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Aghahosseini F, HafeziMotlagh K, Derakhshan S, Bahrami H. Mucoepidermoid carcinoma of the palate in a patient with a history of neuroblastoma: A case report and a review of the literature. Clin Case Rep 2023; 11:e7898. [PMID: 37692154 PMCID: PMC10491751 DOI: 10.1002/ccr3.7898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/14/2023] [Indexed: 09/12/2023] Open
Abstract
Secondary neoplasms were reported as one of the complicated complications of childhood cancer treatment. Salivary gland carcinoma is rare, and mucoepidermoid carcinoma (MEC) is the most prevalent subtype. Secondary neoplasms following neuroblastoma are not often described due to poor long-term survival. The exact cause of these tumors in children, and adults is not clearly known, but they are often observed after head, and neck radiotherapy and mainly involve main salivary glands, especially the parotid. Hence, we report a case of MEC with telangiectasia in the salivary glands of a 20-year-old girl with complaint of a palatal swelling who was treated with chemotherapy (etoposide, G-CSF, cyclophosphamide) without radiotherapy since childhood (18 months) in terms of neuroblastoma. Based on our knowledge, only three cases of MEC following neuroblastoma have been reported before, all of which involved the major salivary glands. Survivors of primary neoplasms who were treated are at risk of secondary malignant neoplasms, which usually occur at a long interval from the primary neoplasm (5-15 years), which necessitates long and close follow-up.
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Affiliation(s)
- Farzaneh Aghahosseini
- Department of Oral MedicineFaculty of DentistryTehran University of Medical SciencesTehranIran
- Dental Research CenterDentistry Research InstituteTehran University of Medical SciencesTehranIran
- The Academy of Medical Sciences TehranTehranIran
| | - Kimia HafeziMotlagh
- Department of Oral MedicineSchool of DentistryTehran University of Medical SciencesTehranIran
| | - Samira Derakhshan
- Oral and Maxillofacial Pathology DepartmentSchool of DentistryTehran University of Medical SciencesTehranIran
- Cancer Preclinical Imaging GroupPreclinical Core FacilityTehran University of Medical SciencesTehranIran
| | - Hosna Bahrami
- Department of Oral MedicineSchool of DentistryTehran University of Medical SciencesTehranIran
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Othman BK, Badawy W. Intraparotid Ganglioneuroma: A rare case report. Indian J Otolaryngol Head Neck Surg 2023; 75:2613-2616. [PMID: 37636636 PMCID: PMC10447343 DOI: 10.1007/s12070-023-03800-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/10/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction: Ganglioneuromas (GNs) are slow-growing, benign tumors arising from Schwann cells, gangliocytes, and neuronal tissues. Case Presentation: We report a rare intraparotid ganglioneuroma in a 42-year-old female presented with a parotid mass. The onset of the lesion dated back to 2021, but the growth was remarkable only in November 2022. The FNA suggested a plexiform neurofibroma. The post-surgical microscopic examination of the excised lesion revealed neoplastic large, rounded cells with abundant, finely granular eosinophilic cytoplasm and a large, eccentric nucleus with a prominent nucleolus as well as fasciculated, with an elongated cytoplasm with fine fibrillar extensions. No mitosis or tumor necrosis was observed. The periphery of the tumor showed perineural entrapment. The immunohistochemical staining for S100 protein, synaptophysin, and chromogranin A were positive. However, the neoplastic cells showed no immunoreactivity for cytokeratin (CK5/6, CK7, AE1/AE3), epithelial membrane antigen, HMB45, Melan A, CD30, CD117 and p40. The case was signed out as mature intraparotid ganglioneuroma. Conclusion: The treatment of choice was surgical resection without adjuvant radiotherapy. No recurrence or post-surgical complications were hitherto reported. To the best of our knowledge, this is the first reported case of intraparotid ganglioneuroma. Caution should be taken not to diagnose this benign neoplasm as a metastasis (e.g. metastatic neuroblastoma) or to request unnecessary overtreatment (e.g., postoperative chemotherapy and radiotherapy).
