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Quixabeira Oliveira GA, Pérez-DE-Oliveira ME, Robinson L, Khurram SA, Hunter K, Speight PM, Kowalski LP, Lopes Pinto CA, Sales De Sá R, Mendonça EF, Sousa-Neto SS, de Carlucci Junior D, Mariano FV, Altemani AMDAM, Martins MD, Zanella VG, Perez DEDC, Dos Santos JN, Romañach MJ, Abrahão AC, Andrade BABD, Pontes HAR, Jorge Junior J, Santos-Silva AR, Lopes MA, Van Heerden WFP, Vargas PA. Epithelial salivary gland tumors in pediatric patients: An international collaborative study. Int J Pediatr Otorhinolaryngol 2023; 168:111519. [PMID: 36965251 DOI: 10.1016/j.ijporl.2023.111519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 03/10/2023] [Accepted: 03/19/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVE Salivary gland tumors (SGT) are a diverse group of uncommon neoplasms that are rare in pediatric patients. This study aimed to characterize the clinicopathological profile of pediatric patients affected by SGT from a large case series derived from an international group of academic centers. STUDY DESIGN A retrospective analysis of pediatric patients with SGT (0-19 years old) diagnosed between 2000 and 2021 from Brazil, South Africa, and the United Kingdom was performed. SPSS Statistics for Windows was used for a quantitative analysis of the data, with a descriptive analysis of the clinicopathological characteristics and the association between clinical variables and diagnoses. RESULTS A total of 203 cases of epithelial SGT were included. Females were slightly more commonly (56.5%), with a mean age of 14.1 years. The palate was the most common site (43.5%), followed by the parotid gland (29%), lip (10%), and submandibular gland (7.5%). The predominant clinical presentation was a flesh-colored, smooth, and painless nodule. Pleomorphic adenoma (PA) was the most frequently diagnosed SGT (58.6%), followed by mucoepidermoid carcinoma (MEC) (26.6%). Surgery (90.8%) was the favored treatment option. CONCLUSIONS Benign SGT in pediatric patients are more commonly benign than malignant tumors. Clinicians should keep PA and MEC in mind when assessing nodular lesions of possible salivary gland origin in pediatric patients.
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Affiliation(s)
| | | | - Liam Robinson
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Syed Ali Khurram
- Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Keith Hunter
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Paul M Speight
- Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Head and Neck Surgery, University of São Paulo (USP) Medical School, São Paulo, Brazil
| | - Clóvis Antonio Lopes Pinto
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Raísa Sales De Sá
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Elismauro Francisco Mendonça
- Department of Stomatology (Oral Pathology), School of Dentistry, Federal University of Goiás (UFG), Goiânia, Brazil
| | | | | | - Fernanda Viviane Mariano
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Virgílio Gonzales Zanella
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Head and Neck Surgery Department, Santa Rita Hospital, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Danyel Elias da Cruz Perez
- Department of Oral Pathology, School of Dentistry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Jean Nunes Dos Santos
- Laboratory of Oral Surgical Pathology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará (UFPA), Belém, Brazil
| | - Jacks Jorge Junior
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Willie F P Van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil; Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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Intra-Cystic (In Situ) Mucoepidermoid Carcinoma: A Clinico-Pathological Study of 14 Cases. J Clin Med 2020; 9:jcm9041157. [PMID: 32325647 PMCID: PMC7231055 DOI: 10.3390/jcm9041157] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS To report on the clinico-pathological features of a series of 14 intra-oral mucoepidermoid carcinomas showing exclusive intra-cystic growth. Materials and methods All mucoepidermoid carcinomas diagnosed in the period 1990–2012 were retrieved; the original histological preparations were reviewed to confirm the diagnosis and from selected cases, showing exclusive intra-cystic neoplastic components, additional sections were cut at three subsequent 200 m intervals and stained with Hematoxylin–Eosin, PAS, Mucicarmine and Alcian Blue, to possibly identify tumor invasion of the adjacent tissues, which could have been overlooked in the original histological preparations. Additionally, pertinent findings collected from the clinical charts and follow-up data were analyzed. Results We identified 14 intraoral mucoepidermoid carcinomas
treated by conservative surgery and with a minimum follow up of five years. The neoplasms were located in the hard palate (nine cases), the soft palate (two), the cheek (two) and the retromolar
trigone (one). In all instances, histological examination revealed the presence of a single cystic space, containing clusters of columnar, intermediate, epidermoid, clear and mucous-producing cells, the latter exhibiting distinct intra-cytoplasmic mucin production, as confirmed by PAS, Mucicarmine and Alcian Blue stains. The cysts were entirely circumscribed by fibrous connective tissue, and no solid areas or infiltrating tumor cell clusters were detected. Conservative surgical resection was performed in all cases, and no recurrences or nodal metastases were observed during follow up. Conclusions Mucoepidermoid carcinomas showing prominent (>20%) intra-cystic proliferation currently are considered low-grade tumors. In addition, we also unveil the possibility that mucoepidermoid
carcinomas, at least in their early growth phase, may display an exclusive intra-cystic component and might be considered as in situ carcinomas, unable to infiltrate adjacent tissues and metastasize.
