• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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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.

• 대한두경부종양학회지
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• 제24권1호
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• pp.9-14
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• 2008

The most important concern to do parotidectomy is correct identification of the facial nerve and preservation of the nerve function. Many descriptions for the localization and branching types of the facial nerve trunk have existed. During the parotid surgery, it is necessary to have knowledges about the incidence and prognostic aspect of a invasion of the facial nerve by the parotid tumors. The method of the dissection and the surgical extent of the parotid gland would be decided not only by the anatomic variation of the facial nerve. but also the size and location of the tumor. Invasion of the facial nerve in parotid malignancies is the most significant factors affecting the prognosis, so radical parotidectomy which consists of the total extirpation of the parotid gland in conjunction with resection of the facial nerve is often required for proper management. Radical parotidectomy is advocated for the surgical treatment of high grade malignancies and in selective recurrent benign tumors intimately involving the facial nerve. Unfortunately, the morphologic and functional deficits created by sacrificing the facial nerve can be emotionally and physically traumatizing to the patient. Therefore, when the facial nerve is sacrificed, immediate reconstruction of the facial nerve should be necessary. Immediate nerve repair with direct anastomosis of the resected nerve ends or placement of a cable nerve graft provides the better cosmetic and functional results. Surgical resection remains the mainstay of treatment for cancer of the parotid gland, and there is general agreement that facial nerve should not be sacrificed unless the tumor is adherent to, or surrounds the nerve. The following statement is described general principles of troublesome management of the facial nerve during surgery for parotid tumor.

• 대한두경부종양학회지
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• 제31권2호
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• pp.39-42
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• 2015

Warthin's tumor is the second most common salivary gland benign tumor, typically occurring in the fifth to seventh decades of life which shows an indolent feature. It is usually found in the parotid gland but occasionally in extra-parotid locations such as peri-parotid lymph node. However, Report of solitary Warthin's tumor in cervical lymph node is unusual. We here report a case of 72-year-old male with simultaneous malignant melanoma on eyelid and cervical lymph node enlargement in cervical level II area thus mimicking malignancy metastasis. After excisional biopsy under the local anesthesia, pathology was reported as papillary cystadenoma lymphomatosum, which is a histologically pathognomic finding of Warthin's tumor. However, there was no suspicious tumorous lesion in major or minor salivary glands. This case suggests that Warthin's tumor should be considered as a possible pathology in solitary lymph node lesion of neck.

• 대한두경부종양학회지
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• 제5권1호
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• pp.21-25
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• 1989

It is frequently difficult to assess the presence of malignancy in patients with parotid tumor, because of unreliable diagnostic tools and riskful preoperative biopsy, In our case, a parotid adenocarcinoma and pleomorphic adenoma was revealed on permanent histologic section, which was made a impression as pleomorphic adenoma on preoperative Tru-Cut biopsy and intraoperative frozen section, So, the most accurate diagnosis of the parotid malignancy is a complete removal of tumor tissue, accompanied with permanent histologic section.

• 대한두경부종양학회지
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• 제28권1호
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• pp.12-15
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• 2012

Carcinosarcoma of the parotid gland is extremely uncommon and is known to be an aggressive malignant mixed tumor in which carcinomatous and sarcomatous elements coexist and metastasize together. We report a case of recurrent parotid gland carcinosarcoma that showed squamous cell carcinoma and chondrosarcoma in a 58-year-old woman.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.352-356
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• 2015

Basal cell adenoma (BCA) is a rare, benign neoplasm that most frequently arises in the parotid gland. We treated a 54-year-old female patient with BCA that had developed in the deep portion of the left parotid gland. The patient presented with gradual facial swelling with no other symptoms. We performed a total parotidectomy to excise the mass, but we preserved the facial nerve. Histopathology revealed a well-encapsulated mass. The tumor was composed of islands of comparatively uniform, small, dark, basaloid epithelial cells in the stroma. Histologic and immunohistochemical studies concluded that the BCA tumors were mostly trabecular. Postoperatively, there was no facial nerve weakness, and the tumor did not recur during the 24-month follow-up period.

• 대한두경부종양학회지
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• 제15권2호
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• pp.200-204
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• 1999

Objectives: Injuries of neurologic structures during parotid surgery are sometimes unavoidable even in benign tumors. Since the major postoperative neurologic complications such as facial nerve palsy and Frey's syndrome give a serious and heavy burden to both patients and surgeons, it is very important to know detailed information concerning risk factors, the incidence of complication, possibility of recovery, and the term before complete recovery. Materials and Methods: This report was based on 95 patients with parotid gland tumor who had been treated and followed up over 1 year at department of surgery and otolaryngology, chonnam university hospital. Results: 1) Among total 95 cases, the facial nerve palsy developed in 18 cases(l8.9%) and Frey's syndrome in 6 cases(6,3%). 2) The incidence of facial nerve palsy increased in cases with large tumor size, and in those operated with bipolar method. However, we didn't find out relationships between the incidence of facial palsy, localization, and histologic type. 3) The incidence of Frey's syndrome showed an increasing tendency in the cases with large tumor size, benign nature, and in those underwent superficial lobectomy with posterior approach, without a statistical significance. Conclusions: Risk of facial nerve palsy, especially a transient form, seems to be related to tumor size and bipolar coagulation method. Although Frey's syndrome tends to develop easily in the cases treated with superficial lobectomy under the diagnosis of benign tumor, a futhermore study is suggested to obtain a statistical significance.

• 대한두경부종양학회지
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• 제33권2호
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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.

• 대한두경부종양학회지
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• 제7권2호
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• pp.114-119
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• 1991

Malignant oncocytoma(oxyphil cell adenoma) is a extremely rare malignant tumor of the salivary glands and almost occurs in the parotid gland. A case of malignant oncocytoma of the parotid gland occurring in a 63 year old man is reported. Establishing a diagnosis of malignant oncocytoma essentially requires the application of two sets of criteria to the tumor under examination. First, the tumor cells must be identified as oncocyte and second, malignancy must be determined. Histochemical stains are not as useful as generally believed. Electron microscopy confirms the diagnosis by demonstrating an abundance of mitochondria. The diagnosis of malignant oncocytoma depends on several additional criteria in addition to cellular and nuclear pleomorphism, including lack of encapsulation, local infiltration, perineural and intravascular growth, and regional and/or distant metastasis. Satisfactory results from surgical resection and postoperative radiotherapy in our patient serve as additional experience in the treatment of this rare malignancy.

• Archives of Plastic Surgery
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• 제32권5호
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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.