Evaluation of benign tumors of large salivary glands according to the new classification of the European Salivary Gland Society

Olejniczak, Izabela; Leduchowska, Agata; Kozłowski, Zbigniew; Pietruszewska, Wioletta

doi:10.5604/01.3001.0014.7889

Cited by 2 publications

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“…The distinctiveness of the APG is reflected in the classification established by the Third Meeting of the European Salivary Gland Society (ESGS). The ESGS proposes to subdivide the parotid parenchyma into five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), and V (accessory) [4]; this proposal has been followed by others [5].…”

Section: Introductionmentioning

confidence: 99%

Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland—Observations Based on 2192 Cases of the Polish Salivary Network Database

Wierzbicka,

Bartkowiak,

Pietruszewska

et al. 2024

Cancers

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The accessory parotid gland (APG, Vth level) differs in histological structure from main parotid tissue. This gives rise to the hypothesis, mirrored in clinical observations, that the representation of tumours is different than in the rest of the gland. The aim of the study was to analyse the epidemiological and histological differences of parotid tumours located in regions I–V, with particular emphasis on the distinctiveness of region V. To define the epidemiological factors that will indicate the risk of histological malignancy from clinically benign appearance, multicentre prospective studies conducted between 2017–2021 by five Head and Neck Surgery University Departments, cooperating within the Polish Salivary Network Database 1929 patients (1048 women and 881 men), were included. The age, gender, patient occupation, place of inhabitation, tumour size, clinical features of malignancy, histology, and facial nerve (FN) paresis were analysed for superficial (I_II) and deep (III_IV) lobes and with special regard to the tumours affecting region V. Twenty eight tumours were located exclusively in region V (1.45% total) and seventy-two tumours were found in region V exhibiting extensions to neighbouring regions (3.7% total), characterised as significantly younger and less frequent in retirees. In I–IV regions, approximately 90% of tumours were benign, with pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V, PA exceeded 75% but WT were casuistic (2/28). Incidences of malignancies in region V was 40% but clinical signs of malignancy were evident only in tumours > 4 cm or in the presence of FN paresis. In 19% of patients with a benign appearance, imaging revealed malignancy; however, 38% of patients showed false negative results both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumours located exclusively in region V vs. 1901 other patients and in 100 patients with V extension vs. 1829 other patients showed no clinical symptoms of malignancy binding with final malignant tumour histology as a single variable or in combination with other variables. The logistic regression models obtained in this study show strong linkage between tumour location and predictors (age, male gender, and tumour diameter) and also aimed to function as a good classifier. Our conclusion is that, despite the very clear image of the mid-cheek tumour which is easily accessible in palpation and ultrasound examination, it is necessary to improve oncological vigilance and preoperative patient preparation.

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Section: Introductionmentioning

confidence: 99%

Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland—Observations Based on 2192 Cases of the Polish Salivary Network Database

Wierzbicka,

Bartkowiak,

Pietruszewska

et al. 2024

Cancers

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show abstract

“…The distinctiveness of the APG is re ected in the classi cation established by the Third Meeting of the European Salivary Gland Society (ESGS). The ESGS proposes to subdivide the parotid parenchyma into ve levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), and V (accessory) [4] and have been followed by others [5].…”

Section: Introductionmentioning

confidence: 99%

Rationale for increasing oncological vigilance in relation to clinical findings in accessory parotid gland- observations based on 2192 cases of the Polish Salivary Network Database

Wierzbicka,

Bartkowiak,

Pietruszewska

et al. 2023

Preprint

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The accessory parotid gland (APG, Vth level) differs in histological structure from main parotid tissue. This gives rise to the hypothesis, mirrored in clinical observations, that the representation of tumours is different than in the rest of the gland. Aim To analyse the epidemiological and histological differences of parotid tumours located in regions I-V, with particular emphasis on the distinctiveness of region V. To define the epidemiological factors that will indicate the risk of histological malignancy from clinically benign appearance. Material and Method Multicentre prospective study conducted between 2017-2021 by five Head and Neck Surgery University Departments, cooperating within the Polish Salivary Network Database 1929 patients (1048 women and 881 men) were included. The age, gender, patient occupation, place of inhabitation, tumour size, clinical features of malignancy, histology, facial nerve (FN) paresis were analysed for superficial lobe (I_II), deep lobe (III_IV) and with special regard to the tumours affecting region V. Results 28 tumours were located exclusively in region V (1.45% total) and 72 tumours in region V with extension to neighbouring regions (3,7% total), characterized by significantly younger age and less frequent in retirees. In I-IV regions approximately 90% of tumours were benign, pleomorphic adenoma (PA) and Whartin tumour (WT) predominance. In region V PA exceed 75% but TW were casuistic (2/28). Incidence of malignancies in region V was 40% but clinical signs of malignancy were evident only in tumours>4 cm or in the presence of FN paresis. In 19% of patients with a benign appearance, imaging revealed malignancy, however in 38% of patients, the result remained false negative both in terms of clinical and radiological features of malignancy. Logistic regression models in 28 patients with tumour located exclusively in region V vs 1901 other patients and the in 100 patients with V extension vs 1829 other patients showed no clinical symptoms of malignancy bind with final malignant tumor histology as a single variable or in combination with other variables. The logistic regression models obtained in this study shows strong linkage between tumor location and predictors (age, male gender and tumor diameter) and aimed to act as a good classifier. Conclusion Despite the very clear image of the mid-cheek tumour, easily accessible in palpation and ultrasound examination, it is necessary to improve the oncological vigilance and preoperative patient preparation.

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Evaluation of benign tumors of large salivary glands according to the new classification of the European Salivary Gland Society

Cited by 2 publications

References 0 publications

Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland—Observations Based on 2192 Cases of the Polish Salivary Network Database

Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland—Observations Based on 2192 Cases of the Polish Salivary Network Database

Rationale for increasing oncological vigilance in relation to clinical findings in accessory parotid gland- observations based on 2192 cases of the Polish Salivary Network Database

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