically diagnosed as hyalinizing clear cell carcinoma of the minor salivary gland. Her postoperative clinical course was uneventful. No aspiration or difficulty upon deglutition was recognized when she started transoral ingestion on the eighth postoperative day. The patient is currently free from disease 21 months after surgery. The pathology, clinical characteristics, and treatment of hyalinizing clear cell carcinoma are bibliographically reviewed.     

The density of metastatic lymph node as prognostic factor in squamous cell carcinoma of the tongue and floor of the mouth

The presence of metastatic lymph nodes is a relevant prognostic factor in oral cancer.ObjectiveThis paper aims to assess metastatic lymph node density (pN+) in patients with tongue and floor-of-mouth squamous cell carcinoma (SCC) and the association of this parameter with disease-free survival (DFS).Materials and MethodsA group of 182 patients seen between 1985 and 2007 was included, 169 of which were males. Five were on stage I, 35 on stage II, 56 on stage III, and 85 on stage IV. Median values were considered in lymph node density assessment, and the Kaplan-Meier curve was used to evaluate DFS; survival differences within the group were elicited through the log-rank test.ResultsAn average 3.2 metastatic lymph nodes were excised from the patients in the group. Density ranged from 0.009 to 0.4, with a mean value of 0.09. Five-year DFS rates were of 44% and 28% for the groups with lymph node densities below and above the median respectively (p = 0.006). Two-year local/regional control was achieved for 71% and 49% for the patients below and above the median density respectively (p = 0.01). In terms of pN staging, local/ regional control was achieved in 70% and 54% of pN1 and pN2 patients respectively, albeit without statistical significance (0.20%).ConclusionLymph node density may be used as a prognostic indicator for tongue and floor-of-mouth SCC.     

多功能显微支撑喉镜下超声刀在舌根良性肿瘤治疗中的应用

舌根良性肿瘤解剖位置特殊,传统的手术方法暴露肿瘤较困难,且术中易出血,不易止血,术野经血液浸染后无法分清肿瘤和正常组织,复发率较高。我科对28例舌根良性肿瘤患者进行多功能显微支撑喉镜下超声刀切除治疗,疗效满意,现报告如下。     

Synchronous benign and malignant tumors in the ipsilateral parotid gland

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

Pleomorphic adenoma of the base tongue

Pleomorphic adenoma is the benign tumor of salivary glands. The cells of origin are the myoepithelial cells and intercalated duct cells. This tumor is more common in major salivary glands. A rare case of pleomorphic adenoma of the minor salivary glands of base tongue is reported here. It was surgically excised by a median mandibulotomy approach and patient is free of any recurrence in one-year follow-up.     

Pleomorphic adenoma of the lateral side of the tongue

Much evidence, both in vivo and in vitro, suggests that patients with IgA nephropathy (IgAN) have enhanced IgA production. We hypothesized that Haemophilus parainfluenzae     

Correlation between clinical and pathological data and surgical margins in patients with squamous cell carcinoma of the oral cavity

The importance of having tumor-free margins when resecting oral neoplasms has been known for decades.ObjectiveTo correlate clinical and pathology data to surgical margin status in patients with squamous cell carcinoma of the tongue and floor of the mouth.MethodThis historical cohort cross-sectional study included all patients submitted to squamous cell carcinoma resection for tumors of the oral tongue and floor of the mouth between 2007 and 2011 at the Head and Neck Surgery service of our institution.ResultsIn the 117 cases included, 68.3% had tongue tumors. The male-to-female ratio was 2.3:1 and patient mean age was 57.6 years. Broad free resection margins were seen in 23.0% of the cases; narrow margins in 60.6% of the cases; and compromised margins in 16.2%. Tumor diameter and thickness were correlated to resection margins. Tumors in more advanced T-stages presented more unsatisfactory margins. Patients operated with broad free margins had their tumors resected more commonly through transoral approaches.ConclusionsTumors of larger volume both in terms of diameter and thickness were more correlated to unsatisfactory resection margins. Higher complexity procedures were not associated with better resection margins.     

Submandibular approach for excision of a large schwannoma in the base of the tongue

A 24-year-old Turkish woman is described, who gradually developed progressive swallowing problems over 6 months due to a tumor in the base of the tongue. Magnetic resonance imaging showed a large well-circumscribed solid mass. Histopathological examination of an incisional biopsy showed a schwannoma. The tumor was completely removed through a submandibular approach. The postoperative course was uneventful and her complaints disappeared. The submandibular approach used gave an excellent exposure of the base of tongue with a less obvious scar than a lip-splitting incision. Received: 16 June 1999 / Accepted: 22 July 1999     

Neoplasms of the parotid gland in northern Poland, 1991–2000: an epidemiologic study

A review of patients treated for malignant and benign parotid tumors in a 10-year period (1991–2000) in the Pomeranian County of Poland revealed 417 new cases. The age-standardized incidence rate was 0.23 and 1.35 per 100,000 inhabitants for malignant and benign tumors, respectively. The following data were collected: age, sex, place of living, education, job, smoking, symptoms, duration of symptoms at the time of diagnosis, result of histopathological tumor examination, tumor size, TNM staging and distant metastases. The results were divided into two parts: malignant neoplasms and benign neoplasms. The most common malignant neoplasms were carcinomas (96.8%), and among them the most numerous were mucoepidermoid carcinoma (22.2%), carcinoma in pleomorphic adenoma (20.6%) and adenoid cystic carcinoma (15.9%). The most common benign neoplasms were adenomas (95.5%), most frequently pleomorphic adenoma (65.5%) and adenolymphoma (24.0%), but rarely basal cell adenoma (4.2%). We also observed a steady increase in the number of benign parotid tumors in the examined period of time.     

