Efficacy of digital zoning design for the resection of benign parotid gland tumor

The objective of this study is to verify the role of digital modified parotid tumor zoning method in modified parotid incision. The data of patients with parotid benign tumors from November 2021 to December 2023 were collected. Through the use of digital technology for soft tissue reconstruction, the parotid tumor was divided into four areas according to the digital image marker points. We designed the surgical incision according to the parotid gland division, found that it was feasible to guide the incision selection by division, and summarized the common incision and division corresponding, zone I was I and V-shaped incision, zone II was V incision, zone III was V and C- shaped incision, and zone IV was C- shaped incision. We conclude that the digital modified parotid gland zoning method can provide a better distinction in the surgical incision, and provide a better cosmetic incision and prognosis.

Factors influencing Frey syndrome after parotidectomy with acellular dermal matrix

BACKGROUND

Frey syndrome, also known as ototemporal nerve syndrome or gustatory sweating syndrome, is one of the most common complications of parotid gland surgery. This condition is characterized by abnormal sensations in the facial skin accompanied by episodes of flushing and sweating triggered by cognitive processes, visual stimuli, or eating.

AIM

To investigate the preventive effect of acellular dermal matrix (ADM) on Frey syndrome after parotid tumor resection and analyzed the effects of Frey syndrome across various surgical methods and other factors involved in parotid tumor resection.

METHODS

Retrospective data from 82 patients were analyzed to assess the correlation between sex, age, resection sample size, operation time, operation mode, ADM usage, and occurrence of postoperative Frey syndrome.

RESULTS

Among the 82 patients, the incidence of Frey syndrome was 56.1%. There were no significant differences in sex, age, or operation time between the two groups (P > 0.05). However, there was a significant difference between ADM implantation and occurrence of Frey syndrome (P < 0.05). ADM application could reduce the variation in the incidence of Frey syndrome across different operation modes.

CONCLUSION

ADM can effectively prevent Frey syndrome and delay its onset.

Metastasizing Pleomorphic Adenoma of Parotid Gland: A Case Report and Literature Review

The authors hereby present a case report of metastasizing pleomorphic adenoma (MPA) of the parotid gland with multiple metachronous cervical lymph node metastases and sternocleidomastoid muscle infiltration. Diagnostic evaluation, surgical management, and follow-up are discussed along with a brief review of the literature.

Characterization of parotid gland tumors: Whole-tumor histogram analysis of diffusion weighted imaging, diffusion kurtosis imaging, and intravoxel incoherent motion - A pilot study

PURPOSE

To investigate the diagnostic performance of histogram features of diffusion parameters in characterizating parotid gland tumors.

METHOD

From December 2018 to January 2023, patients who underwent diffusion weighted imaging (DWI), diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) were consecutively enrolled in this retrospective study. The histogram features of diffusion parameters, including apparent diffusion coefficient (ADC), diffusion coefficient (Dk), diffusion kurtosis (K), pure diffusion coefficient (D), pseudo-diffusion coefficient (DP), and perfusion fraction (FP) were analyzed. The Mann-Whitney U test was used for comparison between benign parotid gland tumors (BPGTs) and malignant parotid gland tumors (MPGTs). Receiver operating characteristic curve and logistic regression analysis were used to identify the differential diagnostic performance. The Spearman's correlation coefficient was used to analyze the correlation between diffusion parameters and Ki-67 labeling index.

RESULTS

For diffusion MRI, twenty-three histogram features of diffusion parameters showed significant differences between BPGTs and MPGTs (all P < 0.05). Compared with the DWI model, the IVIM model and combined model had better diagnostic specificity (58 %, 94 %, and 88 %, respectively; both corrected P < 0.001) and accuracy (64 %, 89 %, and 86 %, respectively; both corrected P = 0.006). The combined model was superior to the single DWI model with improved IDI (IDI improvement 0.25). Significant correlations were found between Ki-67 and ADCmean, Dkmean, Kmean, and Dmean (r = -0.57 to 0.53; all P < 0.05).

