Cancer Metastatic to the Parotid Gland

Carcinoma metastatic to the parotid gland is a region-specific disorder. History usually reveals a previous cutaneous squamous cell carcinoma (SCC) or melanoma. Physical examination may show scars of previous operations, current head and neck lesions, associated lymphadenopathy, and altered sensation. Investigations include fiberoptic naso-endoscopy, fine needle aspiration cytology, computed tomography scan, magnetic resonance imaging, and positron emission tomography. Treatment options include surgery (ablative/reconstructive), radiotherapy (indicated for SCC and melanoma), chemotherapy (indicated for SCC), chemo-immunotherapy (may have a role for melanoma). Complications to avoid include (1) wound-related complications (skin flap necrosis and skin flap “button-hole” formation), (2) tumor-related complications (inappropriate surgery due to inadequate preoperative investigation or omitting neck dissection in patients with concomitant neck disease, tumor rupture, and local tumor recurrence), (3) gland-related complications (salivary fistula and sialocele), and (4) nerve-related complications (facial nerve injury, Frey's syndrome or gustatory sweating, and great auricular nerve neuroma).

2016 ◽  
Vol 60 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Monica Onorati ◽  
Marta Nicola ◽  
Chiara Luisa Bianchi ◽  
Francesco Bini ◽  
Nadia Bellaviti ◽  
...  

Background: The aim of the current case report is to re-evaluate the key features and pitfalls of fine-needle aspiration cytology (FNAC) in the diagnosis of sclerosing pneumocytoma (previously named sclerosing hemangioma) and to establish the importance of FNAC in addressing a proper surgical strategy. Case: Herein we documented a case of a 70- year-old man with a lung nodule which showed a hypermetabolic uptake on positron emission tomography. He therefore underwent FNAC under computed tomography scan guidance with a 22-gauge needle. The cytopathological examination allowed a diagnosis of sclerosing pneumocytoma. A wedge surgical excision was performed and the histological examination confirmed the cytological diagnosis. Conclusion: FNAC is a fundamental tool for distinguishing sclerosing pneumocytoma from a malignant lung tumour and together with clinical, radiological and pathological multidisciplinary assessment is indispensable in planning appropriate surgical management. Cytopathologists should be aware of the pitfalls and key features of the cytopathological diagnosis of sclerosing pneumocytoma, which can significantly change the surgical approach to the patient and protect him from aggressive overtreatment.


2020 ◽  
Vol 13 (12) ◽  
pp. e234366
Author(s):  
Jason Wee ◽  
Salar Sobhi ◽  
Bastiaan De Boer ◽  
Dan Xu

We describe a case of a 61-year-old man with a background of rheumatoid arthritis who presented to the emergency department with a single-reported episode of haemoptysis on the background of an upper respiratory tract infection. A CT scan revealed an incidental 40 mm mass in upper right lobe of the liver abutting the diaphragmatic surface. A subsequent positron emission tomography scan confirmed the mass and raised the possibility of another lesion in the liver raising the suspicion of malignancy. The case was complicated by the inability to perform a fine needle aspiration biopsy due to the mass’ proximity to the diaphragm. After discussion with the patient, it was decided to resect the affected liver segment. Histological analysis of the mass revealed localised necrotising granulomatous inflammation suggestive of a rheumatoid nodule, which is seldom reported in the literature.


2013 ◽  
Vol 7 (4) ◽  
pp. 409-415 ◽  
Author(s):  
Alfredo E. Romero-Rojas ◽  
Julio A. Diaz-Perez ◽  
Deirdre Amaro ◽  
Alfonso Lozano-Castillo ◽  
Sandra I. Chinchilla-Olaya

2021 ◽  
Vol 14 (2) ◽  
pp. e236372 ◽  
Author(s):  
Sanchit Sharma ◽  
Anoop Saraya ◽  
Prasenjit Das ◽  
Deepak Gunjan

The report describes a patient with cholestatic jaundice who had incidentally detected parathyroid hormone-independent hypercalcaemia. The differential diagnosis for this presentation includes systemic granulomatous and infiltrative disorders, drug-induced liver injury and malignancy. As the initial investigations were non-contributory towards the aetiology, she was given steroids and later plasma exchange for symptomatic treatment. The differentials were revised again in view of no clinical and biochemical response. A repeat fine-needle aspiration cytology of the thyroid nodule (seen on positron emission tomography/CT) revealed papillary carcinoma of the thyroid. The patient underwent total thyroidectomy. There was a complete normalisation of liver function tests and serum calcium, and resolution of pruritus 3 months post surgery. She was retrospectively diagnosed as a case of papillary carcinoma of the thyroid with paraneoplastic manifestations—hypercalcaemia and cholestatic jaundice—which got resolved with treatment of the primary tumour.


2021 ◽  
Author(s):  
Olga Guiban ◽  
Antonello Rubini ◽  
Daniele Fresilli ◽  
Giuseppe Tiziano Lucarelli ◽  
Massimo Ralli ◽  
...  

Aims: To evaluate the pre-surgical diagnostic value of Multiparametric Ultrasound (MPUS) and Fine Needle Aspiration Cytology (FNAC) in differentiating parotid gland tumors, comparing the results with histology. Materials and methods:The study enrolled 84 patients with parotid gland lesions surgically treated in a single tertiary center and evaluated by MPUS. Each patient underwent FNAC. Histological examination was considered the gold standard. Results: Histology identified 62 benign tumors and 22 malignancies. In the differential diagnosis between malignant and benign lesions, B-mode Ultrasound (US), Color-Doppler US, Contrast-Enhanced US (CEUS), Elastography (USE) and FNAC showed the following values of sensitivity: 82%, 81%, 86%, 77%, 73% respectively; specificity: 97%, 61%, 95%, 71%, 97% respectively; PPV: 90%, 43%, 86%, 50%, 89% respectively; NPV: 93%, 90%, 95%, 88%, 91% respectively; and accuracy: 89%, 71%, 90%, 78%, 84% re-spectively. Conclusions: CEUS proved to be a valid and accurate method for identifying malignant tumors of parotid gland; the combination of B-mode US with CEUS showed similar diagnostic accuracy, but better sensitivity than CEUS taken alone. USE did not improve the diagnostic performance of the B-mode US, alone or in association with CEUS; however, it revealed the highest diagnostic accuracy in the differentiation between benign lesions. FNAC demonstrated lower values in comparison with CEUS and with USE. Therefore, according to our study, MPUS could be proposed as a valid alternative to FNAC.


2018 ◽  
Vol 275 (11) ◽  
pp. 2609-2613 ◽  
Author(s):  
Peter Zbären ◽  
Asterios Triantafyllou ◽  
Kenneth O. Devaney ◽  
Vincent Vander Poorten ◽  
Henrik Hellquist ◽  
...  

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