Endoscopic-assisted resection of pleomorphic adenoma in the accessory parotid gland

Hasegawa, Kazuaki; Sukegawa, Shintaro; Ono, Sawako; Ando, Masayuki; Shibata, Aya; Sukegawa‐Takahashi, Yuka; Fujimura, Ai; Matsuyama, Tamamo; Ibaragi, Soichiro; Nagatsuka, Hitoshi; Mizobuchi, Koichi; Sasaki, Akira; Furuki, Yoshihiko

doi:10.2152/jmi.68.376

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…For the diagnosis of soft tissue lesions in the oral cavity, MRI and US are effective for confirming the location, size, nature, and morphology of the tumor ( 44 , 45 ). A preoperative diagnosis is particularly important for primary salivary gland tumors of the labial gland, as malignancy is observed in 20–30% of cases ( 46 , 47 ).…”

Section: Discussionmentioning

confidence: 99%

Lip pleomorphic adenomas: case series and literature review

Umemori¹,

Ono²,

Kanemoto³

et al. 2022

Gland Surg

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Background: Pleomorphic adenoma (PA) is the most frequent benign salivary gland tumor, but a lip PA is rare. Although this tumor may be definitively diagnosed by imaging or a tissue biopsy if it is reasonably large, PAs on the lip are relatively small, and they present findings that are similar to those of other lip lesions, which can make a preoperative diagnosis difficult. Methods:We analyzed all PAs in the oral region and lesions on the lips treated in our department over the past 20 years, and we discuss them together with the relevant literature.Results: We found that 11.8% (n=6) of the PAs occurred on a lip (upper lip: 9.8%, lower lip: 2.0%), and ~1% of all mass lesions of the lips were PAs. The average size of the lip PAs was 1.5±0.7 cm (range, 0.7-2.2 cm).For preoperative diagnostic assistance, ultrasonography (US) (n=4), magnetic resonance (MR) (n=3), or no imaging (n=2) was used. An excisional biopsy was performed in all cases, and to date, no recurrence or malignant transformation has been observed.Conclusions: Lip PA is relatively rare. Because almost all of these lesions are small, a preoperative diagnosis is more difficult compared to palatal lesions. This tumor is also prone to long-term neglect and has the potential for recurrence and malignant transformation. It is thus necessary to perform an excision that includes the capsule and surrounding tissues, and careful postoperative follow-up should be continued.

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Section: Discussionmentioning

confidence: 99%

Lip pleomorphic adenomas: case series and literature review

Umemori¹,

Ono²,

Kanemoto³

et al. 2022

Gland Surg

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“…A transoral approach is known to mitigate patients' cosmetic concerns [21,22]; however, prior reports utilised endoscopic assistance on patients with smaller tumours [23]. The endoscopic-assisted technique has proven useful to achieve tumour resection while avoiding serious complications due to surgical procedures [24,25]. Nevertheless, a current standard parotidectomy approach is still thought to be safe and cosmetically appealing [14,15,17].…”

Section: Introductionmentioning

confidence: 99%

Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland—Observations Based on 2192 Cases of the Polish Salivary Network Database