CONCLUSIONS

Whole-tumor histogram analysis of IVIM and combined diffusion model could further improve the diagnostic performance for differentiating BPGTs from MPGTs.

Deep Network-Based Comprehensive Parotid Gland Tumor Detection

RATIONALE AND OBJECTIVES

Salivary gland tumors constitute 2%-6% of all head and neck tumors and are most common in the parotid gland. Magnetic resonance (MR) imaging is the most sensitive imaging modality for diagnosis. Tumor type, localization, and relationship with surrounding structures are important factors for treatment. Therefore, parotid gland tumor segmentation is important. Specialists widely use manual segmentation in diagnosis and treatment. However, considering the development of artificial intelligence-based models today, it is seen that artificial intelligence-based automatic segmentation models can be used instead of manual segmentation, which is a time-consuming technique. Therefore, we segmented parotid gland tumor (PGT) using deep learning-based architectures in the paper.

MATERIALS AND METHODS

The dataset used in the study includes 102 T1-w, 102 contrast-enhanced T1-w (T1C-w), and 102 T2-w MR images. After cropping the raw and manually segmented images by experts, we obtained the masks of these images. After standardizing the image sizes, we split these images into approximately 80% training set and 20% test set. Hereabouts, we trained six models for these images using ResNet18 and Xception-based DeepLab v3+. We prepared a user-friendly Graphical User Interface application that includes each of these models.

RESULTS

From the results, the accuracy and weighted Intersection over Union values of the ResNet18-based DeepLab v3+ architecture trained for T1C-w, which is the most successful model in the study, are equal to 0.96153 and 0.92601, respectively. Regarding the results and the literature, it can be seen that the proposed system is competitive in terms of both using MR images and training the models independently for T1-w, T1C-w, and T2-w. Expressing that PGT is usually segmented manually in the literature, we predict that our study can contribute significantly to the literature.

CONCLUSION

In this study, we prepared and presented a software application that can be easily used by users for automatic PGT segmentation. In addition to predicting the reduction of costs and workload through the study, we developed models with meaningful performance metrics according to the literature.

Classification of benign and malignant parotid tumors based on CT images combined with stack generalization model

Parotid tumors are among the most prevalent tumors in otolaryngology, and malignant parotid tumors are one of the main causes of facial paralysis in patients. Currently, the main diagnostic modality for parotid tumors is computed tomography, which relies mainly on the subjective judgment of clinicians and leads to practical problems such as high workloads. Therefore, to assist physicians in solving the preoperative classification problem, a stacked generalization model is proposed for the automated classification of parotid tumor images. A ResNet50 pretrained model is used for feature extraction. The first layer of the adopted stacked generalization model consists of multiple weak learners, and the results of the weak learners are integrated as input data in a meta-classifier in the second layer. The output results of the meta-classifier are the final classification results. The classification accuracy of the stacked generalization model reaches 91%. Comparing the classification results under different classifiers, the stacked generalization model used in this study can identify benign and malignant tumors in the parotid gland effectively, thus relieving physicians of tedious work pressure.

Differential diagnosis of parotid gland tumors using apparent diffusion coefficient, texture features, and their combination

OBJECTIVES

Warthin's tumors (WT) and pleomorphic adenomas (PA) are the commonest parotid gland tumors; however, their differentiation remains difficult. This study aimed to investigate the utility of the apparent diffusion coefficient (ADC) value, texture features, and their combination for the differential diagnosis of parotid gland tumors.

