Sclerosing Polycystic Adenosis Arising in the Parotid Gland Without PI3K Pathway Mutations

A 15-year-old old Japanese male with a 2-month history of swelling of his left subauricular area was admitted to our department. A thumb-sized, hard mass with mild tenderness was palpated on the left parotid gland. Ultrasonography revealed a well-circumscribed, hypoechoic mass exhibiting heterogeneity in the left parotid gland measuring 1.7 × 1.5 × 1.3 cm. Computed tomography scan revealed a well-circumscribed, solid mass exhibiting slight peripheral enhancement in the left parotid gland. Magnetic resonance imaging revealed a hypointense mass in the left parotid gland on both T1- and T2-weighted images. Clinicoradiologic findings suggested a benign or low-grade malignant parotid tumor. The patient underwent left superficial parotidectomy with adequate safety margins. The facial nerve was identified and preserved. Neither facial paralysis nor tumor recurrence was observed as of 1 year postoperatively. Histologically, the nodule consisted of a vaguely nodular arrangement of variably sized ducts and acini in a hyalinized fibrous background with focal myxoid changes. The ductal/acinar component exhibited a bilayered arrangement of cuboidal luminal and flattened abluminal cells exhibiting a variety of epithelial proliferative patterns, including micropapillary and cribriform. Areas of oncocyte-like changes with intracellular coarse eosinophilic granules, apocrine-like feature, foamy/vacuolated changes, and clear cells were noted in the proliferating epithelium. Immunohistologically, the luminal cells were positive for gross cystic disease fluid protein-15. The Ki-67 labeling index was 2–3%. The histologic features and immunohistologic profile were consistent with sclerosing polycystic adenosis. Targeted next-generation sequencing of 160 cancer-related genes using the surgical specimen revealed no mutations, including known significant mutations in PTEN, PIK3CA, or PIK3R1.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12105-021-01339-z.     

37例腮腺切除术患者医院感染相关因素分析

目的 探讨腮腺切除术患者发生医院感染情况,以采取有效的预防控制措施.方法 回顾性分析2005-2011年腮腺切除术患者发生医院感染临床相关资料.结果 482例腮腺切除术患者共发生医院感染37例,感染率7.68％;感染部位以呼吸道居首位,占47.83％;其次为手术创口,占21.74％;主要病原菌为克雷伯菌属,占9.3％;医院感染与年龄、住院时间、基础疾病、手术操作时间有密切的关系,差异有统计学意义(P＜0.05).结论 腮腺切除术患者医院感染的发生是多种因素所致,应严格无菌操作技术、缩短住院日和手术操作时间、提高机体的抵抗力可降低医院感染的发生.     

Drainless parotidectomy using tissue fibrin sealant – A retrospective case-control study

The aim of this study was to evaluate the impact of drainless parotidectomy using fibrin sealant on length of stay, post-operative seroma and related complications. For this purpose, a retrospective matched case-control series was held in a single academic center. All patients who underwent drainless parotidectomies, including deep lobe tumors and revision surgeries, were compared to matched controls in which a suction drain was inserted. Main outcomes were length of hospital stay and post-operative seroma. A total of 123 patients (41 cases and 82 controls) were included in the study. Fibrin sealant group had higher rates of total parotidectomy compared with the control group (25.0% vs. 10.5%, p = 0.054). Length of stay was significantly shorter in the fibrin sealant group (1.0 ± 0.3 days vs. 1.5 ± 0.6 days, p < 0.001, respectively). No statistically significant difference was found between the fibrin sealant group and the control regarding post-operative seromas (9.8% vs. 14.6%, p = 0.574, respectively), aspirations rate (7.3% vs. 14.6%, p = 0.381), and infection rates (0% vs.3.7%, p = 0.550). In conclusion, drainless parotidectomy does not increase post operative seroma rates and related complications, and can also be implemented for revision surgery.     

Synchronous unilateral pleomorphic adenomas in the parotid gland: report of a case

A 45 year old man presented with a swelling on the right side of his face of 12 months duration. Subsequent magnetic resonance imaging (MRI) scans revealed he did in fact have two discrete tumours of his right parotid gland. Following a superficial parotidectomy and dissection of the deep lobe, histopathology revealed both tumours to be pleomorphic adenomas. We discuss the clinicopathological findings and implications in contemporary surgical management of parotid neoplasms.     

Outcome following surgical treatment for regional metastases from cutaneous cancers of the head and neck in patients aged 80 and over

INTRODUCTION

Population demographics and disease epidemiology is resulting in more elderly patients presenting with regional metastases from cutaneous malignancy of the head and neck region. Surgery remains the most appropriate primary treatment option.

PATIENTS AND METHODS

We analysed consecutive patients aged 80 and over who developed regional metastases from cutaneous cancers of head and neck and underwent a neck dissection over a two-and-a-half-year period. Data were obtained from the cancer database and patients’ notes. A Kaplan-Meier survival graph was constructed.

RESULTS

Our study demonstrated a low postoperative morbidity but one patient died from medical complications with in the first 30 days post surgery. The median survival time following surgery is nearly two years.

CONCLUSIONS

We continue to advocate primary surgery for cutaneous metastatic malignancy from the head and neck area but patients need multidisciplinary team discussions, thorough assessment and counselling.     

Endoscope-assisted partial–superficial parotidectomy through a concealed postauricular skin incision

Background  This study evaluated the feasibility of endoscope-assisted partial–superficial parotidectomy through a concealed postauricular skin incision. Methods  Endoscope-assisted partial–superficial parotidectomy through a concealed postauricular skin incision was performed for 18 cases of benign tumor located in the superficial lobe of the parotid gland. Results  All 18 operations were successfully performed endoscopically. This new approach provided safe dissection of the facial nerve and exposed working space. Two patients had transient facial paresis and recovered in 1 and 2 months, respectively. The duration of the procedure was 90 to 120 min. The patients were satisfied with the almost invisible scar. Conclusions  Endoscope-assisted partial–superficial parotidectomy is a feasible method for treatment of benign tumors located in the superficial lobe of the parotid gland. The main advantage of this procedure is that the small operative scar is concealed in the postauricular area, resulting in improved cosmesis. Presented orally at the International and 9th National Head and Neck Tumor Conference, Wulumuqi, China, 7–11 September 2007.