Multiple parotid gland primary neoplasms after radiation therapy

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.

Unusual case of myoepithelioma associated with adenoid cystic carcinoma of the parotid gland

Tumors of the salivary glands comprise less than 3% of all neoplasms of the head and neck, with synchronous parotid tumors of differing histologic types being extremely rare. We present a 71-year-old woman with a myoepithelioma associated with an adenoid cystic carcinoma of the left parotid gland. The 48 previously reported cases of synchronous occurring parotid gland tumors of differing histologic types are reviewed.

Primary malignancy of the salivary gland in children

Seventeen pediatric patients with a major salivary gland malignancy (16 parotid, 1 submaxillary) were reviewed. Eight patients presented with carcinoma. The usual presentation was a mass over the affected gland. Six patients had localized disease, which was treated by excision. This was accomplished by either a total or subtotal parotidectomy or resection of the submaxillary gland. Two patients received adjuvant radiation therapy. All six patients with localized carcinoma are alive, without evidence of disease. Two patients presented with metastatic disease and died of the disease despite treatment with multiagent chemotherapy, and in one case, radiation therapy. Nine patients had rhabdomyosarcoma (RMS). The usual presentation was a mass at the angle of the mandible. Five patients had involvement of one or more cranial nerves, and two had concomitant cervical adenopathy. Eight patients had a biopsy and then were treated according to an existing prospective institutional protocol. The ninth patient initially underwent a superficial parotidectomy. Seven patients received radiation therapy. In one patient, rapid progression of the disease precluded this treatment. Seven patients died of progressive local and distant disease 2 months to 2 years (median, 6 months) from the time of diagnosis. Two patients are alive, without evidence of disease, 3 and 7 years after presentation. We conclude that carcinoma should be managed with complete excision. For RMS of the salivary gland, a biopsy should be performed, and treatment should consist of chemotherapy and radiation therapy.

Multiple synchronous bilateral Warthin's tumors of the parotid glands with pleomorphic adenoma. Case report and review of the literature

A case of multiple bilateral synchronous Warthin's tumors of the parotid glands with a simultaneous pleomorphic salivary adenoma in one patient is presented. This case appears to be unique. Only three previous cases of multiple synchronous bilateral Warthin's tumors have been reported. The occurrence of salivary tumors of different histologic types in the same patient is also rare. Twenty cases of Warthin's tumor that occurred with pleomorphic salivary adenoma were found in our review of the literature. However, none of these represented synchronous bilateral multiple Warthin's tumors.

Synchronous tumors arising in a single major salivary gland

Multiple separate tumors arising in the major salivary glands are distinctly unusual. The records on 25 patients with synchronous unilateral salivary gland tumors on file at St Louis University and at the Armed literature. Bilateral tumors arose more frequently than multiple unilateral ones. The most common tumors with bilateral synchronous or metachronous development are the Warthin tumors, with more than 100 reported cases; the mixed tumor with at least 34 cases; and the acinic cell carcinoma, with 12 reported cases. The Warthin tumor also was the most likely to present with multifocal unilateral involvement with 29 tumors having three or more separate foci of tumor. The next most common tumor combinations are a Warthin tumor and a mixed tumor (20 cases), the multifocal membranous basal cell adenoma (12 cases), and multiple oncocytomas (nine cases). Numerous other tumor combinations were found covering the range of salivary gland neoplasia, however one of the tumors usually was a mixed tumor or a Warthin tumor.