METHODS

Patients who underwent magnetic resonance imaging (MRI) between April 2008 and March 2021 for parotid gland tumors were included and divided into two groups according to the tumor type: WT and PA. The tumor types were used as predictor variables, while the ADC value, texture features, and their combination were the outcome variables. Texture features were measured on short tau inversion recovery (STIR) images and selected using the Fisher's coefficient method and probability of error, and average correlation coefficients. The Mann-Whitney U-test was used to analyze bivariate statistics. Receiver operating characteristic curve analysis was used to assess the ability of the ADC value, texture features, and their combination to distinguishing between the two tumor types.

RESULTS

A total of 22 patients were included, 11 in each group. The ADC value, 10 texture features, and their combination were significantly different between the two groups (p < .001). Moreover, all three variables had high area under the curve values of 0.93-0.96.

CONCLUSION

The ADC value, texture features, and their combination demonstrated good diagnostic ability to distinguish between WTs and PAs. This method may be used to aid the differential diagnosis of parotid gland tumors, thereby promoting timely and adequate treatment.

A rare case of canalicular adenoma in the parotid gland: Highlighting diagnostic limitations of fine-needle aspiration

BACKGROUND

Canalicular adenoma is a rare, benign tumor of primarily salivary gland origin that presents mostly in the upper lip. However, there are only six reports in the English literature detailing canalicular adenoma of the parotid gland, none of which discuss discrepancy between preoperative cytology and surgical pathology. In this report, we present a rare case of parotid gland canalicular adenoma where preoperative ultrasound-guided fine-needle aspiration (USFNA) suggested malignancy. The patient was treated with deep lobe parotidectomy due to the FNA results and her multiple comorbidities. However, her tumor may have been treated with observation alone if canalicular adenoma had been suspected prior to surgery.

MAIN FINDINGS

A 59-year-old female with a history of heart and lung disease presented with a 1.6 cm well defined, enhancing lesion involving the superficial portion of the right parotid gland. This lesion was incidentally noted on CT angiography (CTA) of the neck and chest. The well-defined characteristics of this lesion on CT imaging suggested benign neoplasm. However, USFNA results were suggestive of a malignant parotid lesion. The patient subsequently underwent right deep lobe parotidectomy with facial nerve dissection and superficial musculoaponeurotic system (SMAS) rotational flap reconstruction. Surgical pathology and immunohistochemistry yielded a final diagnosis of benign canalicular adenoma.

CONCLUSIONS

USFNA diagnosis of CA is extremely difficult due to its low-grade neoplastic cells mimicking neoplastic cells in other benign and malignant tumors of the head and neck. FNA remains a useful tool for assessing malignancy risk, but the results always have some level of uncertainty and do not provide sufficient detail. Therefore, FNA results should be interpreted in concert with imaging and patients' medical history. Cytopathologists can also report salivary gland FNA results in a more uniform and detailed manner by utilizing the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC).

Value of pre-/post-contrast-enhanced T1 mapping and readout segmentation of long variable echo-train diffusion-weighted imaging in differentiating parotid gland tumors

PURPOSE

This study aimed to explore the value of pre-/post-contrast-enhanced T1 mapping and readout segmentation of long variable echo-train diffusion-weighted imaging (RESOLVE-DWI) for the differential diagnosis of parotid gland tumors.

METHODS

A total of 128 patients with histopathologically confirmed parotid gland tumors [86 benign tumors (BTs) and 42 malignant tumors (MTs)] were retrospectively recruited. BTs were further divided into pleomorphic adenomas (PAs, n = 57) and Warthin's tumors (WTs, n = 15). MRI examinations were performed before and after contrast injection to measure the longitudinal relaxation time (T1) value (T1p and T1e, respectively) and the apparent diffusion coefficient (ADC) value of the parotid gland tumors. The reduction in T1 (T1d) values and the percentage of T1 reduction (T1d%) were calculated.