Wierzbicka,

Bartkowiak,

Pietruszewska

et al. 2024

Cancers

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The accessory parotid gland (APG, Vth level) differs in histological structure from main parotid tissue. This gives rise to the hypothesis, mirrored in clinical observations, that the representation of tumours is different than in the rest of the gland. The aim of the study was to analyse the epidemiological and histological differences of parotid tumours located in regions I–V, with particular emphasis on the distinctiveness of region V. To define the epidemiological factors that will indicate the risk of histological malignancy from clinically benign appearance, multicentre prospective studies conducted between 2017–2021 by five Head and Neck Surgery University Departments, cooperating within the Polish Salivary Network Database 1929 patients (1048 women and 881 men), were included. The age, gender, patient occupation, place of inhabitation, tumour size, clinical features of malignancy, histology, and facial nerve (FN) paresis were analysed for superficial (I_II) and deep (III_IV) lobes and with special regard to the tumours affecting region V. Twenty eight tumours were located exclusively in region V (1.45% total) and seventy-two tumours were found in region V exhibiting extensions to neighbouring regions (3.7% total), characterised as significantly younger and less frequent in retirees. In I–IV regions, approximately 90% of tumours were benign, with pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V, PA exceeded 75% but WT were casuistic (2/28). Incidences of malignancies in region V was 40% but clinical signs of malignancy were evident only in tumours > 4 cm or in the presence of FN paresis. In 19% of patients with a benign appearance, imaging revealed malignancy; however, 38% of patients showed false negative results both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumours located exclusively in region V vs. 1901 other patients and in 100 patients with V extension vs. 1829 other patients showed no clinical symptoms of malignancy binding with final malignant tumour histology as a single variable or in combination with other variables. The logistic regression models obtained in this study show strong linkage between tumour location and predictors (age, male gender, and tumour diameter) and also aimed to function as a good classifier. Our conclusion is that, despite the very clear image of the mid-cheek tumour which is easily accessible in palpation and ultrasound examination, it is necessary to improve oncological vigilance and preoperative patient preparation.

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“…A transoral approach is known to mitigate patients' cosmetic concerns [22,23], however, prior reports utilized endoscopic assistance on patients with smaller tumours [24]. The endoscopic-assisted technique has proven useful to achieve tumour resection while avoiding serious complications due to surgical procedures [25,26]. Nevertheless, a current standard parotidectomy approach is still thought to be safe and cosmetically appealing [15,16,18].…”

Section: Introductionmentioning

confidence: 99%

Rationale for increasing oncological vigilance in relation to clinical findings in accessory parotid gland- observations based on 2192 cases of the Polish Salivary Network Database

Wierzbicka,

Bartkowiak,

Pietruszewska

et al. 2023

Preprint

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The accessory parotid gland (APG, Vth level) differs in histological structure from main parotid tissue. This gives rise to the hypothesis, mirrored in clinical observations, that the representation of tumours is different than in the rest of the gland. Aim To analyse the epidemiological and histological differences of parotid tumours located in regions I-V, with particular emphasis on the distinctiveness of region V. To define the epidemiological factors that will indicate the risk of histological malignancy from clinically benign appearance. Material and Method Multicentre prospective study conducted between 2017-2021 by five Head and Neck Surgery University Departments, cooperating within the Polish Salivary Network Database 1929 patients (1048 women and 881 men) were included. The age, gender, patient occupation, place of inhabitation, tumour size, clinical features of malignancy, histology, facial nerve (FN) paresis were analysed for superficial lobe (I_II), deep lobe (III_IV) and with special regard to the tumours affecting region V. Results 28 tumours were located exclusively in region V (1.45% total) and 72 tumours in region V with extension to neighbouring regions (3,7% total), characterized by significantly younger age and less frequent in retirees. In I-IV regions approximately 90% of tumours were benign, pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V PA exceed 75% but TW were casuistic (2/28). Incidence of malignancies in region V was 40% but clinical signs of malignancy were evident only in tumours>4 cm or in the presence of FN paresis. In 19% of patients with a benign appearance, imaging revealed malignancy, however in 38% of patients, the result remained false negative both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumour located exclusively in region V vs 1901 other patients and the in 100 patients with V extension vs 1829 other patients showed no clinical symptoms of malignancy bind with final malignant tumor histology as a single variable or in combination with other variables. The logistic regression models obtained in this study shows strong linkage between tumor location and predictors (age, male gender and tumor diameter) and aimed to act as a good classifier. Conclusion Despite the very clear image of the mid-cheek tumour, easily accessible in palpation and ultrasound examination, it is necessary to improve the oncological vigilance and preoperative patient preparation.

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Endoscopic-assisted resection of pleomorphic adenoma in the accessory parotid gland

Cited by 5 publications

References 21 publications

Lip pleomorphic adenomas: case series and literature review

Lip pleomorphic adenomas: case series and literature review

Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland—Observations Based on 2192 Cases of the Polish Salivary Network Database

Rationale for increasing oncological vigilance in relation to clinical findings in accessory parotid gland- observations based on 2192 cases of the Polish Salivary Network Database

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