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Venkatakarthikeyan C, Nair S, Gowrishankar M, Rao S. Robotic Surgery in Head and Neck in Pediatric Population: Our Experience. Indian J Otolaryngol Head Neck Surg 2020; 72:98-103. [PMID: 32158664 DOI: 10.1007/s12070-019-01768-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022] Open
Abstract
Robot assisted surgery of the head and neck is a relatively novel approach in the management of head and neck tumors. There are very few reported cases of robot-assisted surgery of the head and neck in pediatric population in the world literature and no report of such procedures in the Indian subcontinent. In this article we present three such cases we performed for the first time in the country. The first case is that of second branchial cleft cyst, the second is a 4-year-old boy with a tongue base cyst and the third patient is a 12-year-old girl with left parotid gland tumor. All the patients underwent successful Robotic surgeries. Case 1 underwent robotic excision of the cyst through a retroauricular hairline incision. Case 2 underwent transoral robotic excision of the tongue base cyst. Case 3 underwent robotic excision of the tumor through a modified facelift incision. The mean docking time for the robot was 12.33 min and approximate blood loss was less than 10 ml in all cases. The patient and their parents were extremely satisfied with the cosmetic outcomes of the scarless surgery. Robot assisted surgery has the advantage of performing minimally invasive procedures within constrained spaces especially in children. The multiarticulated endowrist movements of the robotic arms combined with higher magnification and three-dimensional depth perception allows a precise surgery with better visualization in otherwise inaccessible areas resulting in better surgical outcome. With exceptional advantages of scarless surgery, minimal blood loss and postoperative pain and better surgeon ergonomics, robotic technique is an effective and feasible option in Pediatric Head and neck Surgery.
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Affiliation(s)
- C Venkatakarthikeyan
- Department of Otorhinolaryngology and Head and Neck Surgery, Apollo Main Hospital, Room No. 25B Sindoori Block, Ground Floor, 21 Greams Lane, Off Greams Road, Chennai, 600006 India
| | - Swati Nair
- Department of Otorhinolaryngology and Head and Neck Surgery, Apollo Main Hospital, C-304 Pawitra Apartments, Vasundhara Enclave, Delhi, 110096 India
| | - M Gowrishankar
- Department of Otorhinolaryngology and Head and Neck Surgery, Apollo Main Hospital, Room No. 25B Sindoori Block, Ground Floor, 21 Greams Lane, Off Greams Road, Chennai, 600006 India
| | - Soorya Rao
- Department of Otorhinolaryngology and Head and Neck Surgery, Apollo Main Hospital, C-304 Pawitra Apartments, Vasundhara Enclave, Delhi, 110096 India.,Department of Otorhinolaryngology and Head and Neck Surgery, Apollo Main Hospital, S2, Gopalakrishna Flats, No. 14/21, Lake View Road, West Mambalam, Chennai, 600033 India
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Thielker J, Grosheva M, Ihrler S, Wittig A, Guntinas-Lichius O. Contemporary Management of Benign and Malignant Parotid Tumors. Front Surg 2018; 5:39. [PMID: 29868604 PMCID: PMC5958460 DOI: 10.3389/fsurg.2018.00039] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/30/2018] [Indexed: 12/25/2022] Open
Abstract
To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors. Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors. Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes. The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.
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Affiliation(s)
- Jovanna Thielker
- Department of Otorhinolaryngology, Universitätsklinikum Jena, Jena, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Stephan Ihrler
- Laboratory for Dermatohistology and Oral Pathology, Munich, Germany
| | - Andrea Wittig
- Department of Radiotherapy and Radiation Oncology, Universitätsklinikum Jena, Jena, Germany
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