Retrospective Analysis of 136 Patients Operated for a Parotid Global Tumor

Abstract

Background: While salivary gland tumors constitute 5-6% of all head and neck tumors, they constitute 2-3% of all trunk tumors. About 3.8 per 100,000 of parotid tumors are diagnosed in the US each year, about 1300 to 1600 cases. The salivary gland cancer rate is 0.9 per 10000. The frequency of salivary gland tumors varies according to localization. Objective: In our study, we aimed to evaluate retrospectively the histopathological results, incidence, surgical treatment modalities and complications of parotid tumors operated in our clinic. Methods: We examined the patients who were operated for parotid gland tumor. The files of 136 patients who were admitted to the Otorhinolaryngology department of Dicle University Medical Faculty Hospital between January 2010 and April 2020 due to a parotid mass and underwent parotidectomy and whose pathology results were reported as benign or malignant parotid tumors were retrospectively scanned and included in the study. Patients’ age, gender, FNAB cytology result, type of surgery, histopathological results after surgery and complications after surgical treatment were recorded. Results: A total of 136 patients, 73 (53.7%) male and 63 (46.3%) female, were included in the study. The mean age of the patients was 48.26±17.37 (min=14, max=83) years. Superficial parotidectomy was performed in 108 (79.4%) patients and total parotidectomy was performed in 28 (20.6%) patients. According to the histopathological results after surgery, 108 (79.4%) benign tumors and 28 (20.6%) malignant tumors were diagnosed. Accordingly, pleomorphic adenoma (47.8%) was the second most common with 65 patients, followed by Whartin tumor (25.7%) with 35 patients. The sensitivity (sensitivity) of FNAB was 85.2%, and the specificity (specificity) was 96.2%. The accuracy of FNAB was found to be 94.0%. Conclusion: Good identification of the parotid mass preoperatively, together with both FNAB and radiological imaging methods, gains much more value in differentiating malignant and benign pathologies. While superficial parotidectomy is mostly sufficient in benign tumors, total parotidectomy-radical parotidectomy in malignant tumors and neck dissection should be considered in high-grade tumors even if there is no neck metastasis. Patients should be evaluated for RT and CT according to the tumor type after surgery.

Tratamiento quirúrgico de las neoplasias en la glándula parótida

“…En el presente estudio se identificaron hallazgos similares a lo señalado en la literatura nacional e internacional, en cuanto a la frecuencia por categoría del sexo, edad, tipo histológico, y ubicación en el lóbulo superficial (1,3,8,20,21) . El adenoma pleomórfico representa más del 65% de los tumores benignos.…”

“…Ocurre en personas de todas las edades, con una alta incidencia entre la cuarta y sexta década de la vida. Algunas características frecuentes al momento del diagnóstico son su ubicación en el lóbulo superficial, con un diámetro que puede ser menor de 4 cms y movible (1)(2)(3)(4)(5)(6)(7)20,21) . Respecto al carcinoma mucoescamoso es referido como la variedad histológica más común en el grupo de las neoplasias malignas con un elevado porcentaje entre el cuarto y séptimo decenio de la vida (3,8,10,20,21) .…”

“…Las neoplasias de la glándula parótida representan el 2% de los tumores del área de cabeza y cuello, además corresponden al 80% de aquellas surgidas en las glándulas salivales (1)(2)(3)(4) . El tratamiento operatorio representa la principal opción terapéutica (5,6) .…”

“…El 20% restante son tumores malignos. En ambos casos existe una amplia variedad de tipos histológicos de distinto patrón de comportamiento y grado de agresividad (1,3,7,6) . La punción con aguja fina es la principal alternativa de muestreo histológico preoperatorio.…”

“…El primer grupo relacionado con aquellas metástasis ganglionares que aparecen en la glándula salival provenientes de neoplasias cutáneas de piel facial, auricular o de cuero cabelludo. El segundo grupo se asocia a la extensión de tumores primarios originados en estructuras anatómicas cercanas a la glándula parótida, como la infiltración por neoplasias de conducto auditivo externo (3,8) . Aunque el propósito de la cirugía es el control de la enfermedad en cada uno de estos grupos, cada uno posee distintos porcentajes de recurrencia y sobrevida (7) .…”