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Affiliation(s)
- Bacem K. Othman
- Faculty of Medicine in Pilsen (Lékařská fakulta v Plzni), Charles University: Univerzita Karlova, Plzeň, Czech Republic
| | - Wafaey Badawy
- Department of Pathology, Alkharj (AKMICH), Military Industries Hospital, Kingdom of Saudi Arabia (KSA), Al-Kharj, Saudi Arabia
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Ronchi A, Di Martino M, Caputo A, Zeppa P, Colella G, Franco R, Cozzolino I. Fine-Needle Aspiration Cytology Is an Effective Diagnostic Tool in Paediatric Patients with Mucoepidermoid Carcinoma as Secondary Neoplasm. Acta Cytol 2020; 64:520-531. [PMID: 32526741 DOI: 10.1159/000508395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in paediatric population, accounting for 16% of all cases. Patients affected by a previous solid or leukaemic neoplasm during their childhood may develop a second different tumour during the follow-up. In this setting, salivary gland MEC is relatively frequent, accounting for 6% of the second neoplasms in paediatric patients. Consequently, the occurrence of salivary gland nodules in paediatric patients with a previous neoplasm should be considered an event with a high risk of malignancy that poses peculiar diagnostic challenges. SUMMARY This study was designed to define clinical and instrumental findings and morphological features of MEC on fine-needle aspiration cytology (FNAC) samples in paediatric patients with and without a previous neoplasm. Five patients under 19 years are included in this series. FNAC was performed in all patients on a parotid nodule. We have identified 2 groups of patients: (a) 2 cases with previous history of malignancy (acute lymphoblastic leukaemia and Hodgkin lymphoma) and (b) 3 cases without previous malignant neoplasms. In all cases, a final diagnosis of MEC was rendered. Key Messages: MEC may occur as a second malignancy in paediatric patients. FNAC is certainly a valid and accurate diagnostic tool for this type of neoplasm, even in the paediatric age, allowing the correct management of the patients.
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Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Martina Di Martino
- Unit of Hematology-Oncology, Pediatric Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - Giuseppe Colella
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Dental Specialty, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy,
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Hao L, Shi C, Xu Y. Comparison Between Primary and Secondary Pediatric Mucoepidermoid Carcinoma of the Head and Neck. Front Pediatr 2020; 8:473. [PMID: 32974245 PMCID: PMC7468489 DOI: 10.3389/fped.2020.00473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives: Secondary mucoepidermoid carcinoma (MEC) of the head and neck is occasionally observed in childhood cancer survivors. The goal of this research was to compare the demographic and pathologic characteristics, as well as survival between primary and secondary MEC in children and adolescent patients. Methods: Pediatric patients (younger than 19 years old) with surgically treated MEC of the head and neck were retrospectively enrolled at the Affiliated Children's Hospital of Zhengzhou University and divided into two groups based on their cancer history. Demographic, pathologic, and survival characteristics between the two groups were compared. The main study interests were recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS). Results: The primary and secondary groups consisted of 63 and 15 patients, respectively. The two groups had similar distributions in terms of age, sex, tumor stage, neck lymph node stage, perineural invasion, lymphovascular invasion, p53, Bcl-2, proliferating cell nuclear antigen, carcinoembryonic antigen, and Ki-67 index. The 10-year RFS rates for the primary group and secondary group were 80 and 71%, respectively, and this difference was not significant (p = 0.464). The 10-year DSS rates for the primary group and secondary group were 83 and 82%, respectively, and this difference was also not significant (p = 0.649). The 10-year OS rates for the primary group and secondary group were 74 and 51%, respectively; this difference was significant (p = 0.023). Further Cox model analysis confirmed the independence of a previous cancer history (p = 0.043) in decreasing OS. Conclusions: Pediatric patients with secondary MEC exhibit similar demographic, pathologic, and molecular characteristics as primary patients but worse OS. These findings indicate that special disease management approaches might be needed for secondary patients.
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Affiliation(s)
- Li Hao
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Children Hospital of Zhengzhou University, Henan Children Hospital, Zhengzhou, China
| | - Caixiao Shi
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Children Hospital of Zhengzhou University, Henan Children Hospital, Zhengzhou, China
| | - Ying Xu
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Children Hospital of Zhengzhou University, Henan Children Hospital, Zhengzhou, China
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Dombrowski ND, Wolter NE, Irace AL, Cunningham MJ, Mack JW, Marcus KJ, Vargas SO, Perez-Atayde AR, Robson CD, Rahbar R. Mucoepidermoid carcinoma of the head and neck in children. Int J Pediatr Otorhinolaryngol 2019; 120:93-99. [PMID: 30772619 DOI: 10.1016/j.ijporl.2019.02.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Mucoepidermoid carcinoma is a rare malignant salivary gland neoplasm in the pediatric population. Few studies have discussed best practice with respect to diagnosis and treatment in children. OBJECTIVE To present our institution's experience with the evaluation and management of pediatric mucoepidermoid carcinoma of the head and neck. METHODS Retrospective chart review of patients under 20 years of age diagnosed with mucoepidermoid carcinoma of the head and neck between 1998 and 2017. Data assessed includes demographics, clinical presentation, imaging examinations, histopathology, treatment, complications, local recurrence, distant metastasis, and follow-up. RESULTS Sixteen patients (10 female, 6 male) were identified with a median age of 12.9 (IQR: 10.9-15.0) years. Tumors were located within the parotid gland (n = 11, 68.8%), accessory lobe of the parotid gland (n = 2, 12.5%), palate (n = 2, 12.5%), and submandibular region (n = 1, 6.3%). In 9 patients (56.3%) a neoplastic etiology was suspected based on the clinical and/or radiographic findings and confirmed pathologically on biopsy or excision. All patients were treated surgically and five patients required adjuvant radiotherapy. One patient had recurrence requiring re-excision. Seven patients (43.8%) had transient facial paresis post-operatively and one had Frey syndrome. Median follow-up time was 59.7 months (IQR: 18.9-99.3). CONCLUSION The malignant nature of mucoepidermoid carcinoma requires comprehensive, multidisciplinary management. Imaging and tissue sampling by fine needle aspiration give clinicians the best insight into location and nature of the mass. Complete surgical excision with attention to preservation of facial nerve and achieving negative margins is desired.