RESULTS

The T1d and ADC values of the BTs were considerably higher than those of the MTs (all P <.05). The area under the curve (AUC) of the T1d and ADC values for differentiating between BTs and MTs of the parotid was 0.618 and 0.804, respectively (all P <.05). The AUC of the T1p, T1d, T1d%, and ADC values for differentiating between PAs and WTs was 0.926, 0.945, 0.925, and 0.996, respectively (all P >.05). The ADC and T1d% + ADC values performed better in differentiating between PAs and MTs than the T1p, T1d, and T1d% (AUC values: 0.902, 0.909, 0.660, 0.726, and 0.736, respectively). The T1p, T1d, T1d%, and T1d% + T1p values all had high diagnosis efficacy in differentiating WTs from MTs (AUC values: 0.865, 0.890, 0.852, and 0.897, respectively, all P >.05).

CONCLUSION

T1 mapping and RESOLVE-DWI can be used to differentiate parotid gland tumors quantitatively and can be complementary to each other.

Malignant trichilemmal carcinoma misdiagnosed with parotid gland malignant tumor

Malignat proliferating trichilemmal tumor (MPTT) are rare tumors usually presenting in photo-exposed areas, especially on the face, scalp, neck,and dorsal part of the hand. Differential diagnosis include squamous cell carcinoma, basal-cell carcinoma, keratoacanthoma and malignant nodular melanoma, so that only incisional biopsy can lead to pre-operative diagnosis. We present case MPTT misdiagnosed with parotid gland malignant tumor that underwent radical surgical excision and adijuvant radiotherapy.

Diffusion-weighted and gadolinium-enhanced dynamic MRI in parotid gland tumors

PURPOSE

To evaluate the value of diffusion-weighted imaging and dynamic contrast-enhanced MRI for the diagnosis of parotid gland tumors.

METHODS

Retrospective review of patients with surgically treated parotid tumors between January 2009 and June 2020, who underwent a preoperative parotid gland MRI including standard morphological sequences, diffusion-weighted echoplanar imaging with apparent diffusion coefficient measurement and T1-weighted gadolinium-enhanced dynamic MRI sequences with Fat Saturation. The lesion was classified between malignant vs benign and precisions regarding its histological type were given when possible. Imaging findings were compared with pathology results.

RESULTS

Inclusion of 133 patients (mean age: 53 years). Multiparametric MRI had a sensitivity of 90.3%, a specificity of 77.5%, an overall accuracy of 80.5%, a positive predictive value of 54.9% and a negative predictive value of 96.3% to differentiate benign parotid tumor from malignant ones. Specificity (85.5%) and positive predictive value (67.6%) were improved for cases, where anatomical and functional MRI characteristics were conclusive and consistent with clinical findings.

CONCLUSIONS

Combining diffusion-weighted and gadolinium-enhanced dynamic sequences, in addition to morphological ones enables high (> 90%) sensitivity to detect malignant parotid gland tumors. It also gives the possibility to characterize pleomorphic adenomas and Warthin tumors and to avoid fine-needle aspiration in cases of typical imaging presentation and reassuring clinical findings.

Multicentric Intra/Extracranial Cystic Facial Nerve Schwannoma: Case Report and Review of Literature

To report a case of facial nerve schwannoma which presented a diagnostic and management challenge because of unusual multicentric cystic presentation. A 25-year-old female patient with a history of deep facial pain, parotid gland swelling and normal facial function showed multiple expansive cystic lesions of the temporal bone and parotid gland which turned out to be multicentric cystic facial nerve schwannomas. One should be keep this diagnosis in mind when dealing with a cystic lesions of the temporal bone and parotid gland.

Comparison of different methods for evaluating the relationship between facial nerve and benign parotid tumors

Objectives

The goals of benign parotid gland tumor resection are complete resection of the lesion and preservation of the facial nerve function. As the facial nerve cannot be directly visualized via imaging modalities, several methods, including the facial nerve line, Utrecht line, retromandibular vein, Stenon duct, and minimum fascia-tumor distance techniques, have been developed to estimate its location. However, there are no reports on their accuracy in determining tumor location. In the present study, we aimed to assess the diagnostic accuracy of these methods based on tumor location.

Methods

This retrospective study analyzed medical records and histological reports of 359 patients with various types of benign parotid gland tumors who underwent a parotidectomy between April 2014 and March 2020. The tumor location was subdivided into the following sections: anterior, superior, inferior, and middle. The tumor location was estimated using five methods: facial nerve line, Utrecht line, retromandibular vein, Stenon duct, and minimum fascia-tumor distance. The final diagnosis of superficial or deep lobe tumor was made based on surgical findings.

Results

Each method showed a higher accuracy for superficial tumors (was more than 90%) than for deep lobe tumors. In contrast, for deep lobe tumors, the accuracy of diagnosis with the facial nerve line, Utrecht line, and retromandibular vein methods was low, in the 30% range. Among all methods, the Stenon duct method had the highest accuracy in the diagnosis of deep lobe tumors. The SD method was most useful in cases where both the duct and tumors were detected. The minimum fascia-tumor distance method had the second highest diagnostic accuracy (63%); however, for anterior tumors, it tended to provide false negatives.

Conclusions

All tested methods were useful in diagnosing superficial lobe tumors; however, they were not helpful in diagnosing deep lobe tumors, especially anterior tumors.

Efficacy of modified face lift incision for the resection of benign parotid gland tumor located anteriorly or superiorly

OBJECTIVES

The goals of resection of benign parotid gland tumor are complete resection of lesion and preservation of the facial nerve function. Traditionally, the bayonet-shaped incision (Blair incision: BI) and the modified face lift incision (mFLI) are commonly used for parotidectomy. However, concerns exist about the adequacy of exposure and identification of the facial nerve in anterior or superior parotid lesions. The aim of this study was to compare the surgical outcomes between BI and mFLI and to evaluate the adequacy, possible indications, and limitations of mFLI for the resection of benign parotid gland tumors located anteriorly or superiorly.

METHODS

This retrospective study analyzed the medical records of 175 patients with various types of benign parotid tumor who underwent partial parotidectomy via BI (97 patients) or mFLI (78 patients). Tumors were divided into five categories depending on their location: anterior, superior, inferior, middle, and deep lobe tumors. The outcomes of operation were analyzed according to tumor location between the incision types.

RESULTS

Tumor locations were not significantly different between the two groups. Transient facial palsy occurred in 23 out of 152 patients (15.1%); permanent palsy was not observed in either group. The incidence rates of facial palsy were higher among patients with superior and deep lobe tumors; in the mFLI and BI groups, proportions of superior tumors were 22.2% and 27.2%, respectively, and those of deep lobe tumors were 35.7% and 23.5%, respectively. With regard to superior and anterior tumors, the incidence rate of postoperative facial palsy was insignificantly lower in the mFLI group (10.5%) than in the BI group (18.2%).

CONCLUSIONS

There were no differences in the incidence rates of postoperative facial palsy between mFLI and BI for any tumor location. Use of the mFLI is feasible for the resection of most benign parotid tumors located anteriorly or superiorly.

Change in Warthin's tumor incidence: a 20-year joinpoint trend analysis

PURPOSE

The incidence of Warthin's tumor (WT) has increased worldwide. In this study, we aimed to evaluate the incidence of WT in our hospital, which provides health care for an extremely large population.

METHODS

We retrospectively evaluated 573 patients, comprising 345 males and 228 females, who all experienced parotid tumor for the past 20 years. Patients with WT that were operated in the last 20 years were evaluated according to the number of patients per year to determine the annual WT increase trend.

RESULTS

In the distribution of WT over the years of surgery, the ratio of WT to all tumors irregularly changed. Furthermore, the total number of parotidectomies per year increased in time. We investigated whether WT had any increasing trend over the years. The annual percentage change (APC) of WT was calculated, and according to the segmented regression analysis, the APC was insignificant (APC = 4.3, 95% CI = - 3.6-12.9, P = 0.300).

CONCLUSION

The incidence of WT has increased across the world. However, in our study, no significant APC was observed according to the segmented regression analysis.

A Cribriform Cancer Metastatic to Liver: Case Report and Literature Review

Metastasis from salivary gland tumors to liver is exceedingly uncommon. Reported is the first case of a mammary analog secretory carcinoma (MASC) of salivary gland origin metastasized to the liver, even after complete surgical resection. A 76 year old female, with past history of a completely extirpated right parotid gland MASC, presented 2 years after right superficial parotidectomy and right neck dissection, with back and flank pain. Subsequent abdominal and pelvic CT revealed multiple small hepatic lesions. Biopsy of the largest hepatic lesion confirmed metastatic MASC of primary parotid gland origin. Both the parotid primary and the hepatic metastases had the confirmatory ETV6 rearrangement by fluorescence in situ hybridization. Although high-grade malignancy and distant metastases of MASC of salivary gland origin to liver is rare, recognizing metastatic MASC potentially alters prognosis and determines therapeutic options.

The differential diagnosis of parotid gland tumors with high-resolution ultrasound in otolaryngological practice

The aim of the study is to define the utility of ultrasound (US) in differentiating benign from malignant parotid tumors as well as pleomorphic adenomas (PA) from monomorphic adenoma (MA). Seventy-two consecutive parotid gland tumors were analysed with high-resolution ultrasonography (12 MHz) with color Doppler imagining. The histopathological diagnosis was confirmed after parotidectomy for each lesion. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for the US were established. Receiver operating characteristic curves were constructed to determine the predictive values of echogenicity, heterogeneity, and vascularity on color Doppler. Area under the curve (AUC) was calculated for each parameter considered. The analysed material included 27 MA, 26 PA, 1 basal cell adenoma, 8 inflammatory conditions, and 10 malignant neoplasms. The sensitivity, specificity, and accuracy of US in differentiation of malignant from benign lesions in the parotid gland were 60, 95.2, and 90.3%, respectively. The predictive values were: PPV 66.8% and NPV 93.6%. Differentiating diagnoses between PA and MA with US resulted in a sensitivity of 61.5%, specificity of 81.5%, and accuracy of 73.1%. The predictive values were: PPV 50% and NPV 68.8%, respectively. For distinguishing malignant from benign tumors, the highest AUC values noted were for heterogeneity and vascularization (0.8 and 0.743, respectively). The AUC values were the highest for hypoechogenicity and vascularization in separating PA from MA (0.718 and 0.685, respectively).

Diagnostic value of metabolic heterogeneity as a reliable parameter for differentiating malignant parotid gland tumors

OBJECTIVE

Exact classifying between malignant and benign tumors in the parotid gland is important because the cancer has relatively poor prognosis. There have been several studies that F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) can differentiate between malignant and benign parotid gland tumors. However, the role of FDG PET is still controversial because many benign parotid gland tumors, such as Warthin's tumor and pleomorphic adenoma, show high FDG uptake. We hypothesized that metabolic heterogeneity would differentiate malignant parotid tumors because tumoral heterogeneity is an important characteristic in the malignancies.

METHODS

From January 2010 to April 2015, we retrospectively reviewed the 46 patients who showed FDG uptake at the parotid gland. To differentiate malignant parotid gland tumors, we obtained maximum SUV and mean SUV. Metabolic tumor volume and total lesion glycolysis were measured as metabolic volumetric parameters. We also included heterogeneity parameters of FDG PET such as heterogeneity factor (HF) and the coefficient of variation for all patients.

