Contemporary management of tumors of the salivary glands

Scianna, Joseph M.; Petruzzelli, Guy J.

doi:10.1007/s11912-007-0011-6

Cited by 39 publications

(30 citation statements)

References 39 publications

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“…1,4,[6][7][8][9] All of these modalities were forms of local and symptomatic treatment. They neither addressed the overall and systemic context of the HIV infection, nor stopped the progression of HIV disease.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients

Syebele

Bütow

2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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Objective. T h i s s tu dy ' s ai m w as to a s s e ss th e ef f e c t of h i gh l y a c ti v e an ti r e tr ov i r al d r u g s (HAART) on benign lymphoepithelial cysts (BLEC) of the parotid and ranulas.Study design. The records of 10 HIV-positive patients who presented with BLEC were reviewed, and 14 HIV-positive patients who presented with ranulas were prospectively enrolled. Patients in 2 both groups received the same combination of HAART and were clinically evaluated for the first three months. Patients with ranulas were followed up for an additional three months. A clinical reduction in the size of the lesions was considered to be a positive outcome.Results. All parotid glands with BLEC resolved within three months. No positive results were observed in ranulas during the first three months. However, some of the ranulas displayed a positive result after the initial three months of HAART. Conclusion.In contrast to BLEC, ranulas in HIV-positive patients seem to present a mixed and delayed response to HAART.Numerous publications report about HIV-related salivary gland disease (HIV-SGD). HIV-related enlargement of the parotid salivary gland, particularly benign lymphoepithelial cysts (BLEC), remains the most reported form of HIV-SGD. [1][2][3][4][5][6] Other salivary glands are affected as well 1 .However, little has been reported about ranulas as being part of HIV-related salivary gland Currently, the generally accepted standard mode of treatment for ranulas is surgical removal of the offending ipsilateral salivary gland either with or without the attached cystic lesion. [13][14][15] However, this radical surgical approach might face limitations in the current clinical presentations of some cases of ranulas in HIV-positive patients. Current cases seem to include more cases of plunging and bilateral ranulas (Fig. 1). More importantly, there are reported cases of BLEC co-existing with ranulas in the same subject and in multiple sites (Fig. 1A). This c l i n i c a l p r e s e n t a t i o n o f b o t h p a t h o l o g i e s i s o f g r e a t e t i o l o g i c a l i m p o r t a n c e a n d p r e s e n t s therapeutic implications in the context of HIV-SGD. The quest for a less invasive modality of 4 treatment for ranulas in HIV-positive patients might, therefore, become a greater challenge. To date, there is no evidence-based proof of treatment for ranulas with HAART. 12 The welldocumented benefit of HAART for BLEC in HIV-positive patients has led these authors to hypothesize that the very same drugs may positively affect ranulas in the context of HIV-SGD. A comparative approach has not been performed before.The aim of this study is, therefore, to assess how ranulas in HIV-positive patients respond to HAART, and compare the results with those of BLEC in parotid salivary glands in the context of HIV-SGD. Furthermore, a secondary objective is to define the time-frame within which to assess the effectiveness of the therapy in both groups. PATIENTS AND METHODSThis was a clinical study with both retrospective an...

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Section: Discussionmentioning

confidence: 99%

Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients

Syebele

Bütow

2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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“…One of the most important means to distinguish inflammatory from neoplastic lesions of the salivary glands is a well-performed history and physical examination [96,97]. The typical presentation of a benign salivary gland tumor is a painless slow-growing mass on the face (parotid gland), angle of the jaw (parotid tail, submandibular gland), or neck (submandibular gland) or a swelling at the floor of the mouth (sublingual gland) [14].…”

Section: Diagnostic Evaluation and Stagingmentioning

confidence: 99%

“…The management of the neck in a patient with positive nodes is a modified radical neck dissection with resection of the primary lesion. The management of the N0 neck is based on the tumors characteristics [96,97]. High-grade tumors, advanced T stage, presence of FN paralysis preoperatively, and histologic demonstration of extra-glandular spread or peri-lymphatic invasion merit an elective neck dissection [96].…”

Section: Operative Managementmentioning

confidence: 99%

Current Thinking on Malignant Salivary Gland Neoplasms

Arrangoiz¹

2013

JCTR

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Abstract:Malignant salivary gland neoplasms are rare, representing approximately 3% to 7% of all head and neck cancers. Contrasting from the more common mucosal head and neck cancers, which, in general, are ascribed to excessive tobacco, alcohol use, and more recently to viral infection, specific carcinogenic factors for malignant salivary gland growths have not been as clearly identified. Histologically, they represent a heterogeneous group of tumors. Forty histologic types of epithelial tumors of the salivary glands have been reported; some are exceedingly rare and may be the topic of only a few case reports. Salivary tumors can arise in the major salivary glands or in one of the minor salivary glands (predominantly mucus secreting glands), which are distributed throughout the upper aerodigestive. Most patients who develop malignant salivary gland tumors are in the sixth or seventh decade of life. FNA should be considered as part of the diagnostic evaluation but due to its varying sensitivities and specificities imaging modalities such as ultrasound, CT scans, and MRI should also be used as diagnostic adjuncts. Surgery is the primary modality for management of these tumors, nontraditional surgical approaches and instrumentation, as well as facial nerve monitoring, can be selectively utilized to try and decrease the morbidity associated with these surgical procedures. Adjuvant treatment is primarily achieved with radiation therapy. Chemotherapy continues to have a palliative role in the management of salivary gland tumors; however, research in this field is trying to identify a therapeutic role for chemotherapy in order to improve overall survival.

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“…Special caution needs to be exercised during these operations to avoid an unsightly facial scar and to preserve the facial and the lingual nerves as well as the salivary gland duct (Wharton). 13,16,18,21,22 The young age of some patients is also an important factor to be considered. If the result we have observed in this case is effectively related to the ART, then the link between HIV infection and mucoceles, including ranulas, may be consolidated, and the possibility of causative relationship may be hypothesized.…”

Section: Discussionmentioning

confidence: 99%