Parotid gland metastases of distant primary tumours: A diagnostic challenge
Parotid gland metastases of distant primary tumours: A diagnostic challenge
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DOI：
10.1016/j.anl.2015.09.010
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发表时间：
2016-04-01
影响因子：
1.7
通讯作者：
Lieder, Anja
中科院分区：
文献类型：
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作者：
Franzen, Achim M.;Guenzel, Thomas;Lieder, Anja
目的：转移性疾病在腮腺恶性肿瘤中较为常见。大多数原发肿瘤位于头部和颈部，但也必须考虑锁骨以下的原发肿瘤，特别是在原发腮腺或皮肤肿瘤中不常见的组织学类型。良性肿瘤555例(86%)，恶性肿瘤89例(14%)。结果：89例恶性肿瘤中39例为转移瘤(44%)。5例原发肿瘤位于锁骨以下(占恶性肿瘤的6%)。3例患者随后被诊断为支气管癌：1例为乳腺癌，1例为肾细胞癌。结论：腮腺的大多数转移瘤来自头颈部的原发肿瘤。在10-20%的转移瘤中，原发肿瘤发生在锁骨下方。腮腺转移可以是恶性肿瘤的首发临床表现，也可以在治疗意向治疗数年后发生。组织病理学和免疫组织化学将提供可能的转移过程和原发肿瘤位置的线索：完整切除肿瘤的腮腺切除术可以是一种治疗措施，也可以构成症状控制的基本部分，除了最垂死的患者外，所有患者都应该考虑这样做。(C)2015爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: Metastatic disease is common among parotid malignancies. The majority of primary tumours are located in the head and neck, but primary tumours below the clavicle must also be considered, especially in histological types not usually found in primary parotid or skin tumours.Methods: We performed 644 consecutive parotidectomies between 1980 and 2012. Benign tumours were found in 555 patients (86%) and malignant tumours in 89 patients (14%).Results: Of 89 malignant tumours, 39 were metastases (44%). In 5 cases, the primary tumour was located below the clavicle (6% of malignant tumours). A carcinoma of the bronchus was subsequently diagnosed in three patients: one patient had breast carcinoma and one renal cell carcinoma.Conclusion: The majority of metastases in the parotid gland arise from primary tumours of the head and neck. In 10-20% of metastases, the primary tumour arises below the clavicle. Parotid metastases can be the first clinical manifestation of a malignant tumour, and can also occur years after curative intent treatment. Histopathology and immunohistochemistry will offer clues to a possible metastatic process and to primary tumour location: Parotidectomy with complete excision of the tumour can be a curative measure or form an essential part of symptom control and should be considered in all but the most moribund patients. (C) 2015 Elsevier Ireland Ltd. All rights reserved.