Inflamed benign tumors of the parotid gland: Diagnostic pitfalls from a potentially misleading entity

Mantsopoulos, Konstantinos; Psychogios, Georgios; Agaimy, Abbas; Künzel, Julian; Zenk, Johannes; Iro, Heinrich; Bohr, Christopher

doi:10.1002/hed.23541

Cited by 28 publications

(21 citation statements)

References 29 publications

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“…18,19 Consequently, there is a clear potential for a false working hypothesis in preoperative diagnostics in such cases. The aforementioned literature data and our clinical experience show that clinical and imaging approaches can often prove to be demanding in cases of a parotid gland tumor.…”

Section: Discussionmentioning

confidence: 99%

Unexpected Detection of Parotid Gland Malignancy during Primary Extracapsular Dissection

Mantsopoulos

Velegrakis

Iro

2015

Otolaryngol.--head neck surg.

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Objective. To evaluate the oncologic and functional outcome in cases in which a false preoperative working hypothesis ''benign parotid tumor'' led to a primary extracapsular dissection being performed rather than a traditional, more radical surgical modality.Study Design. Case series with chart review.Setting. Academic tertiary referral center.Subjects and Methods. The records of all patients treated for malignant tumors of the parotid gland between 2006 and 2012 were retrospectively studied. Patients were excluded from our study sample for insufficient data or if their histories indicated manifestation of malignant tumors without primary parotid origin (squamous cell carcinomas, lymphomas, melanomas), revision surgery, as well as concomitant or past malignant tumors. Consequently, a total of 29 patients with 30 primary malignant tumors of the parotid gland formed our study sample (14 men, 15 women; male:-female ratio, 0.93:1; mean age, 55.4 years; range, 14-85 years).Results. Of 30 cases, 22 had low-grade tumors. Further tumor cells were detected in only the histology specimens of the parotid in 3 of the 25 cases treated subsequently with completion parotidectomy. Five patients received adjuvant radiation. Five-year disease-specific survival was 100%; local disease control was 96.6%. Of 30 cases, 28 had HouseBrackmann I after tumor treatment; the other 2 cases had a slight paralysis (House-Brackmann II). Conclusion.Beginning with the ''false'' working hypothesis and performing an extracapsular dissection in unsuspected cases seems to have no adverse impact on patients' survival and postoperative quality of life in cases in which definitive histology reveals malignancy.

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Section: Discussionmentioning

confidence: 99%

Unexpected Detection of Parotid Gland Malignancy during Primary Extracapsular Dissection

Mantsopoulos

Velegrakis

Iro

2015

Otolaryngol.--head neck surg.

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“…This procedure, allowed an identification rate of the RMV in 98% of the cases which is above that described in literature but is sometimes time consuming. Nevertheless, the variability of the vein and preoperative inflammation and displacement caused by large lesions can be misleading . Lim et al found that the accuracy of the RMV landmark was higher in patients with tumors <2 cm .…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the variability of the vein and preoperative inflammation and displacement caused by large lesions can be misleading. 21 Lim et al found that the accuracy of the RMV landmark was higher in patients with tumors <2 cm. 13 Seldom the RMV can run superficially to the FN and lead to misinterpretation of the US findings.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound can help to indirectly predict contact of parotid tumors to the facial nerve, correct intraglandular localization, and appropriate surgical technique

et al. 2019

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Background The purpose of this prospective study is to evaluate the role of ultrasound in benign parotid tumor surgery, particularly by helping to identify the tumor location and its relationship to the facial nerve (FN) and by predicting the appropriate surgical approach. Methods Fifty patients underwent preoperative ultrasound. The course of the FN was indirectly defined, and the following predictions were made: contact of the tumor with the FN, the necessity for intraoperative nerve exposure, localization in the correct parotid lobe, and choice of the appropriate surgical technique. Results Contact of parotid tumors with the FN was determined with an accuracy of 96%. The need for intraoperative nerve exposure was incorrectly determined only once. The appropriate surgical technique was correctly predicted in 98% of the patients. Conclusions Ultrasound is helpful for indirectly predicting the relationship between parotid tumors and the FN. The retromandibular vein is the most important landmark.

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“…In cases with unclear intraoperative findings, frozen section was performed. There is no doubt that detection of cystadenolymphomas on frozen section is straightforward in the vast majority of cases, and only infarcted or inflamed cases could pose a diagnostic problem . After 17 years of increasing experience in ED, we aimed, in this study, at evaluating the performance and results of minimally invasive surgery in our cases.…”

Section: Discussionmentioning

confidence: 99%

Extracapsular dissection for warthin tumors despite the risk of ipsilateral metachronous occurrence

et al. 2018

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Inflamed benign tumors of the parotid gland: Diagnostic pitfalls from a potentially misleading entity

Abstract: In most cases, a high suspicion index combined with close monitoring of the patient may allow prompt and successful diagnosis and therapy.

Cited by 28 publications

References 29 publications

Unexpected Detection of Parotid Gland Malignancy during Primary Extracapsular Dissection

Unexpected Detection of Parotid Gland Malignancy during Primary Extracapsular Dissection

Ultrasound can help to indirectly predict contact of parotid tumors to the facial nerve, correct intraglandular localization, and appropriate surgical technique

Extracapsular dissection for warthin tumors despite the risk of ipsilateral metachronous occurrence

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