• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.499-508
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• 2007

Background and Purpose: Some subtypes of malignant salivary gland tumors such as adenoid cystic carcinoma (ACC) frequently result in distant metastasis of vascular origin, which are main causes of treatment failure. The reasons for the affinity for vascular metastatic potential are unclear. Therefore, molecular characteristics that influence the dissemination of metastatic tumor cells are important for the design of more effective treatment of salivary ACC. Tumor angiogenesis has been known to be essential for the distant metastasis of malignant cells. So, we determined expressions of vascular metastasis related factors in orthotopic (parotid) murine models of parotid ACC and compared with those in ectopic (subcutis) tumors of athymic mice. Experimental Design: Using specimens from murine parotid (orthotopic, experimental group) and subcutaneous (ectopic, control group) tumors, which have developed via transplantation of tumor cells, originated from human parotid ACC, we performed immunohistochemical assays with anti-vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF, FGF2), matrix metalloproteinase (MMP)-9, and interleukin (IL)-8 antibodies. We also performed immunohistochemical assays with VEGF receptor (VEGFR)-1, VEGFR-2, VEGFR-3, and phosphorylated VEGFR-2. Results: Transplantation of human ACC tumor cell $(5{\times}10^5)$ into the parotid and subcutis successfully resulted in orthotopic (parotid) and ectopic (subcutaneous) tumors in athymic mice. Immunohistochemical staining demonstrated higher expression of major angiogenic factors (VEGF, bFGF, MMP-9) in the orthotopic tumors than in ectopic tumors (P<0.05). But the expression level of angiogenic receptors were same in orthotopic and ectopic tumors of parotid ACC. Conclusion: VEGF, bFGF, and MMP-9 could be a good candidates for antiangiogenic therapy for the contol of vascular metastatic lesions of salivary ACC.

• Archives of Plastic Surgery
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• v.48 no.2
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• pp.213-216
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• 2021

Many surgeons have demonstrated the validity of sternocleidomastoid muscle flaps for the reconstruction of head and neck tumors. We present a case in which we used an island sternocleidomastoid muscle flap to reconstruct a cheek depression after excision of a malignant parotid tumor. A 44-year-old woman presented with a right malignant parotid tumor. We performed total resection of the parotid gland and facial nerve with the sural nerve and reconstructed the facial nerve and cheek depression with an island sternocleidomastoid muscle flap. The sternal head of the right sternocleidomastoid muscle was cut at the cranial and caudal segments to elevate it as an island flap. We used the superior thyroid artery as the sole pedicle for the island muscle flap. At 1 year and 3 months after the operation, the mimic muscles had gradually recovered and progressed without complications such as Frey syndrome, cervical motor dysfunction, or concave deformation of the neck and cheeks.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.205-210
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• 1999

Objectives: Major salivary gland tumor mainly develops in the parotid gland and pleomorphic adenoma is a large percentage. The aim of this study is to get clinicopathologic characteristics of overall major salivary gland tumors and suggestions regarding surgical management through collective review of 315 cases. Materials and Methods: This is a clinicopathologic review of 315 cases of major salivary gland tumor who were treated surgically at Department of Surgery, Head and Neck Clinic, Pusan Paik Hospital, Inje University during the period of 18 years from 1980 to 1997. Analysis was performed regarding the incidence, classification, surgery and its complications, and survival rate of salivary gland cancer. Results : 1) Parotid gland was the most prevalent site of salivary gland tumor(78%) and submandibular gland(21%) was next in order. Benign tumors were 257cases(81%) and malignant tumors were 58 cases(19%). 2) Male to female sex ratio was 1:1.2, the most prevalent age group was 3rd decade and the second group was 4th decade. 3) Histopathologically, the most common benign salivary gland tumor was pleomorphic adenoma. Warthin's tumor was next common. Among the malignant tumors, mucoepidermoid carcinoma was most common, and the next were adenoid cystic carcinoma and acinic cell carcinoma. 4) In pleomorphic adenoma, superficial parotidectomy was performed in 129 cases, and extracapsular tumorectomy was performed in 3 cases. In non-pleomorphic benign tumor, tumorectomy was performed in 21 cases. In 40 cases of deep lobe tumor, total parotidectomy was performed in only 2 cases and deep parotidectomy was performed in 38 cases. 5) Surgical complications were facial nerve injury 19 cases, Frey syndrome 13 cases, and salivary fistula 3 cases. 6) Overall 5-year survival rate of salivary gland cancer was 63%. Conclusion: Postoperative recurrence rate is low in benign tumor, but high in cancer of salivary gland tumor. Surgical procedure should not be aggressive in benign tumor, especially in parotid tumor, but should be aggressive in malignant salivary gland tumors.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.99-102
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• 2010

Purpose: Primary malignant lymphomas of the salivary glands are uncommon, representing only 1.7% to 3.1% of all salivary neoplasms and 0.6% to 5% of all tumors and tumor-like lesions of the parotid gland. Lymphomas of the parotid glands are usually manifestations of a systemic disease process but primary lymphomas of the parotid glands are rare. Most of these lesions are classified as extranodal non-Hodgkin's lymphoma. We report the clinicopathological features of primary malignant lymphoma of the parotid gland based on an analysis of our cases. Methods: The subject was a 48-year-old male patient with a malignant lymphoma originating in the parotid gland, which had been slowly increasing in size over previous 6 months. The diagnosis was established by MRI and a superficial lobectomy. After diagnosis, the patient was referred to an oncologist for staging and medical treatment. Results: The stage was IIIA. The patient was treated with chemotherapy following surgery with rituximab and CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). The tumor was controlled successfully by chemotherapy. The patient was followed up for 1 year with no relapse. Conclusion: A case of primary non-Hodgkin's lymphoma of the parotid gland was treated with a superficial parotidectomy and chemotherapy. The disease was well controlled after a 1 year follow-up.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.85-88
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• 2017