RESULTS

There was significant difference of HF between malignant (-0.30 ± 0.25; range -0.937 to -0.084) and benign parotid gland tumors (-0.06 ± 0.05; range -0.291 to -0.012; p < 0.0001). In receiver operating characteristic analysis, when ≤-0.084 was used as the cut-off value for HF, the sensitivity and specificity were 100 % (95 % CI 81.5-100) and 89.2 % (95 % CI 71.8-97.7), respectively. HF showed the highest area under the curve of 0.947 among the parameters. In logistic regression analysis, the HF was the most powerful factor for differentiation of the parotid gland tumors (p = 0.002).

CONCLUSIONS

Our results suggest that HF can be utilized as a reliable and non-invasive method for differentiation of malignant and benign parotid gland tumors.

Effectiveness of platysma muscle flap in preventing Frey syndrome and depressive deformities after parotidectomy

BACKGROUND

Frey syndrome (FS) or depressive deformity (DD) occurring after parotidectomy significantly reduces a patient's quality of life. However, there seems to be no effective treatment strategy against these complications. In this study, we report our experience of using platysma muscle flap (PMF) to prevent the development of FS and DD after parotidectomy, and evaluate its effect subjectively and objectively.

METHODS

Superficial parotidectomy was performed for eight cases of parotid gland tumor, and a PMF was transferred to cover the site. The incidence of FS and DD were evaluated subjectively, using a questionnaire to the patients and board-certified reconstructive surgeons, and objectively, using Minor's starch-iodine test.

RESULTS

In seven patients, the defect could be completely covered with PMF, and none of them developed FS or obvious DD. However, in one patient, the defect could be only partially covered, and the patient developed complications in the exact site that the flap did not cover. Overall scores from the questionnaire were high in relation to both cosmetic and functional perspectives from most of the patients and all the surgeons. No patients had major postoperative complications requiring revision.

CONCLUSIONS

PMF can be useful to cover the defect and prevent complications after parotidectomy. PMF is relatively easy to perform with fewer complications; however, a complete coverage of the defect should be ensured to obtain optimal results.

Different histological subtypes of parotid gland tumors: CT findings and diagnostic strategy

AIM: To present computed tomography (CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.

METHODS: From January 2009 to November 2011, 56 patients were collected through the histopathology and Picture Archiving and Communication Systems records, which revealed 5 basal cell adenoma (BCA), 16 pleomorphic adenoma (PA), 25 Warthin’s tumor (War-T), 3 Kimura’s disease (KD) and 7 parotid carcinoma (PCa) cases. All the CT images were retrospectively analyzed by two radiologists in consensus, based on their description of morphology (location, number, size, margin and fibrous capsule) and enhancement patterns of masses. In addition, the diagnostic efficiency of diagnostic strategy is tested.

RESULTS: War-T and BCA patients’ mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years; the significant difference was seen in War-T vs PA and BCA vs PA. About 40% of War-Ts presented with bilateral multifocal lesions, a higher ratio than others. Seventy two percent of War-Ts were limited to the superficial lobe, followed by BCA 60% and PA 40%. Vessel facing sign and enlarged lymph nodes were both frequent in War-T, which respectively accounts for 84% and 76% of cases. Rapid contrast enhancement and decreases were unique for War-T. BCA and PA showed obvious delayed enhancement. The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency, with high accuracy, sensitivity and specificity.

CONCLUSION: Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data. A diagnostic strategy with high diagnostic efficiency was established.

Surgical excision of sialoblastoma in the parotid gland in newborn

OBJECTIVES

To evaluate outcome of surgical excision of sialoblastoma in the parotid gland in newborn.

PATIENTS AND METHODS

This was a retrospective review of 3 pediatric patients with sialoblastoma in the parotid gland that underwent surgical resections. All patients are newborn boys. The lesions ranged from 5 cm × 5 cm to 8 cm × 5 cm in size. The tumor was resected en bloc, and the facial nerve was preserved.

RESULTS

None surgical complications occurred. The mean follow-up was 34 months; none patients had recurrent lesions.

CONCLUSION

Surgical dissection of sialoblastoma in the parotid gland in the newborn is most efficient and safe.