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Pediatric salivary gland lesions.Semin
Pediatr Surg. 2006 May;15(2):76-84.
The salivary
glands comprise three main pairs of glands (ie, the parotid, the
submandibular, and the sublingual) and a number of minor glands found
in the mucosa of the upper aerodigestive tract. Lesions may be
inflammatory or obstructive in nature or may stem from granulomatous
or neoplastic disease. As such, establishing a definitive diagnosis is
often quite challenging. This article reviews widely used diagnostic
approaches and briefly describes various salivary gland lesions within
an etiologic framework.
Mucoepidermoid carcinoma of salivary glands in the
pediatric age group: 18 clinical cases, including 11 second malignant
neoplasms. Head
Neck. 2006 Sep;28(9):827-33.
BACKGROUND:
Salivary gland tumors represent 1% of head and neck tumors, with only
5% of these occurring in patients younger than 20 years.
Mucoepidermoid carcinoma (MEC) is one of the most frequent salivary
gland cancers among adults and children. METHODS: This survey was
conducted among 34 French pediatric oncology departments. From 1980 to
2000, 18 cases were reported. RESULTS: Treatment included surgery or
radiotherapy, or both. The 5-year survival rate was 93.7%. Eleven
patients had been previously treated by radiotherapy and/or
chemotherapy for a first malignant tumor, specifically, lymphoid
leukemia (n = 4), lymphoma (n = 3), brain tumor (n = 2), sarcoma (n =
1), and retinoblastoma (n = 1). CONCLUSIONS: MEC is very rare in the
pediatric age group. Treatment involves surgical removal of the tumor
plus radiotherapy, according to histologic staging. MEC has a good
prognosis in young patients. The survival rate does not differ in the
subgroup of patients with MEC as a secondary tumor.
Clinical characteristics and survival for major
salivary gland malignancies in children.Otolaryngol
Head Neck Surg. 2006 Apr;134(4):631-4.
OBJECTIVE:
Determine presentation and survival rates for malignant pediatric
salivary gland neoplasms. METHODS: All cases of malignant neoplasms
involving the parotid or submandibular gland in patients ages birth to
18 years were extracted from the Surveillance, Epidemiology, and End
Results database (1988-2001). Variables included age, gender, tumor
histology, size, follow-up time, and vital status. Kaplan-Meier
survival curves were constructed. RESULTS: 113 primary salivary gland
malignancies (103 parotid, 10 submandibular) were identified. Mean age
at presentation was 13.2 years. Female:male ratio of 5:4. Mean tumor
size was 2.5 cm. Among parotid tumors, there were 44 (43%)
mucoepidermoid carcinomas and 35 (34%) acinic cell carcinomas. At a
mean follow-up of 69.4 months, 6 (5.8%) patients with parotid
malignancy were deceased; none of the submandibular malignancies were
fatal. Mean Kaplan-Meier survival for parotid gland lesions was 153
months, with rhabdomyosarcomas exhibiting significantly worse
survivals as compared to other malignancies (P < 0.001, log-rank
test). CONCLUSIONS: Both epithelial and mesenchymal tumors present in
the pediatric salivary gland. Survival for both parotid and
submandibular gland malignancies is good in children.
Salivary gland neoplasms in children: the experience of the Istituto
Nazionale Tumori of Milan.Pediatr
Blood Cancer. 2006 Nov;47(6):806-10.
BACKGROUND:
Epithelial salivary gland tumors are very uncommon in pediatric age.
We report a series of 52 cases treated at the Istituto Nazionale
Tumori of Milan, Italy, over a 30-year period. These results are
presented in conjunction with a literature review of salivary tumors
with a view to providing an up-to-date overview of the clinical
course, prognosis, and treatment options for this rare tumor.
PROCEDURE: Fifty-two cases of epithelial salivary tumors were reviewed
and the clinical-pathological information concerning tumor
characteristics, therapy, and follow-up were collected. Patients' age
ranged between 4 and 18 years. RESULTS: The major salivary glands were
the main site of tumor occurrence (79% of cases arose in parotid
glands); 37 patients had benign tumors (pleomorphic adenoma), 15 had
malignant tumors (12 mucoepidermoid carcinoma, 9 low grade). All the
patients were treated by surgery; local relapses after parotidectomy
were 4% and 25%, in benign and malignant tumors, respectively. When
tumor enucleation was performed, recurrences occurred in 50% of benign
neoplasms. At the time of the report, all patients with benign tumors
were alive, 35(95%) without evidence of disease; only one patient with
malignant tumor died of disease. CONCLUSIONS: Epithelial salivary
glands tumor in children had different characteristics compared with
their adult counterpart with respect to the frequency of histotypes
and site of occurrence, but their prognosis seems to be similar.
