What is Parotid Tumor
Parotid tumors benign pleomorphic adenoma, accounting for about 80% of parotid gland tumors and malignant breast epidermoid carcinoma ranks first, accounting for about 10% of parotid tumors. Parotid gland malignancies 1/2, followed by the pleomorphic adenoma malignant transformation, various types of adenocarcinoma and acinar cell carcinoma.
The mesenchymal tissue benign hemangioma and lymphangioma, followed lipoma minority occurred since the facial nerve neurofibroma, parotid primary malignant lymphoma of the other types of malignant tumors are rare.
Pleomorphic adenoma was the expansion slowly diffuse growth, parotid tumors can be huge and no facial paralysis. The sudden growth to accelerate or pain should be considered malignant transformation. Malignant tumors usually showed infiltrative growth involving the nerve pain or facial nerve function
Symptoms of Parotid Tumor
The parotid tumors mostly the facial nerve shallow lobe organizers, more than 80%. The vast majority of patients with parotid gland tumors discovered unintentionally painless slow-growing mass earlobe as the center. Uncertain stage of disease, the elderly up to several years or even decades. The parotid tumors performance for the pain, especially persistent pain and aggravated sexual dysfunction or paralysis of the facial nerve, is one of the signs of the parotid gland malignancies, but not all malignant tumors have this symptom. Malignancy merger facial paralysis, cervical lymph node metastasis rate increase, the prognosis is poor. Approximately 10% of parotid gland tumors occur in the parotid gland deep tissue. Location deep in the early difficult to find, when you reach a certain volume, visible the ipsilateral tonsillar above soft palate bulging.
What Causes Parotid Tumor
Tests and Diagnosis for Parotid Tumor
Careful analysis of the history and careful examination is an important means of diagnosis of parotid tumors.
Clinical examination generally benign texture is softer, perimeter clear, malignant and more hard, the perimeter often unclear. Check tumor activity to be careful to distinguish between tumor activities, or the tumor along with the entire gland activity. The location of the tumor can help in the diagnosis of parotid tumors reference. Pleomorphic adenoma often appear in the earlobe parts of Warthin tumor often occurred in the lower part of the parotid gland after preauricular joint area hard lumps often mucoepidermoid carcinoma edge ramus and mastoid such as touching the mass of poor activity, suggesting that tumors may occur in the parotid gland deep tissue.
2. Imaging studies
B-as the the parotid tumor imaging studies parotid mass lesions preferred method. Generally benign tumor was homogeneous echo, clear boundary, posterior echo enhancement, cystic lesions is particularly significant, was not homogeneous echo of malignant, the posterior echo weakened or disappear. Lymph node inflammation such as tuberculosis also have a similar change, therefore, the lack of qualitative diagnostic performance. CT parotid density lower than the surrounding muscle tissue and above the subcutaneous tissue, the tumor density higher than the glandular tissue. In addition to the cysts and lipomas level of distinction between the tumor can not be based on the density of benign and malignant. Diagnosis of parotid tumors generally benign clear boundary, high density, low-grade malignant and benign Similar malignancies generally ill-defined and irregular, often difficult to distinguish and inflammation.
TNM classification and staging
1.1987 TNM staging of the International Union Against Cancer salivary gland
T: examination and imaging.
N: examination and imaging.
M: examination and imaging.
2. Clinical classification
Tx: primary tumor can not be assessed.
T0: occult primary tumor.
T1: tumor diameter ≤ 2 mm, no local spread.
T2: tumor diameter> 2mm ≤ 4mm no local spread.
T3: tumor diameter> 4 mm, ≤ 6mm, accompanied by local spread, but the facial nerve uninvolved.
T4: tumor diameter> 6mm, associated with the base of the skull and (or) the facial nerve involvement.
Local spread to the clinically visible skin, soft tissue, bone, or nerve violated; microscope diffusion does not affect the TNM classification.
Treatments of Parotid Tumor
Surgical treatment of parotid tumors treatment, the parotid tumor therapy should be guided by two principles: First, complete a thorough resection not torn tumor, to protect the facial nerve. Accurate pathological diagnosis is the basis of the further therapeutic measures. The chemical drugs treat the majority of the parotid gland uncertain, are palliative treatment.
Well-differentiated mucoepidermoid carcinoma, acinar cell carcinoma, the limitations of small malignant tumors completely cut net, do not have to do postoperative radiotherapy. The case of the following situations, postoperative radiotherapy should be considered the: ① degree of malignancy is high, if not differentiated carcinoma, squamous cell carcinoma, poorly differentiated adenocarcinoma, salivary duct carcinoma, adenoid cystic carcinoma; ② malignant be separated save close to the facial nerve; ③ tumor invasion of muscle, bone, temporomandibular joint, or parotid deep lobe malignant tumors involving the skull base; (4) the anatomical conditions can not cut the net or postoperative microscopic examination of specimens positive margins; ⑤ parotid gland tumors surgery, although the naked eye cut net, but not after reoperation opportunity to various types of malignant tumors, recurrent malignancy reoperation.