Parotid

Pediatric rhabdomyosarcoma

July 13, 2014     Rosemary Ojo, MD; Si Chen, MD; Liset Pelaez, MD; Ramzi Younis, MD
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All children with rhabdomyosarcoma require multimodality therapy to maximize local tumor control. This can involve different combinations of chemotherapy, surgery, and radiation therapy.

Sebaceous carcinoma of the parotid gland: A case report and review of the literature

June 8, 2014     Alexander Manteghi, DO; Seth Zwillenberg, MD; Vivian Arguello-Guerra, MD
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Abstract

Sebaceous carcinoma is a rare malignancy primarily affecting the periocular sebaceous glands. Sebaceous carcinoma of the parotid gland is exceedingly rare, with only 30 cases reported in the literature. Our case brings this total to 31. We present a case involving a 57-year-old man with a slowly enlarging, right tail-of-parotid mass abutting the ear lobule with overlying skin discoloration. Excision of the mass with superficial parotidectomy was performed, and microscopic examination demonstrated sebaceous carcinoma with positive margins. Subsequently, the patient underwent a completion parotidectomy and inferior auriculectomy with no evidence of residual tumor. Six months after postoperative adjuvant radiotherapy, the patient remains tumor-free. The clinical and morphologic features of this tumor are discussed.

Massive pleomorphic adenoma of the parotid gland: Surgical considerations

May 7, 2014     Alex Fernandez, MS; Ryan F. Osborne, MD, FACS; Jason S. Hamilton, MD, FACS
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Preservation of the facial nerve and its branches requires special consideration when dealing with a large parotid mass. The traditional approach of anterograde dissection of the facial nerve proves ineffective in patients with large lesions that effectively obstruct the field of view and origin of the nerve trunk

Accessory parotid malignancy requiring ductal transection

February 12, 2014     Avery Kaplan; Alex Fernandez, MS; and Ryan Osborne, MD, FACS
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While malignancies of the accessory parotid gland are rare, when they do occur they jeopardize ductal integrity.

Melioidosis of salivary glands with coexisting diabetes: Management of a difficult case

January 21, 2014     M. Panduranga Kamath, MS, DLO; Kiran Bhojwani, MS; Mahabala Chakrapani, MD; Katara P. Vidyalakshmi, MD; K.P. Vishnuprasad, MBBS
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Abstract

Melioidosis is an infectious disease caused by the gram-negative bacillus Burkholderia pseudomallei. Melioidosis is endemic in Southeast Asia and northern Australia. An important risk factor for the development of melioidosis is the presence of diabetes mellitus, which may increase the relative risk of infection by as much as 100-fold. We report a rare case of melioidosis of the parotid and submandibular gland with coexisting diabetes. This was successfully managed conservatively with intravenous ceftazidime followed by trimethoprim/sulfamethoxazole and doxycycline.

Lymphoepithelial carcinoma of the parotid gland, a very unusual tumor: Case report and review

September 18, 2013     Natarajan Anantharajan, MRCS, MCh; Nagamuttu Ravindranathan, FRCS, FDRCS; Pathmanathan Rajadurai, MBBS, FRCPA
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Abstract

Lymphoepithelial carcinoma (LEC) of the parotid gland is rare. When it does occur, it is usually seen in Asians and Greenland Eskimos. An association with Epstein-Barr virus (EBV) infection has been documented. We report a case of EBV-associated LEC of the parotid gland in a 30-year-old Chinese woman. The patient underwent a total parotidectomy with preservation of the facial nerve, followed by postoperative radiotherapy. She recovered well without complications or recurrence. We present this case in view of the rarity of LEC, which has prevented extensive study of its clinical course, optimal treatment options, and overall prognosis.

Mucoepidermoid carcinoma presenting as a large cyst of the parotid gland in HIV disease

July 21, 2013     Nelson Goldman, MD; Sania Shuja, MD; Raafat Makary, MD; Reginald L. Griffin, MD
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Abstract

Cystic lesions of the parotid gland may be the presenting symptom in human immunodeficiency virus (HIV)-positive patients. The most common lesion is the benign lymphoepithelial cyst. Malignant lesions may also be associated with-or be hidden by-a cystic mass. We report a case of mucoepidermoid carcinoma in a 40-year-old HIV-positive woman who presented with a large cystic mass of the parotid that had been previously misdiagnosed as benign on several fine-needle aspiration biopsies. On our histologic examination, the true pathologic nature of the lesion was revealed. We suggest that an image-guided fine-needle aspiration biopsy of the thickened wall of cystic masses of the parotid may be more diagnostic than a random sampling of the contents.

Intraparotid neurofibromatosis presenting with multiple nodules

June 11, 2013     Ryan F. Osborne, MD, FACS; Jason S. Hamilton, MD, FACS; and Reena Gupta, MD, FACS
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Often asymptomatic initially, neurofibromas may cause pain, weakness, and numbness as they grow as a result of compression of the underlying nerve fascicles.

Letters to the Editor

June 11, 2013    
article

Methicillin-resistant Staphylococcus aureus as a cause of neonatal suppurative parotitis: A report of two cases and review of the literature

June 11, 2013     Sean T. Donovan, MD; Grant T. Rohman, MD; John P. Selph, MD; Roy Rajan, MD; Rosemary M. Stocks, MD; and Jerome W. Thompson, MD, MBA
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Abstract

Suppurative parotitis is an uncommon entity identified in newborns. While Staphylococcus aureus has been frequently identified as the causative pathogen among the few patients diagnosed with neonatal suppurative parotitis (NSP), there has only been one prior case described in the literature that was due to methicillin-resistant Staphylococcus aureus (MRSA). Because of its virulence, MRSA presents new and substantial challenges for the surgeon; we describe two cases of NSP caused by MRSA and the subsequent surgical intervention necessitated for cure. We also include a review of all cases of NSP described in the English-language literature.

Facial nerve preservation in total parotidectomy for parotid tumors: A review of 27 cases

June 11, 2013     Soliman El-Shakhs, MD; Yaser Khalil, MD; and Asmaa Gaber Abdou, MD
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Abstract

We conducted a study to evaluate the success of facial nerve preservation in 27 adults with a parotid tumor who underwent total parotidectomy. Of this group, 11 patients had a malignant tumor, 10 had a recurrent benign tumor, and 6 had a primary benign tumor. Preoperatively, 7 patients had facial nerve paresis. Postoperatively, facial nerve preservation was achieved in all but 1 case; in the exception, the nerve was sacrificed and grafting was necessary. In conclusion, facial nerve preservation can be achieved in almost all cases of total parotidectomy.

Secondary lymphoma of the parotid gland: Clinical experience

February 25, 2013     Lorraine Williams-Smith, MD, FACS; Reena Gupta, MD, FACS; and Ryan F. Osborne, MD, FACS
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 It is important to remember that parotid lymphomas do occur and should be considered in the differential diagnosis for parotid masses.

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