Asian Oncology Research Journal

Malignant Parotid Salivary Gland Tumour: Mucoepidermoid Carcinoma- Treated with Surgical Excision and Adjuvant Therapy

Pankaj Goyal *

Apollo E.N.T. Hospital, Jodhpur, Rajasthan, India.

Kishan Kumawat

Apollo E.N.T. Hospital, Jodhpur, Rajasthan, India.

Itisha Dhiman

SRL Diagnostics, Shastri Nagar, Jodhpur, Rajasthan, India.

*Author to whom correspondence should be addressed.

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Abstract

Salivary gland tumours are quite rare. The most common symptom of salivary gland tumours is an expanding, painless swelling. Most are benign and are found in the parotid glands. The biggest obstacle in handling them is the difficulty in differentiating benign from malignant tumours. However, the majority of cases will require surgical excision as a means of arriving at a certain diagnosis. The most common type of malignant tumour of the major salivary glands is mucoepidermoid carcinoma (MEC). Investigations like fine needle aspiration cytology and Magnetic Resonance imaging scans offer some important information in this regard. Surgery alone can effectively cure early-stage low-grade malignancies, but postoperative radiation is necessary for more advanced, high-grade tumours that have metastasized to nearby lymph nodes. We presented a case of mucoepidermoid parotid carcinoma (intermediate grade) in a twenty-two-year-old male patient who was treated with surgical excision and post-operative adjuvant chemo-radiotherapy.

Keywords: Parotid gland, mucoepidermoid carcinoma, major salivary gland, MRI, surgical excision, chemo-radiotherapy

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References

McHugh JB, Visscher DW, Barnes EL. Update on selected salivary gland neoplasms. Arch Pathol Lab Med. 2009;133:1763-1774.

Védrine PO, Coffinet L, Temam S, Montagne K, Lapeyre M, Oberlin O, Orbach D, Simon C, Sommelet D. Mucoepidermoid carcinoma of salivary glands in the pediatric age group: 18 clinical cases, including 11 second malignant neoplasms. Head Neck. 2006;28:827–833.

Batsakis JG. Salivary gland neoplasia: An outcome of modified morphogenesis and cytodifferentiation. Oral Surg Oral Med Oral Pathol. 1980;49:229-232.

Stewart FW, Foote FW Jr, Becker WF. Muco-epidermoid tumors of salivary glands. Ann Surg. 1945;122:820-844

Goode RK, Auclair PL, Ellis GL. Mucoepidermoid carcinoma of the major salivary glands: Clinical and histopathologic analysis of 234 cases with evaluation of grading criteria. Cancer. 1998;82:1217-1224.

Brandwein MS, Ivanov K, Wallace DI, et al. Mucoepidermoid carcinoma: A clinicopathologic study of 80 patients with special reference to histological grading. Am J Surg Pathol. 2001;25:835-845.

Nascimento AG, Amaral LP, Prado LA, Kligerman J, Silveira TR. Mucoepidermoid carcinoma of salivary glands: A clinicopathologic study of 46 cases. Head Neck Surg. 1986;8:409-417.

Califano L, Zupi A, Massari PS, Giardino C. Indication for neck dissection in carcinoma of the parotid gland: Our experience on 39 cases. Int Surg. 1993;78:347-349.

Luna MA. Salivary mucoepidermoid carcinoma: Revisited. Adv Anat Pathol. 2006;13:293-307.

Tirado Y, Williams HD, Hanna EY, Kaye FJ, Batsakis JG, El-Naggar AK. CRTC1/MAML2 fusion transcript in high grade mucoepidermoid carcinomas of salivary and thyroid glands and Warthin’s tumors: Implications for histogenesis and biologic behavior. Genes Chromosomes Cancer. 2007;46: 708-715.

Cheuk W, Chan JK. Advances in salivary gland pathology. Histopathology. 2007;51: 1-20.

Spiro RH, Huvos AG, Berk R, Strong EW. Mucoepidermoid carcinoma of salivary gland origin: A clinicopathologic study of 367 cases. Am J Surg. 1978;136:461-468.

Byrd SA, Spector ME, Carey T, Bradford CR, McHugh JB. Predictors of recurrence and survival for head and neck mucoepidermoid carcinoma. Otolaryngol. Neck Surg. 2013;149:402–408.

Gilbert J, Li Y, Pinto HA, et al. Phase II trial of taxol in salivary gland malignancies (E1394): A trial of the Eastern Cooperative Oncology Group. Head Neck. 2006;28:197-204.

Horn-Ross PL, Morrow M, Ljung BM. “Diet and the risk of salivary gland cancer.” American Journal of Epidemiology. 1997;146(2):171–176.

Swanson GM, Burns PB. “Cancers of the salivary gland: workplace risks among women and men.” Annals of Epidemiology. 1997;7(6):369–374.

Dong C, Hemminki K. “Second primary neoplasms among 53 159 haematolymphoproliferative malignancy patients in Sweden, 1958–1996: A search for common mechanisms.” British Journal of Cancer. 2001;85(7):997–1005.

Orell SR. “Diagnostic difficulties in the interpretation of fine needle aspirates of salivary gland lesions: The problem revisited.” Cytopathology. 1995;6(5):285–300.

Li CZ, Sun MY, Zhang XH, Luo XL, Sun WB. Analysis of postoperative survival rates of mucoepidermoid carcinoma in salivary gland. Zhonghua Kou Qiang Yi Xue Za Zhi. 2006;41:709–712.

Ali S, Sarhan M, Palmer FL, Whitcher M, Shah JP, Patel SG, Ganly I. Cause-specific mortality in patients with mucoepidermoid carcinoma of the major salivary glands. Ann. Surg. Oncol. 2013;20:2396–2404.

Chen M, Roman SA, Sosa JA, Judson BL. Histologic grade as prognostic indicator for mucoepidermoid carcinoma: A population-level analysis of 2400 patients. Head Neck. 2013;36:158–163.

Agulnik M, McGann C, Mittal B, Gordon S, Epstein J. “Management of salivary gland malignancies: current and developing therapies. Oncology Reviews. 2008;2(2): 86– 94.

Armstrong JG, Harrison LB, Spiro RH, Fass DE, Strong EW, Fuks ZY. “Malignant tumors of major salivary gland origin: A matched-pair analysis of the role of combined surgery and postoperative radiotherapy. Archives of Otolaryngology. 1990;116(3):290–293.