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Affiliation(s)
- Natasha D Dombrowski
- Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, MA, 02115, United States
| | - Nikolaus E Wolter
- Department of Otolaryngology, Hospital for Sick Children, Toronto, ON, Canada; Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alexandria L Irace
- Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, MA, 02115, United States
| | - Michael J Cunningham
- Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, United States
| | - Jennifer W Mack
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Boston, MA, 02115, United States; Department of Hematology/Oncology, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, United States
| | - Karen J Marcus
- Division of Radiation Oncology, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Radiation Oncology, Harvard Medical School, Boston, MA, 02115, United States
| | - Sara O Vargas
- Department of Pathology, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Pathology, Harvard Medical School, Boston, MA, 02115, United States
| | - Antonio R Perez-Atayde
- Department of Pathology, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Pathology, Harvard Medical School, Boston, MA, 02115, United States
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Radiology, Harvard Medical School, Boston, MA, 02115, United States
| | - Reza Rahbar
- Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, United States.
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Morse E, Fujiwara RJT, Husain Z, Judson B, Mehra S. Pediatric Salivary Cancer: Epidemiology, Treatment Trends, and Association of Treatment Modality with Survival. Otolaryngol Head Neck Surg 2018; 159:553-563. [PMID: 29688836 DOI: 10.1177/0194599818771926] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective To characterize the epidemiology of pediatric salivary cancer and associate patient, tumor, and treatment factors with treatment modality and survival. Study Design Cross-sectional analysis. Setting US national database. Subjects and Methods We identified 588 patients 19 years or younger diagnosed with salivary cancer in the National Cancer Database 2004-2013. We characterized patient, tumor, and treatment factors as proportions and associated these factors with treatment modality and overall survival via multivariable logistic regression and multivariable Cox proportional hazards regression, respectively. Results In total, 588 patients were included. Mucoepidermoid carcinoma was identified in 234 of 588 patients (40%) and acinar cell carcinoma in 215 of 588 (37%). Parotid tumors were seen in 504 (86%) of patients. Surgery alone was used to treat 351 (60%) of patients; surgery plus adjuvant radiation was used to treat 145 (25%). Overall 5-year survival was 93%. Controlling for patient and tumor characteristics, treatment with surgery and radiation vs surgery alone was associated with improved overall survival (hazard ratio [HR] = 0.15; 95% confidence interval [CI], 0.02-0.92; P = .041). High tumor grade was associated with decreased overall survival (HR = 33.17; 95% CI, 5.89-186.8; P < .001). Treatment with surgery plus radiation remained associated with improved overall survival in the subset of patients with high tumor grade (HR = 0.12; 95% CI, 0.02-0.64; P = .014). Conclusion Tumor grade is an important predictor of survival in pediatric patients with salivary gland cancer. Surgery plus adjuvant radiation vs surgery alone is associated with improved overall survival and may be considered for high-risk patients, particularly those with high-grade tumors.
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Affiliation(s)
- Elliot Morse
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Rance J T Fujiwara
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Zain Husain
- 2 Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Benjamin Judson
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.,3 Yale Cancer Center, New Haven, Connecticut, USA
| | - Saral Mehra
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.,3 Yale Cancer Center, New Haven, Connecticut, USA
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Primary cervical ganglioneuroblastoma. Int J Pediatr Otorhinolaryngol 2015; 79:1007-12. [PMID: 25921075 DOI: 10.1016/j.ijporl.2015.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Ganglioneuroblastomas represent a histological subgroup of the rare neuroblastic tumours with intermediate malignant potential arising from neural crest progenitor cells of sympathetic nerves. Diagnosis can often be difficult based on imaging alone. We describe 4 cases of children presenting with a solitary neck mass with histology ultimately revealing ganglioneuroblastoma. METHODS A retrospective case note review was carried out of all patients with cervical ganglioneuroblastoma seen at Great Ormond Street Hospital, UK. RESULTS Mean age at presentation was 5 years. Based on imaging, the initial diagnoses for three of the cases were: lymphatic malformation, carotid body tumour, paraganglioma, respectively, whilst the remaining case had an immediate incisional biopsy revealing the correct diagnosis. All cases were managed by surgical excision with no evidence of recurrence after a median follow up of 6 years. CONCLUSION Otolaryngologists should be aware of ganglioneuroblastoma when establishing the differential diagnosis of a child presenting with a neck mass. Biopsy is recommended as the gold standard investigation to avoid an incorrect diagnosis.
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