Parotidectomy (total or superficial) is the best choice for achieving
good cure rates in both benign and malignant tumors.
Sialoblastoma and epithelial tumors in children: their
morphologic spectrum and distribution by age.
Adv Anat Pathol. 1999 Sep;6(5):287-92.
This commentary
addresses the histologic spectrum of salivary gland neoplasms in
children with emphasis on perinatal tumors. Histopathologically,
perinatal tumors fall into four categories: 1) histologically benign
with adult counterpart, 2) hamartomas 3) embryomas-sialoblastomas, and
4) histologically and biologically malignant adult analogue tumors.
Although the criteria to serrate benign from malignant sialoblastomas
are not well-established, the following histologic features would
favor an aggressive clinical course: perineural and/or vascular spaces
invasion, necrosis, and a cytologic atypia beyond the expected for
embryonic epithelium.
Salivary gland neoplasms in children.
Jpn J Clin Oncol. 1994;24(2):88-93.
We reviewed 20
children with salivary gland neoplasms treated at the National Cancer
Center Hospital between 1964 and 1990. Retrospective analyses of
pathological features and the clinical courses of these cases
constituted the bases of the present study. The age of onset was late
childhood in 19 cases, ranging from 9 to 20 years, but one patient was
1 year old. Approximately half (55%) the neoplasms were malignant.
Histologically, all the benign neoplasms were pleomorphic adenomas
(nine cases) and the most common malignant neoplasm was mucoepidermoid
carcinoma (six cases, 55%), followed by adenocarcinoma (three cases,
27%), adenoid cystic carcinoma (one case, 9%) and malignant mixed
tumor (one case, 9%). Recurrences of pleomorphic adenomas occurred
only in the three patients initially treated with enucleation;
meanwhile, five patients treated with superficial parotidectomy, and
one with submandibular glandectomy, had no recurrence. Recurrences of
malignant tumors occurred in all six patients initially treated with
enucleation only and in one with superficial parotidectomy but not in
two patients treated with total parotidectomy. In seven patients
treated with prophylactic neck dissection, no metastasis was
identified pathologically. The results support no enucleation of the
tumor being applied at the first operation for curing both benign and
malignant salivary gland tumors. The indication for radical neck
dissection appears to be limited.
Salivary gland neoplasms in children: a 10-year survey at the
Children's Hospital of Philadelphia. Int
J Pediatr Otorhinolaryngol.1994;29(3):195-202.
Fifteen salivary
gland tumors were treated at The Children's Hospital of Philadelphia
between 1982 and 1991. Eight of these lesions were malignant and 7
were benign. All of the benign tumors were pleomorphic adenomas. For
these, superficial parotidectomy or excision of the submandibular
gland was the treatment of choice. One child had recurrence 2 years
after her initial surgery. Among the malignant lesions, mucoepidermoid
carcinoma was diagnosed in 5 children, and acinic cell carcinoma in 3.
Six malignant tumors involved the parotid gland, while 2 originated in
the submandibular salivary gland. Superficial or total parotidectomy,
or excision of the submandibular gland was performed, according to the
nature and the location of the lesion. The facial nerve was sacrificed
in one patient because of extensive involvement of the nerve. A 2-year
survival rate of 100% was achieved, and all the patients were free of
disease at the end of the follow-up period. Successful management of
salivary gland lesions in children requires a high index of suspicion
of possible malignancy and complete surgical removal as the initial
treatment. Radiation therapy is recommended in the management of those
patients with microscopic residual tumor and/or nodal involvement.
Salivary gland disease in infancy and childhood:
non-malignant lesions.
J
Otolaryngol. 1992 Dec;21(6):422-8.
The
differential diagnosis for benign lesions of the salivary glands in
infancy and childhood can be somewhat overwhelming, especially in
light of their infrequent occurrence in a general otolaryngologic
practice. The purpose of this review is to discuss these conditions
under the headings of inflammatory conditions, immunologic disorders,
granulomatous disease, trauma, cysts, systemic disorders and benign
neoplasms. Basic techniques of diagnosis and treatment as they apply
to children will be outlined.
Salivary gland
disease in children: a review. Part 1: Acquired non-neoplastic
disease.Clin
Pediatr (Phila). 1986 Jun;25(6):314-22.
The early
recognition of salivary gland disease depends upon a high index of
suspicion by the clinician. A systematic approach to salivary gland
disease in children is presented by a group of algorithms, which is
supplemented by a discussion of the historical, physical, and
diagnostic test findings characteristic of salivary gland pathology.
Therapeutic alternatives are discussed for both neoplastic and non-neoplastic
disorders.
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