Botryoid embryonal rhabdomyosarcoma of Stensen's duct

A clinical study of malignant tumors of Stensen's duct

CONCLUSION

Malignant tumors of Stensen's duct are often squamous cell carcinomas. Surgery is the treatment of choice, and maintaining an adequate safety margin and performing parotidectomy may help to reduce postoperative recurrence.

OBJECTIVES

Since malignant tumors of Stensen's duct are extremely rare, the number of cases is limited in single-facility studies, making it difficult to perform a sufficient number of clinical examinations. Therefore, we reviewed 26 cases with Stensen's duct malignancies to examine their clinical features.

METHODS

We conducted a retrospective study of 26 cases with Stensen's duct malignancies, including 1 patient whom we treated and 25 cases previously reported in the English literature, and analyzed their clinical parameters, including age, sex, affected side, chief complaint, tumor size, histopathology, treatment method, and treatment outcome.

RESULTS

Most cases were diagnosed in patients between 40 and 69 years of age. The chief complaint was swelling in the cheek in 24 patients, in 14 of whom the swelling was painful. The most common tumor diameter range was 10-19 mm. Squamous cell carcinoma was the most frequent histopathology. The recurrence rate in surgical patients who did not undergo parotidectomy was 60%, whereas in patients who underwent parotidectomy, the recurrence rate was only 7%.

Fine-needle aspiration biopsy of alveolar rhabdomyosarcoma of Stensen's duct: a case report and review of the literature

The cytologic features of an alveolar rhabdomyosarcoma arising within Stensen's duct of the parotid gland are described. These malignancies and sarcomas in general are not usually included in the differential diagnosis of a parotid lesion as they rarely present as primary parotid malignancies. In addition, these neoplasms are even rarer outside of the pediatric and adolescent populations. Due to the difficulty of this diagnosis, we present this case to increase awareness of the diagnosis in the salivary glands and to highlight the cytomorphologic features that can aid in the correct diagnosis.

Rhabdomyosarcoma of Stensen's duct in children

OBJECTIVES

Stensen's duct is a very uncommon location for rhabdomyosarcoma. The purpose of this article was to review the clinical history of 2 patients who had rhabdomyosarcoma of Stensen's duct.

METHODS

We reviewed the clinical history, imaging studies, histologic analysis, and treatment of 2 patients with rhabdomyosarcoma of Stensen's duct.

RESULTS

An 8-year-old boy (case 1) and a 17-year-old boy (case 2) presented with nonspecific facial swelling. In both patients, imaging studies showed a tumor at Stensen's duct, and biopsy showed embryonal rhabdomyosarcoma. Both patients were treated with preoperative chemotherapy, parotidectomy, and resection of Stensen's duct and postoperative chemotherapy and radiation therapy. Follow-up at 9 years (case 1) and 2 years (case 2) after surgery showed that the patients were free of disease.

CONCLUSIONS

Stensen's duct rhabdomyosarcoma is rare and may have a better prognosis than rhabdomyosarcoma in other locations in the head and neck.

Ipsilateral and Contralateral Acoustic Brainstem Response Abnormalities in Patients With Vestibular Schwannoma

OBJECTIVE: To analyze auditory brainstem response (ABR) data in patients with vestibular schwannomas (VS) in an effort to identify correlations between abnormal ABR parameters and tumor size.

STUDY DESIGN: Cross-sectional study with chart review.

SETTING: Tertiary referral hospital.

SUBJECTS AND METHODS: Retrospective chart review and analysis of bilateral ABR records in patients with VS. Interaural latency differences of interpeak I-V (ILD-I-V) and ILD-V longer than 0.2 ms were used as abnormal criteria.

RESULTS: Thirty patients with a mean age of 50 ± 14 years were included in this study. The most frequent changes in ABR parameters included those of ILD-I-V (100%), wave V latency (96.7%), ILD-V (93.3%), and interpeak I-V latency (90%). Average VS tumor size was 2.48 ± 1.31 cm. For patients with VS greater than or equal to 2 cm, the prevalences of abnormal ipsilateral interpeak III-V latency, contralateral wave V latency, and interpeak III-V latency showed statically significant differences ( P = 0.0035, P = 0.0267, and P = 0.0273, respectively) compared to those in patients with VS less than 2 cm. Tumor size was positively correlated with pure-tone average ( P = 0.0106) and with the total number of bilateral abnormal ABR parameters ( P = 0.004).

