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.

Benign lymphoepithelial cyst of parotid gland without human immunodeficiency virus infection:A case report

BACKGROUND Benign lymphoepithelial cyst(BLEC)of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus(HIV)-positive adults and rarely in non-acquired immune deficiency syndrome patients.The main presentation is a slow-growing,painless mass,and secondary infection may cause acute inflammatory symptoms.CASE SUMMARY A 44-year-old Chinese male patient presented with a 1-year history of a mass in the left side of the neck.On physical examination,a mass similar in size and shape to a quail egg was found in the left parotid gland.The mass was tough,without tenderness,and easily moveable.The results of HIV tests,including antibody and nucleic acid tests and CD4+T cell examination,were negative.Imaging examination revealed a left parotid gland mass.The patient underwent surgical treatment,and BLEC was diagnosed based on postoperative pathology.After 2years of follow-up,the patient survived well without related discomfort.CONCLUSION The detailed characteristics of a BLEC in a patient without HIV infection contribute to an improved understanding of this rare disease.

Pneumoparotid with imaging findings:A case report and review of literature

BACKGROUND Pneumoparotid is a rare disease associated with retrograde airflow into the ductal system.There is no established treatment for this disease,which has no known complications.Mouth puffing and playing wind instruments are known to be the causes of this disease.CASE SUMMARY We managed a case,in which pneumoparotid suddenly recurred 4 months after surgery for purulent parotiditis.The patient did not report any obvious etiological factors,such as mouth puffing or playing a wind instrument.We reviewed 128 articles(from 1941 to 2023)that reported on a total of 166 patients with pneumoparotid,including the patient from the present case report,with imaging findings.This is the first reported case of pneumoparotid following surgery for purulent parotitis.The etiology in our case was classified as idiopathic.CONCLUSION Imaging findings could be sufficient for accurate pneumoparotid diagnoses and the exclusion of complications;computed tomography could be useful.

Parotid metastasis of rare lung adenocarcinoma:A case report

BACKGROUND Lung cancer(LC)is the leading cause of malignancy-related deaths worldwide.The most common sites of metastasis include the nervous system,bone,liver,respiratory system,and adrenal glands.LC metastasis in the parotid gland is very rare,and its diagnosis presents a challenge.Here,we report a case of parotid metastasis in primary LC.CASE SUMMARY The patient was a 74-year-old male who was discovered to have bilateral facial asymmetry inadvertently two years ago.The right earlobe was slightly swollen and without pain or numbness.Computed tomography(CT)examination showed bilateral lung space-occupying lesions.Pulmonary biopsy was performed and revealed adenocarcinoma(right-upper-lung nodule tissue).Positron emission tomography-CT examination showed:(1)Two hypermetabolic nodules in the right upper lobe of the lung,enlarged hy-permetabolic lymph nodes in the right hilar and mediastinum,and malignant space-occupying lesion in the right upper lobe of the lung and possible metastasis to the right hilar and mediastinal lymph nodes;and(2)multiple hypermetabolic nodules in bilateral parotid glands.Parotid puncture biopsy was performed considering lung adenocarcinoma metastasis.Gene detection of lung biopsy specimens revealed an EGFR gene 21 exon L858R mutation.CONCLUSION This case report highlights the challenging diagnosis of parotid metastasis in LC given its rare nature.Such lesions should be differentiated from primary tumors of the parotid gland.Simple radiological imaging is unreliable,and puncture biopsy is needed for final diagnosis of this condition.

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.

Diffuse large B-cell lymphoma arising from follicular lymphoma with warthin’s tumor of the parotid gland-immunophenotypic and genetic features: A case report

BACKGROUND Warthin’s tumor(WT)is composed of several cysts that are lined with tall,bilayered oncocytic columnar cells and lymphoid stroma.Within WT,the two components rarely transform into carcinoma or lymphoma,and when it does,carcinoma is the most common type.Approximately 28 cases of lymphoma with WT have been reported,most of which were non-Hodgkin lymphomas,and only a few cases were Hodgkin lymphomas.In the present report,we studied a case of diffuse large B cell lymphoma(DLBCL)arising from follicular lymphoma(FL)with WT in the parotid gland and its immunophenotypic and genetic features.CASE SUMMARY A 67-year-old man presented with a slowly enlarging right cheek mass for 12 years,and the mass began to change in size over a 2-mo time period.Over time,the patient felt mild local pain and right cheek discomfort.His medical history included a hepatitis B virus infection for 20 years and 30 years of smoking.Gross examination of the excised specimen showed a gray-red and gray-white appearance and a soft texture lobulated external surface neoplasm that measured 9 cm×8 cm×7 cm and was well circumscribed by relative normal parotid gland tissue.In cross section,the cut surfaces of the neoplasm were multicystic and had a homogeneous scaly appearance.A small fluid was discovered in the cyst.Bilateral oxyphilic,cuboidal or polygonal epithelium cells and lymphoid intraparenchymal components were observed.Many medium-to large-sized lymphoid cells were observed diffusely in part of the neoplasm,and a few secondary lymphoid follicles were observed at the center or edge of the neoplasm.Immunohistochemical staining showed that the columnar oncocytic cells were positive for AE1/AE3;neoplastic cells located in coarctate follicular were positive for CD20,Pax-5,bcl-2 and bcl-6;and the adjacent diffusely medium-to large-sized lymphoid cells were positive for Pax-5,bcl-6,CD20,MUM-1,bcl-2 and CD79a.The bcl-6(3q27)break-apart rearrangement was observed,and an Epstein Barr virus test was negative in the tumor cells.The patient survived 6 months after being diagnosed without any treatment.CONCLUSION WT-associated lymphoma is a very rare neoplasm in the parotid gland.Most cases are B cell non-Hodgkin lymphomas and involve middle-age and older males.This case highlights the extremely rare association of DLBCL arising from FL with WT and the importance of deliberate evaluation of the WT intraparenchymal stroma.Molecular detection techniques have potential advantages in the diagnosis of lymphoma with WT.

Dose-Response Relationship between Dietary Polyphenols from Acorns and Parotid Gland Hypertrophy in Pigs

Proline contents of parotid glands (PG) in pigs constantly increase after the inclusion of different amounts of ripe hulled acorns in the diet providing high polyphenols levels. The dose-response relationship was estimated on natural hydrolizable tannins (expressed as tannic acid equivalent TAE) amounts of 25.8 to 36.1 g TAE/kg DM in experimental diets. Macroscopic and histological morphometry of parotid glands greatly varied according to feed intake and dosages of TAE ingested. The PG response (hypertrophy grade) on acorns’ tannins content in the diet was positively correlated (R2 = 0.748): the response to the protein precipitating activity (PPA) of tannins consisted of a functional parotidomegaly (hypertrophy), 1.34 up to 3.55 folds than control PGs, following an oral dosage 0.596 up 1.72 TAE g·kg body weight·d-1 respectively, after one week exposure.

A Case of Pleomorphic Adenoma of the Parotid Gland with Multiple Local Recurrences through Facial to Cervical Regions

Pleomorphic adenoma is the most common benign parotid gland tumor. Although its local recurrence rate is known to be high, the recurrence extending to the cervical region is rare. Here we report a case of a young female (25 years old) with pleomorphic adenoma of the parotid gland which showed multiple recurrences through facial to cervical regions over a span of eight years. We also discuss how this benign tumor with a high recurrence rate has been treated in other cases, and how it should be treated.

Sebaceous Carcinoma in the Parotid Gland, Report of a Case

皮脂腺癌是一种罕见的侵袭性皮肤肿瘤。它可以发生在任何存在皮脂腺的部位。这种肿瘤具有侵袭性的临床病程 ,常出现局部复发和远处转移。本文报告了一例伴有溃疡表现的腮腺皮脂腺癌。对肿瘤进行手术切除及舌骨上颈淋巴清扫术 。

High-Grade Mucoepidermoid Carcinoma Ex-Pleomorphic Adenoma of the Parotid Gland: Case Report and Review of Literature

Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosis. Methods: We present a case of a 71-year-old male with an enlarging left neck mass over several months. CT showed both a parapharyngeal space mass and a separate level II neck mass. Results: The patient underwent resection of the left parapharyngeal mass and ipsilateral selective level II-IV lymphadenectomy. The final pathologic diagnosis was metastatic high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma. Conclusions: We describe a novel presentation of high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma as a metastatic parapharyngeal mass.

Papillary cystadenoma of the parotid gland: A case report

BACKGROUND Papillary cystadenoma is a rare benign epithelial tumor of the salivary gland,which is characterized by papillary structures and oncocytic cells with rich eosinophilic cytoplasm. We found only one case of papillary cystadenoma in nearly 700 cases of salivary gland tumors. Our case was initially mistaken for a tumor of the right temporomandibular joint(TMJ) capsule rather than of parotid gland origin. Preoperative magnetic resonance imaging(MRI) and computed tomography(CT) should be carefully studied, which allows for appropriate preoperative counseling and operative planning.CASE SUMMARY Here, we report an unusual case of a 54-year-old woman with a parotid gland papillary cystadenoma(PGPC) that was misdiagnosed as a tumor of the right TMJ capsule. She was initially admitted to our hospital due to a mass anterior to her right ear inadvertently found 5 d ago. Preoperative CT and MRI revealed a well circumscribed tumor that was attached to the right TMJ capsule. The patient underwent a resection through an incision for TMJ, but evaluation of an intraoperative frozen section revealed a benign tumor of the parotid gland. Then we removed part of the parotid gland above the temporal facial trunk. The facial nerve was preserved. Postoperative histopathological findings revealed that the tumor was PGPC. No additional treatment was performed. There was no recurrence during a 20-mo follow-up period.CONCLUSION The integrity of the interstitial space around the condyle in MRI or CT should be carefully evaluated for parotid gland or TMJ tumors.

A large basal cell adenoma extending to the ipsilateral skull base and mastoid in the right parotid gland: A case report

BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA seems impossible. CASE SUMMARY We presented a case of a 54-year-old woman with a mass in the deep lobe of the right parotid gland involving the ipsilateral skull base and mastoid. The patient exhibited gradual right facial swelling but no other obvious symptoms. Combined resection of the total right parotid gland and partial skull base excision were performed. The biopsy conducted before the surgery and sections cut from intraoperatively obtained tissues were not definitive for identifying the character of the neoplasm. A final diagnosis of tubular BCA without malignant elements was established based on postoperative pathology results and immunohistochemical analysis. The tumour did not recur during the 12-mo follow-up period. CONCLUSION A diagnosis of BCA can only be established based on a histopathological examination after an excisional biopsy, and tubular BCA should carefully be considered as a destructive type.

Multiple clear-cell sarcomas of small intestine with parotid gland metastasis: A case report

Clear-cell sarcoma is a rare, malignant soft tissue tumor that displays melanocytic differentiation with a distinct molecular profile. It is rarely localized in the gastrointestinal tract. Herein we reported a case of multiple synchronous clear-cell sarcomas of the gastrointestinal tract with parotid gland metastasis. A 51-year-old male patient presented with a growing painless mass under the right ear. A preoperative positron emission tomography/computed tomography showed multiple intestinal masses and a mass in the right parotid with increased glucose uptake, and he underwent operative treatment with resection of three tumors in the jejunum and ileum and then received a right parotidectomy. Postoperative pathological examination showed that cells in the intestinal tumor were consistent with clear-cell sarcoma of the gastrointestinal tract, and the malignant cells in the parotid gland were similar to the intestinal tumor. Immunohistochemical studies revealed positive expression of HMB-45, Melan-A, and S-100. EWSR1 gene fusion transcripts were undetectable by fluorescence in situ hybridization.

Histological Features of Parotid Gland of Albino Rats Exposed to. Smokeless Tobacco

Smokeless tobacco is very common personal habit of people living in various areas of Asia which is an alarming sign for the development of different oral diseases in such people. The aim of present study was to investigate effects of smokeless tobacco on parofid glands of the Aalbano rats by using various percentages of the smokeless tobacco. The rats were divided into three different groups, control group （A） no smokeless tobacco, experimental group （B） 5% smokeless tobacco and experimental group （C） 10% of smokeless tobacco with different feeds required according parameters. Weekly weight gain and partid gland were analyzed through student P test and histological structures were recorded through HE stain and Retculin stain. The results showed that as compared to control group body, weight of the rats was decreased in groups B and C having smokeless tobacco percentage in the diet. Weight of parotid gland as compared to control group was decreased in groups B and C with diet of smokeless tobacco. Further, histological observation under HE stain showed that parofid gland of group B showed mild narrowing of ductal lumen, collapse of vessels and stromal was also increased, in group C parenchyrnal tissues with loss of acini found damaged and glandular dystrop and lymphatic infiltration were determined moderate to severe. Meanwhile, reticulin stain showed that vascular collapses were shown because of increasing in stromal glandular atrophy in group C as compared to control group. In conclusion, this study showed that smokeless tobacco caused serious injuries in the tissue level in parotid gland with high percentage of smokeless tobacco which highlight health hazards on its consumption.

Predictors of distant metastasis in acinic cell carcinoma of the parotid gland

BACKGROUND AiCC is a primarily indolent disease process.Our aim with this study is to determine characteristics consistent with rapidly progressive AiCC of the parotid gland.AIM To report on patients with metastatic lung disease from AiCC and potential correlative factors.METHODS Single-institution retrospective review of patients treated at the University of Michigan between 2000 and 2017.Univariate analyses were performed.RESULTS A total of 55 patients were identified.There were 6 patients(10.9%)with primary AiCC of the parotid gland who developed lung metastases.The mean age at diagnosis for patients with lung metastases was 57.8 years of age,in comparison to 40.2 years for those without metastases(P=0.064).All 6 of the patients with lung metastases demonstrated gross perineural invasion intraoperatively,in comparison to none of those in the non-lung metastases cohort.Worse diseasefree and overall survival were significantly associated with gross perineural invasion,high-grade differentiation,and T4 classification(P<0.001).CONCLUSION AiCC of the parotid gland is viewed as a low-grade neoplasm with good curative outcomes and low likelihood of metastasis.With metastasis,however,it does exhibit a tendency to spread to the lungs.These patients thereby comprise a unique and understudied patient population.In this retrospective study,factors that have been shown to be statistically significant in association with worse disease-free survival and overall survival include presence of gross facial nerve invasion,higher T-classification,and high-grade disease.

Sebaceous lymphadenocarcinoma of the parotid gland:A case report

BACKGROUND Sebaceous lymphadenoma is a benign tumor that occurs rarely in the salivary glands,most commonly in the parotid glands or periparotid lymph nodes,and even more rarely undergoes malignant transformation into a sebaceous lymphadenocarcinoma.CASE SUMMARY We report an 82-year-old woman who presented with a painless mass in the right parotid region.We performed extended surgical resection of the parotid gland mass.Intraoperative pathology revealed a sebaceous lymphadenocarcinoma with metastasis into the periparotid cervical lymph nodes,so we also performed neck dissection and lymph node resection.Postoperative pathology confirmed the diagnosis.The literature review revealed that this was the seventh reported case of sebaceous lymphadenocarcinoma and the second reported case of cervical lymph node metastasis and infiltration of the skin of the parotid gland.CONCLUSION Treatment of sebaceous lymphadenocarcinoma depends on the typing and clinical staging of the cancer.Extensive resection is the first choice,and adjuvant radiotherapy should be given to patients with high-grade tumors or those at an advanced clinical stage.

Partial Purification and Characterization of the Rat Parotid Gland Protein Kinase Catalyzing Phosphorylation of Matured Destrin at Ser-2

Destrin, also called actin-depolymerizing factor (ADF), exists in resting parotid tissue as phosphorylated (inactive) and dephosphorylated (active) forms, and β-adrenergic stimulation of this tissue induces dephosphorylation of destrin. It is suggested that destrin dephosphorylation is involved in cortical F-actin disruption observed in parallel with β-agonist-induced amylase secretion. At present, the phosphorylation/dephosphorylation mechanism of destrin in parotid tissue is not known. We previously detected, in a crude rat parotid extract, a constitutively active protein kinase catalyzing phosphorylation of destrin;however, its identification has been hampered by difficulty in its enrichment. The purpose of this study was to explore a simple purification method(s) for this enzyme. To this end, we first developed a high-throughput dot-blot assay for the kinase with an anti-phosphodestrin antibody and then studied its purification by column chromatography on several media. We found that the kinase could be partially purified by sequential chromatography on DEAE-cellulose, phenyl-Sepharose, and hydroxyapatite columns. In each chromatography, however, the kinase could be eluted, at the cost of resolution, only by sharp increases in the elution power of the eluent;gradual increases in the elution power resulted in unacceptably poor recovery. We confirmed that enzymatic properties of the kinase were not basically altered during the purification. Further purification of the kinase was achieved by native polyacrylamide gel electrophoresis (PAGE), which resolved the kinase activity into two bands and separated the activity from most proteins (the kinase activity after PAGE was detected with destrin-coated polyvinylidene difluoride membranes and the anti-phosphodestrin antibody). The two bands seem to constitute the major destrin-phosphorylating activity in the resting rat parotid gland. We here report its partial purification and characterization together with the detection methods.

Re-operation for parotid gland cancer following non-standard surgical treatment

Objective:The purpose of this study was to analyze the clinical disadvantages of non-standard surgical treatment for parotid gland cancer and probe the re-operative indication following non-standard surgical treatment.Methods: Data of 58 cases suffered parotid gland cancer who received non-standard operation at other hospital and received re-operation in tumor hospital of Ganzhou from June 1998 to October 2010 were retrospectively reviewed.Results: In all cases,parotid gland cancer were residual in 46 cases,the facial nerve remaining rate was 81.0% (47/58),facial nerve branches injury rate was 3.5% (2/58),facial nerve partial resection rate was 8.6% (5/58) and total resection rate was 6.9% (4/58).The sensitivity of residual tumor was 83.3%,scanned by contrast-enhanced CT and the CT positive predictive value was 86.9%. Conclusion: Consideration of the higher residual tumor rate in patients who received non-standard operations,the re-operations were necessary.Contrast-enhanced CT positive predictive value was high for residual tumor and it was important for re-operation.

Cystic teratoma of the parotid gland:A case report

BACKGROUND Teratoma is a common tumor,but rarely occurs in the parotid region.Only nine cases have been reported in the current literature.Although it is generally detected in infancy or childhood,it is commonly asymptomatic.Computed tomography(CT)and magnetic resonance imaging(MRI)have important roles in the diagnosis of teratoma.CASE SUMMARY A 36-year-old man developed a lump located below the left auricular lobule 3 years ago.Physical examination revealed a nearly-circular tumor in the left parotid gland region with a defined border,firm texture,and significant movement.Calcification,fat,keratinized substances,and typical fat-liquid levels was observed on CT and MRI.A diagnosis of cystic teratoma of the parotid gland was established preoperatively and confirmed by postoperative pathology.Following surgery,the patient developed temporary facial paralysis.There was no recurrence of teratoma during the 15-mo follow-up period.CONCLUSION When an asymptomatic mass in the parotid region is identified,parotid gland teratoma should be included in the differential diagnosis.Imaging examinations are helpful in the diagnosis.

Adenoid Cystic Carcinoma of Parotid Salivary Gland—A Case Study

Adenoid Cystic Carcinoma (ACC) is an infrequent slow growing epithelial tumour constituting for around less than 1% of all the oral and maxillo-facial malignancies and almost 10% of all the salivary gland tumors. Parotid gland is the second most common site to be involved in the head and neck region along with submandibular gland, Palate being the most common site involved in the oral cavity. Key feature of these tumors include its asymptomatic presentation, indolent nature, typically showing infiltrative growth and peri-neural invasion. Herein, we report a case of adenoid cystic carcinoma of right parotid gland of a 33-year-old male who presented with complaint of painless slow enlargement of left parotid gland and facial muscle weakness. On Examination firm mass in the region of the left parotid gland as well as left facial paralysis was seen. Biopsy results and further management is discussed here within.