Distant metastasis of parotid gland tumors

Abstract

The incidence of distant metastasis in head and neck cancer and especially in salivary gland cancer is relatively low in comparison to other malignancies. However, the presence of distant metastasis heralds a poor prognosis in head and neck cancer, with a median survival of 4.3-7.3 months. Treatment of these patients is usually performed in a palliative setting. Patients with malignant salivary gland tumors should have an X-ray or CT scan of the chest at their initial assessment to exclude the possibility of distant metastasis. The likelihood of developing distant metastasis is associated with high-grade tumors, such as adenoid cystic carcinoma, salivary duct carcinoma, high-grade mucoepidermoid carcinoma and tumors located in the submandibular gland, posterior tongue and pharyngeal tumors. A lower risk of developing distant metastasis is known for all other histological entities of salivary gland tumors. Nevertheless all patients who have a histologically confirmed malignant salivary gland tumor should have lifelong follow-up. On the basis of a clinical case regarding a patient with metastatic parotid gland cancer we present a review of the literature.

Tumours of Deep Lobe of Parotid Gland: Our Experience

“…To perform this manoeuver, the buccal branch may be found just superior to a b Fig. 3 a, b Intra-operative photos of facial nerve branching with deep lobe of parotid gland Frey's syndrome 3 the parotid duct, or the marginal mandibular branch may be found superficial to the facial vessels [4,12]. These may then be traced back to the origin of the main facial nerve trunks.…”

“…These may then be traced back to the origin of the main facial nerve trunks. If the tumour is high grade or >4 cm in greatest diameter, or lymph node metastasis is identified within the specimen, a complete total parotidectomy should be performed [12,13]. If the facial nerve or its branches are adherent to or directly involved by the tumour, and FNAC shows malignancy, they must be sacrificed.…”

“…The major determinants of survival are histology and clinical stage. Poor prognostic factors include high grade of mitosis, neural involvement, locally advanced disease, advanced age, regional lymph node metastases and distant metastasis [5,12,13]. Overall, 5-year survival for all stages and histologic types is approximately 62 % [13].…”

Fine‐needle aspiration of dedifferentiated acinic cell carcinoma: Report of a case with cyto‐histological correlation

“…Myoepithelial and mesenchymal markers are focally positive in carcinoma ex pleomorphic adenoma, whereas androgen receptor and Her2 markers can be positive in salivary duct carcinomas (Table I). [24][25][26] On gross examination of the resected salivary gland specimen, the undifferentiated component of a DAcCC is not well demarcated, therefore requiring thorough sampling. The key histological components for diagnosis are a well differentiated acinic cell carcinoma intimately associated with an undifferentiated component.…”

A Case Study Highlighting the Need for Surgical Excision of Parotid Masses

“…1 Of note, some authors believe that salivary duct carcinomas-which have a metastasis rate of 52-82%-are actually carcinoma ex-pleomorphic adenomas that arise from the most common benign salivary gland tumor. 7 Additionally, the risk for malignant transformation to carcinoma ex-pleomorphic adenoma is 1.5% within the first year of diagnosis and 10% after observation for more than 15 years. 8 Thus, observation of these lesions, as well as other benign lesions, is not recommended in patients stable enough for surgery.…”