CONCLUSIONS: We identified a correlation between ABR parameters and VS tumor size. An ipsilateral ILD-I-V greater than 0.2 ms was sensitive for detecting VS. Abnormal contralateral wave V and interpeak III-V latency indicated a tumor size potentially larger than 2 cm. Further studies are needed to confirm these findings.

Squamous cell carcinoma arising from Stensen's duct

We report a case of squamous cell carcinoma presumably arising from the left Stensen's duct. The tumor was discovered during management of recurrent left parotitis. Ultrasonography, computed tomography, and magnetic resonance imaging were useful for estimating the tumor and coexisting obstructive parotitis. Relapsing symptoms and the presence of parotitis seemed to be characteristic of tumors of Stensen's duct. For a mass accompanied by obstructive parotitis or relapsing parotitis without salivary calculus, a tumor of Stensen's duct should be included in the differential diagnosis.

Le rhabdomyosarcome de la glande parotide. À propos de trois cas et revue de la littérature

Rhabdomyosarcoma of the salivary glands is rare. Tumours develop mostly in children and young patients but can be diagnosed in older people. We report three new cases in women 7, 14 and 75 years old. Tumefaction of the parotid region and facial paralysis were the principle clinical symptoms. Two patients underwent a total parotidectomy and radiotherapy. The third patient had a locally advanced tumour and received chemotherapy followed by radiotherapy. Loco-regional recurrence was observed in all cases and median survival was 12 months. Rhabdomyosarcoma of the salivary glands is locally aggressive. Treatments include surgery and radiotherapy. The role of chemotherapy remains to be discussed.

Mucoepidermoid carcinoma of Stensen's duct: A case report and review of the literature

BACKGROUND

Mucoepidermoid carcinoma of Stensen's duct is a rare neoplasm, with only five cases reported in the literature.

METHODS

We report another case of mucoepidermoid carcinoma of Stensen's duct and review the literature.

RESULTS

Stensen's duct neoplasms tend to be symptomatic at an early stage by causing an obstruction of the parotid duct. New imaging techniques such as MR sialography and sialoendoscopy are very helpful in diagnosis and patient management.

CONCLUSIONS

Although the rarity of this condition prevents definitive conclusions about the optimal treatment, we propose that Stensen's duct neoplasms should be treated like similar neoplasms occurring in the parotid gland tissue, taking into consideration clinical stage, tumor grade, and surgical margins.

Normal audiologic presentations in patients with acoustic neuroma: An evaluation using strict audiologic parameters

Although several studies have previously reported on patients presenting with "normal" audiologic parameters in acoustic neuroma, the present study is, to our knowledge, the first to exclusively examine in detail cases involving exceptionally stringent objective audiometric features. Of 369 patients with acoustic neuroma who were operated on between April 1980 and April 1997 by our group, 10 had strictly normal hearing, defined as follows: (1) pure-tone average < 20 dB; (2) speech discrimination score > 90%; and (3) interaural differences </= 10 dB at every hertz level. A high level of audiologic functioning was found to significantly lower the sensitivity of auditory brainstem response in the detection of acoustic neuroma. Magnetic resonance imaging was the only preoperative test exhibiting 100% sensitivity in this setting. Thus, a high level of clinical suspicion appears warranted in any case involving unexplained unilateral audiovestibular symptoms-including those instances in which strictly normal hearing parameters exist and are associated with negative auditory brainstem response findings.

Malignant tumors of Stensen's duct

A rare case of squamous cell carcinoma arising in Stensen's duct is reported. The literature concerning malignant neoplasia originating in this site is reviewed, with attention given to the histopathologic diversity of neoplasms occurring in the duct, criteria for determination of origin in the duct, and outcomes of therapy.

Clinical Observations on Coexistence of Sudden Hearing Loss and Vestibular Schwannoma

It has long been recognized that sudden hearing loss (SHL) may be a harbinger of vestibular schwannoma (VS). Among 192 VS patients who underwent operation in the Gruppo Otologico, Piacenza, Italy, from April 1987 to October 1995, the charts of 14 (7.3%) cases with a history of SHL were examined. SHL was the first symptom in 8 (4.2%) patients. Eight (57.1%) of 14 VS cases with SHL anamnesis had reported recovery of their previous hearing either totally or partially before establishment of tumor diagnosis. Five (35.7%) cases had recurrent bouts of SHL. SHL was observed less frequently in cases with large tumors (<3 cm). However, the frequency of SHL in patients with small tumors did not differ from that of medium-sized tumors. Awareness about coexistence of SHL and VS, as well as concomitant use of auditory brain stem response and magnetic resonance imaging, is crucial to rule out the diagnosis of VS in a patient with SHL.