Mandibular aneurysmal bone cyst mimicking a malignant tumor

CASE: We report the case of a 24-year-old woman presenting with a rapidly growing mass in the right masseteric region. MRI suggested a diagnosis of a rhabdomyosarcoma but CT-scan evoked a benign lesion such as chondroblastoma or aneurismal bone cyst. The biopsy specimen proved the diagnosis of aneurismal bone cyst and the patient was treated by surgical curettage. There was no recurrence after 4 years of follow-up. DISCUSSION: The aneurismal bone cyst of the jaw is a rare pseudocystic lesion, characterized by replacement of the normal bone with fibro-osseous tissue containing blood-filled sinusoidal or cavernous spaces. The lesion generally affects young persons under 20 years of age. The molar region, the angle, and the ascending ramus of the mandible are the predominantly affected sites. The lesion does not have any clinical or radiological specificity and surgical curettage is the standard treatment. Recurrence is rare and occurs within 30 months after surgery.     

Prognostic factors and overall survival in a 15-year followup of patients with malignant salivary gland tumors: a retrospective analysis of 193 patients

IntroductionMalignant tumors of the salivary glands are uncommon pathological entities, representing less than 5% of head and neck neoplasms. The prognosis of patients with malignant tumors of the salivary glands is highly variable and certain clinical factors can significantly influence overall survival.ObjectiveTo analyze the clinicopathologic and sociodemographic characteristics that influence survival in patients with malignant tumors of the salivary glandsMethodsThis retrospective study analyzed sex, age, race, education level, tumor location, tumor size, lymph node involvement, distant metastasis, margin status, treatment type, marital status, method of health care access and 15-year overall survival in 193 patients with malignant tumors of the salivary glands. The X², log-rank Mantel-Cox, multinomial regression and Cox logistic regression tests were used (SPSS 20.0,p < 0.05).ResultsThe most common histological types were adenocarcinoma (32.1%), adenoid cystic carcinoma (31.1%) and mucoepidermoid carcinoma (18.7%). The 15-year overall survival rate was 67.4%, with a mean of 116 ± 6 months. The univariate analysis revealed that male sex (p = 0.026), age > 50 years (p  = 0.001), referral origin from the public health system (p  = 0.011), T stage (p =  0.007), M stage (p <  0.001), clinical stage (p <  0.001), compromised surgical margins (p =  0.013), and chemotherapy (p <  0.001) were associated with a poor prognosis. Multivariate analyses also showed that age > 50 years was independently associated with a poor prognosis (p =  0.016). The level of education was the only factor more prevalent in older patients (p =  0.011).ConclusionPatients with malignant tumors of the salivary glands older than 50 years have a worse prognosis and an independent association with a low education level.     

Pleomorphic adenoma of the nasal septum

Despite the common occurrence of pleomorphic adenoma of major salivary glands, intranasal pleomorphic adenoma are rare. We present a ease of pleomorphic adenoma of the nasal septum along with a brief review of literature. The histological nature of this lesion in comparison to other salivary gland tumours and the importance of an accurate diagnosis has been stressed.     

MRI在舌鳞状细胞癌中的临床应用

目的：通过与术后病理对照,分析舌鳞状细胞癌颈淋巴结转移MRI征象及客观诊断指标,探讨MRI在诊断舌鳞状细胞癌颈部淋巴结转移中的临床价值。方法：对36例舌鳞状细胞癌患者共计115个淋巴结进行MRI术后病理对照分析。结果：舌鳞状细胞癌颈部转移淋巴结在MRI上多数存在微观的淋巴结受侵润征象。舌鳞状细胞癌转移与非转移淋巴结横径差异有统计学意义,但两者T2信号强度差异无统计学意义。结论：MRI可在术前为舌鳞状细胞癌患者提供有效信息,常规MRI图像上肿大淋巴结横短径可作为诊断受到侵润的一个参考指标。     

Pleomorphic adenoma of the submandibular gland: an evolving change in practice following review of a personal case series

We reviewed patients with submandibular gland pleomorphic adenoma treated at a tertiary referral centre in the United Kingdom (1988–2004). Thirty-seven patients were identified, 32 newly diagnosed cases and 5 cases of recurrent disease previously treated elsewhere. The exact pre-operative diagnosis was “unknown” in 76% of the new cases. All cases were surgically excised (41% with extracapsular gland excision and 59% by selective level Ib, IIa and III neck dissection). Temporary marginal mandibular nerve neuropraxia was documented in 25% of cases. All 32 new cases remain clinically tumour free at the time of writing. In patients with recurrent disease, complete microscopic tumour clearance was achieved in three of the five cases, however all remain clinically tumour free. Pleomorphic adenomas of the submandibular gland are uncommon, with good prognosis following complete tumour excision. Recurrent tumours, however, are frequently multi-focal and difficult to excise completely. The adequacy of primary surgery is crucial and supports an approach for a more radical excision primarily by a selective level lb, IIa and III neck dissection; ensuring complete disease clearance for pleomorphic adenoma, avoiding the risks of tumour spillage associated with a limited excision and tumour handling; and removing the primary echelon of lymph nodes at risk of metastasis if the pathology turns out to be malignant.     

Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth

The presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors.ObjectiveTo evaluate the causes of treatment failure in carcinomas of the tongue and floor of themouth due to staging.MethodThis study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+.ResultsAmong the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients.ConclusionSalvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease.