Tumors of the Parotidomasseteric Area Associated with Inadequate Primary Treatment: Report of 2 Cases

부적절한 일차 처치와 연관된 이하선 종양 2례

  • Song, Jin Woo (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Choi, Hwan Jun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Mi Sun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Ahn, Hyung Sik (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Jun Hyuk (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Lee, Young Man (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University)
  • 송진우 (순천향대학교 의과대학 성형외과학교실) ;
  • 최환준 (순천향대학교 의과대학 성형외과학교실) ;
  • 김미선 (순천향대학교 의과대학 성형외과학교실) ;
  • 안형식 (순천향대학교 의과대학 성형외과학교실) ;
  • 김준혁 (순천향대학교 의과대학 성형외과학교실) ;
  • 이영만 (순천향대학교 의과대학 성형외과학교실)
  • Received : 2006.03.27
  • Published : 2006.11.10

Abstract

Purpose: Parotid neoplasia are relatively frequent, representing approximately 3% of all tumors in the head and neck regions. But incomplete resection and misdiagnosis of parotid gland is followed by multiple tumor invasion, tumor recurrence, and other iatrogenic tumor formation. In patients undergoing parotidectomy for confirmed or suspected malignancy, the traditional or modified rhytidectomy incision may prove suboptimal because it does not easily lend itself to a continuous neck dissection. Similarly, patients with tumors of the anterior accessory lobe or patients with large anterior tumors may also require the modified Blair incision for adequate surgical exposure. This report serves to revisit the topic of accessory and parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of recurrence are avoided. Methods: This is a retrospective review of our experience with two cases of parotid tumors; one accessory parotid gland neoplasm and one parotid gland neoplasm. We report the case of parotid tumor and epidermal cyst in a 54-year old male patient and the case of case of recurrent parotid tumor with local invasion in 30-year old male patient. Results: All were removed through a modified Blair incision. Pathologic report notified that One was found pleomorphic adenoma and epidermal cyst, and the other one pleomorphic adenoma with subcutenous invasion. The patients recovered well without any complication such as infection, hematoma, facial nerve palsy, and necrosis of skin flap. Patients were discharge POD#7. Patients were followed up to for 1 year and they have no sign of recurrence. Conclusions: A high index of suspicion, prudent diagnostic skills(including fine-needle aspiration biopsy, CT, US), and meticulous surgical approach are the keys to a successful management of these lesions. We experienced two cases of parotid neoplasia, in the treatment of tumor reccurence & iatrogenic tumor arising from the parotid gland and are presented with the review of literatures.

Keywords

References

  1. Choi HJ, Park ES, Jtmg SK, Kim YB, Go ES: A case of lymphoepithelioma-like carcinoma arising from the parotid gland. J Korean Cleft Palate-Craniofac Assoc 4: 66, 2003
  2. Klotz DA, Coniglio JU: Prudent management of the mid-cheek mass: revisiting the accessory parotid gland tumor. Laryngoscope 110: 1627, 2000 https://doi.org/10.1097/00005537-200010000-00010
  3. Bradley PJ: Recurrent salivary gland pleomorphic adenoma: etiology, management, and results. Curr Opin Otolaryngol Head Neck Surg 9: 100, 2001 https://doi.org/10.1097/00020840-200104000-00008
  4. Stennert E, Wittekindt C, Klussmann JP, Arnold G, Gtmtinas-Lichius O: Recurrent pleomorphic adenoma of the parotid gland: a prospective histopathological and immtmohistochernical study. Laryngoscope 114: 158, 2004 https://doi.org/10.1097/00005537-200401000-00030
  5. Larson DL: Management of the recurrent, benign tumor of the parotid gland. Plast Reconstr Surg 108: 734, 2001 https://doi.org/10.1097/00006534-200109010-00020
  6. Lin DT, Coppit GL, Burkey BB, Netterville JL: Tumors of the accessory lobe of the parotid gland: a 10-year experience. Laryngoscope 114: 1652, 2004 https://doi.org/10.1097/00005537-200409000-00028
  7. Witt RL: The significance of the margin in parotid surgery for pleomorphic adenoma. Laryngoscope 112: 2141, 2002 https://doi.org/10.1097/00005537-200212000-00004