Clinicopathological analysis and survival outcomes of primary salivary gland tumors in pediatric patients: A systematic review

Abstract

Background: Salivary gland tumors are a diverse group of uncommon neoplasms that are rare in pediatric patients. The aim of this study was to evaluate the clinicopathological profile and survival outcomes of pediatric patients affected by salivary gland tumors.Materials and methods: An extensive search was carried out using the MEDLINE/ PubMed, EMBASE, Scopus databases, and grey literature. The risk of bias was available in all papers included.Results: A total of 2,830 articles were initially retrieved with 54 remaining for data extraction, resulting in 2,937 cases. This comprised forty-five case series' and nine cohort studies. These tumors were slightly more prevalent in females (57.4%). The patients' age ranged from 0.3 to 19 years old, with a mean age of 13.3 years. Parotid was the most affected site (81.9%), and 99.2% of cases clinically exhibited a swelling.Presence of pain/tenderness was reported in 13.5% of the cases, with an average duration of 12.6 months for the appearance of symptoms. Most of the reported cases were malignant tumors (75.4%), with mucoepidermoid carcinoma the most common tumor of all tumors (44.8%), followed by pleomorphic adenoma (24.1%). Surgery alone was the leading treatment choice in 74.9% cases, and the 5-year overall survival rate of patients was 93.1%. Patients with symptoms (P = .001), local recurrence (P < .001), metastasis (P < .001), and those not undergoing surgery or surgery combined with radiotherapy (P < .001) showed lower survival rates. Conclusion:The pediatric patients present a high frequency of malignant salivary neoplasms and a high overall survival rate.

Indications and Outcomes of Parotidectomy in Saudi Children: Experience From Two Tertiary Centers

“…Mucoepidermoid carcinoma (MEC) was the most common malignancy in our study, which is in line with findings from other studies [ 10 , 11 ]. Nevertheless, five out of six cases of MEC (83%) in our series were high grade (HG MEC).…”

“…In fact, eight out of 14 cases that presented at this age range were malignant, constituting 57% of all cases presenting in this age range (Figure 1). This is in line with findings from previous studies in other populations reporting that it is unlikely for a parotid tumor presenting at age less than 10 years to be malignant; however, it is more likely to be malignant than benign when presenting in the second decade of life [2,8,10,11].…”

“…Nevertheless, five out of six cases of MEC (83%) in our series were high grade (HG MEC). In a recent systemic review of salivary gland malignancies in children by Louredo et al, most parotid MEC were low grade (LG MEC) [ 11 ]. Moreover, they reported differences in the epidemiology and pathology of pediatric salivary gland malignancies among different countries [ 11 ].…”

“…In a recent systemic review of salivary gland malignancies in children by Louredo et al, most parotid MEC were low grade (LG MEC) [ 11 ]. Moreover, they reported differences in the epidemiology and pathology of pediatric salivary gland malignancies among different countries [ 11 ]. We don’t know if this high rate of HG MEC in our study is by chance or due to bias inherent to tertiary care cases or is reflective of a true higher incidence of HG MEC in our pediatric population.…”

“…Moreover, in our series, all epithelial malignancies were MEC. There were no cases of other epithelial malignancies such as adenoid cystic carcinoma, adenocarcinoma, or acinic cell carcinoma, which is reported to be the second most common after MEC [ 10 , 11 ]. We speculate this may be related to our small number of cases.…”