Radiation therapy as a treatment for benign lymphoepithelial parotid cysts in patients infected with human immunodefiency virus-1

Goldstein, Jeffrey; Rubin, John S.; Silver, Carl E.; Meritz, Keith; Chao, Celia; Ting, Joseph; Davis, Lawrence W.

doi:10.1016/0360-3016(92)90912-2

Cited by 31 publications

(26 citation statements)

References 14 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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“…The results with this treatment have been partial. 22 As a minimally invasive treatment sclerotherapy with doxycycline has been suggested, but the series that were carried out are small and long term follow up with these patients is necessary in order to compare results. 21 …”

Section: In the Absence Of An Answer If The Patients Reports Local DImentioning

confidence: 99%

“…sobre todo en el caso de población pediátrica y los resultados obtenidos con dicho tratamiento han sido parciales. 22 Como tratamiento minimamente invasivo se ha planteado la escleroterapia con doxiciclina, pero las series en las que se ha realizado son pequeñas y se precisa un seguimiento a más largo plazo de estos pacientes para comprobar resultados. 21 …”

Section: The Lblc Is a Topic That Should Be Taken Into Account When Dunclassified

Lesión linfoepitelial quística benigna de glándula parótida en paciente con infección por VIH

García

González-García

et al. 2009

Rev Esp Cirug Oral y Maxilofac

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Mujer de 44 años de edad que acude a consultas de Cirugía Oral y Maxilofacial derivada por su Médico de Familia. Presenta de forma bilateral, en región correspondiente a cola de parótida tumoraciones de consistencia elástica, no fijas a planos adyacentes, asintomáticas y de varios meses de evolución. Dentro de sus antecedentes destaca infección por VIH. En la TC cervico-facial se observan lesiones de aspecto quístico en ambas glándulas parótidas Figura 2. Imagen de la paciente en la que se aprecia la tumoración laterocervical izquierda (en región correspondiente a cola de parótida izquierda). Página del Residente IntroducciónLa Lesión Linfoepitelial Quística Benigna (LLQB) es un trastorno poco frecuente que afecta a las glándulas salivales, fundamentalmente a la glándula parótida y que se ha asociado a la infección por el VIH. Desde el punto de vista clínico, a nivel parotídeo y cervical, se manifiesta por la presencia de una tumoración elástica no dolorosa, de crecimiento progresivo y asociada a adenopatías cervicales. La LLQB es una entidad a tener en cuenta en el diagnósti-co diferencial de las masas cervicales en pacientes infectados por el VIH. DiscusiónLa infección por el VIH se ha asociado a diversas entidades que afectan a las glándulas salivales como son el linfoma, síndrome de Sjögren, sarcoma de Kaposi y la lesión linfoepitelial quística benigna. 1-6 Antes de la década de los ochenta las LLQB de parótida constituían menos del 3% de los tumores benignos de esta glándula, posteriormente y debido al aumento de la incidencia de la infección VIH, se ha incrementado el numero de casos. 1,2 La LLQB de las glándulas salivales afecta con más frecuencia a la parótida que a las submaxilares. 6-8 Histológicamente la lesión está compuesta por uno o varios quistes llenos de líquido gelatinoso claro, tapizados por epitelio metaplásico escamoso o columnar y rodeados por un infiltrado linfoide, que contiene islotes de células

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“…Als weitere Therapiemöglichkeit, gerade beim Vorliegen von lymphoepithelialen Zysten, wurde der Einsatz der Radiotherapie mit einer Gesamtdosis von 8 ± 20 Gy beschrieben [89,238].…”

Section: Virussialadenitisunclassified

Therapie nichttumoröser Speicheldrüsenerkrankungen und postoperativer Komplikationen

Maier¹

2001

Laryngorhinootologie

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Inhalt 1 Einleitung 90 2 Entzündungen 90 2.1 Akute bakterielle Sialadenitis und Speicheldrüsenabszess 90 2.1.1 Akute postoperative Parotitis 90 2.2 Akute toxische Parotitis bei Alkylphosphat-Intoxikation 91 2.2.1 Medikamentös-induzierte Sialadenitis 91 2.3 Chronisch-unspezifische Parotitis, Lymphadenitis der Gl. parotis 91 2.4 Aktinomykose 91 2.5 Mykobakterielle Infektionen der Speicheldrüsen 92 2.5.1 Tuberkulose 92 2.5.2 Atypische mykobakterielle Infektonen 92 2.6 Pneumoparotitis 93 2.7 Virussialadenitis 93 2.8 HIV-assoziierte Speicheldrüsenerkrankungen (HIV-SGD) 94 2.9 Strahlensialadenitis 95 2.10 Chronisch rezidivierende Parotitis 95 2.11 Obstruktive Sialadenitis, Elektrolytsialadenitis 97 2.12 Immunsialadenitis 97 2.12.1 Myoepitheliale Sialadenitis 97 2.12.2 Epitheloidzellige Sialadenitis (Sarkoidose) 99 2.12.3 Allergische Sialadenitis 99 2.1.1 Akute postoperative Parotitis Diese Sonderform der akuten eitrigen Parotitis tritt selten, im Gefolge ausgedehnter, insbesondere abdominalchirurgischer Eingriffe auf, wobei es wahrscheinlich durch vaskulär-toxische Faktoren bzw. durch eine neurovegetative Fehlsteuerung zu einer durch Kininogenasen induzierten intraglandulären Aktivierung proteolytischer Fermente mit konsekutiver Autodigestion der Drüse kommt [112, 209]. Infolge der ausgeprägten Entzündungsreaktion und einer häufig bestehenden Exsikkose resultiert ein verminderter Speichelfluss, der eine duktogene Keimaszension (meist Staph. aureus) und damit eine sekundäre, oft foudroyant verlaufende bakterielle Sialadenitis zur Folge hat (Abb. 2). Nach Diagnosestellung (Anamnese, klinisches Bild mit Parotisschwellung, hohes Fieber, reduzierter Allgemeinzustand, Abstrich) erfolgt eine intravenöse antibiotische Therapie (Cephalosporine der 1. oder 2. Generation, Amoxicillin + Clavulansäu-Abb. 1 Multiple Abszesse der Gl. parotis links.

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Radiation therapy as a treatment for benign lymphoepithelial parotid cysts in patients infected with human immunodefiency virus-1

Cited by 31 publications

References 14 publications

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

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

Lesión linfoepitelial quística benigna de glándula parótida en paciente con infección por VIH

Therapie nichttumoröser Speicheldrüsenerkrankungen und postoperativer Komplikationen

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