Mammary analogue secretory carcinoma (MASC) is a rare malignant tumor of the salivary gland, which was first described in 2010. In this case report, we describe a 62-year-old woman with a MASC of the parotid gland, who initially presented with an asymptomatic preauricular mass. At first, computed tomography (CT) and fine needle aspiration cytology were performed; these suggested a possible Warthin's tumor but also some suspicious malignant findings. For the main treatment, adequate parotidectomy was conducted via modified Blair incision to remove the tumor. Postoperative pathology report revealed a MASC of the parotid gland. Specific MASC findings were observed upon immunohistochemical examination.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.653-655
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• 2005

Epithelial-myoepithelial carcinoma (EMC) of the salivary gland is a rare tumor that comprises approximately 1% of all salivary gland tumors. It has a distinctive histological appearance comprising ductal structures with an inner epithelial cell component and an outer layer of myoepithelial cells. We report a case of EMC of the parotid gland in a 41- year-old man. He presented left-sided subauricular swelling developed 3-month earlier. Neck CT scans revealed a well-defined mass in the left superficial parotid gland. He underwent superficial parotidectomy and was diagnosed as EMC. He was taken postoperative radiotherapy. There was no evidence of recurrence during a follow-up period of 12 months. A EMC is a low grade malignant tumor which can cause diagnostic confusion during workup and also frequently misdiagnosed as other benign or malignant tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.165-169
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• 2004

Pleomorphic adenoma is the most common neoplasm of the parotid gland, generally presenting as a slowly growing, firm, well-circumscribed, painless nodule. It is often difficult to separate into benign and malignant categories because its bland histomorphologic and cytologic features. This tumor can be rarely associated with cystic change, hemorrhagic necrosis, or spontaneous infarction. Necrosis of lesional tissue may be associated with malignant transformation, particularly in a pleomorphic adenoma. We report a case of 50-year-old woman presented with a enlarging right parotid mass. Computed tomographic scan demonstrated a right superficial lobe mass with ill-defined border. The preoperative fine needle aspiration yielded necrotic debris and atypical squamous elements that were thought to be compatible with high degree of mucoepidermoid carcinoma. A total parotidectomy with intraoperative frozen section revealed extensive necrosis and diagnosed as malignant tumor. This tumor was finally diagnosed as a pleomorphic adenoma with necrosis on permanent sections. Caution should be exercised in evaluation of the parotid neoplasms with central necrosis to avoid misdiagnosis of such lesions as malignancy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.505-509
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• 2011

Epithelial-myoepithelial carcinoma (EMC) is a low-grade malignant salivary gland neoplasm that was first described in 1972. EMC occurs in the older age group, there is a female predilection and mainly involves the parotid gland. Most authors recommend superficial parotidectomy as a treatment for low-grade malignant tumor in the superficial lobe of parotid gland. The treatment of epithelial-myoepithelial tumors typically includes surgical excision aimed at achieving a R0 resection. This paper reports a case of EMC of the parotid gland treated only by a conservational surgical excision. The lesion was exposed by the retromandibular approach and detached. After the parotid gland envelop was exposed, the mass was observed and was easy to remove due to capsulation. The preoperative diagnosis was a pleomorphic adenoma on the left parotid gland. The tumor was removed surgically with a conservative extracapsular dissection. The postoperative diagnosis was EMC, so superficial parotidectomy or radiation therapy was considered. Nevertheless, the patient was observed and no additional treatment was attempted because the patient was old and a successfully excision of the tumor had been achieved.

• Korean Journal of Head & Neck Oncology
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• v.6 no.2
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• pp.97-100
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• 1990

Malignant mixed tumor of the parotid gland account for a very small number of the head and neck malignancies. Authors had experienced the recurrent malignant mixed tumor on 70 years old female patient. The first surgical removal was done before the 5years ago and at that time, histological diagnosis was the malignant mixed tumor. We had done the second operation, and histopathological diagnosis was malignant mixed tumor.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.43-50
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• 1994

A retrospective analysis was performed on 55 patients with malignant parotid tumor who were treated with radiation therapy between March, 1979 and July, 1989. Of these patients, 8 patients received radiation therapy(RT) alone and 47 patients were treated with combined operation and radiation therapy(OP + RT). The follow-up period of the survivors ranged from 1 to 129 months with a median of 48 months. The common histologic types were mucoepidermoid carcinoma (25 cases), malignant mixed tumor(12 cases), adenoid cystic carcinoma(6 cases). The 5 and 10 year local control rate were 69.8% and 65.7% in all patients. In OP+RT group, prognostic factors related to local control were histologic grade, tumor size, lymph node metastasis. Resection of facial nerve did not affect the local control rate significantly(p=0.129). Distant metastasis developed in 23.6% of patients, mostly to the lung. Actuarial overall survival rate was 72.2% at 10 years and formed plateau after 5 years. Disease-free (NED) survival rate was 49.4% at 10 years and was better achieved in OP+RT group and low grade lesions. Based on our result, a well planned postoperative RT following parotidectomy is highly efficacious in controlling malignant tumors of the parotid gland and preservation of facial nerve.