Risk of Carcinoma in Pleomorphic Adenomas of the Parotid

被引:7
|
作者
Levyn, Helena [1 ]
Subramanian, Tejas [2 ]
Eagan, Alana [1 ]
Katabi, Nora [3 ]
Lin, Oscar [3 ]
Badillo, NatalieDeana Dizon [2 ]
Martinez, German [3 ]
Scholfield, Daniel W. [1 ]
Wong, Richard J. [1 ]
Shah, Jatin P. [1 ]
Givi, Babak [1 ]
Morris, Luc G. T. [1 ]
Ganly, Ian [1 ]
Patel, Snehal G. [1 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, 1275 York Ave,C1083, New York, NY 10065 USA
[2] Weill Cornell Med, New York, NY USA
[3] Mem Sloan Kettering Canc Ctr, Dept Pathol, New York, NY 10065 USA
基金
美国国家卫生研究院;
关键词
D O I
10.1001/jamaoto.2023.3212
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Importance: Surgery is the mainstay of treatment for pleomorphic adenomas (PAs) of the parotid to prevent further growth and potential future malignant transformation. While historical case series have reported transformation rates as high as 10%, there is a lack of contemporary methodologically sound data. Objective: To examine the rate of carcinoma ex pleomorphic adenoma (CXPA) detection in untreated PAs and investigate factors associated with malignant neoplasm. Design, Setting, and Participants: This cohort study reviewed all cases of primary PAs managed at a quaternary referral center between December 1990 and January 2015. Patients whose clinical presentation was compatible with a primary benign PA and whose history indicated tumor duration of over 1 year were included. Data were analyzed from January to April 2023. Exposure: Untreated PA. Main Outcomes and Measures: Rate of CXPA detection among untreated PAs and association of tumor duration with rates of CXPA detection. Pathology slides of patients who underwent surgery were reviewed by a single expert pathologist for the presence of CXPA. Univariable logistic regression was performed to evaluate possible factors associated with CXPA. Results: A total of 260 patients (median age, 47 years [IQR, 38-60 years]; 174 [66.9%] female) had a median tumor duration of 3.2 years (range, 1-30 years; mean [SD], 5.7 [5.5] years). Patients were divided into 4 groups by tumor duration: 1 to 4 years (158 [60.7%]), 5 to 9 years (47 [18.1%]), 10 to 14 years (27 [10.4%]), and 15 to 30 years (28 [10.8%]). In 156 of 170 patients who underwent preoperative fine-needle aspiration (91.8%), a benign tumor was diagnosed; 5 of these patients (3.2%; 95% CI, 1.4%-7.3%) were later diagnosed with CXPA on pathology after eventual excision, and the rate of high grade CXPA was 1.3%. None of the patients had permanent facial nerve paralysis. Tumor size at presentation (odds ratio [OR], 1.66; 95% CI, 1.22-2.24) and incremental (per year) increase in age (OR, 1.04; 95% CI, 1.01-1.08) were found to be associated with CXPA, whereas tumor duration was not (OR, 1.00; 95% CI, 1.00-1.01). Conclusions and Relevance: In this study, the rate of malignant neoplasm detection among initially untreated PA was 3.2%. The results suggest that tumor size and older age are associated with the development of CXPA, while tumor duration is not. Observation of PA for longer periods was not associated with serious permanent complications.
引用
收藏
页码:1034 / 1041
页数:8
相关论文
共 50 条
  • [21] Histopathological comparison of pleomorphic adenomas of the parotid and submandibular gland
    Mantsopoulos, Konstantinos
    Sievert, Matti
    Iro, Ann-Kristin
    Mueller, Sarina Katrin
    Koch, Michael
    Schapher, Mirco
    Agaimy, Abbas
    Iro, Heinrich
    ORAL DISEASES, 2022, 28 (04) : 1131 - 1136
  • [22] Giant Pleomorphic Adenomas of Parotid Gland: a Case Series
    Pareek, Yogendra Kumar
    Gupta, Deendayal
    Aseri, Yogesh
    Rawat, Digvijay Singh
    Singh, Bhuvenesh K.
    Verma, Praveen Chandra
    INDIAN JOURNAL OF OTOLARYNGOLOGY AND HEAD & NECK SURGERY, 2022, 74 (SUPPL 2) : 2008 - 2013
  • [23] Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience
    Kumus, Ozgur
    Ikiz, Ahmet Omer
    Sarioglu, Sulen
    Erdag, Taner Kemal
    TURKISH ARCHIVES OF OTORHINOLARYNGOLOGY, 2016, 54 (03) : 112 - 117
  • [24] Giant Pleomorphic Adenomas of Parotid Gland: a Case Series
    Yogendra Kumar Pareek
    Deendayal Gupta
    Yogesh Aseri
    Digvijay Singh Rawat
    Bhuvenesh K. Singh
    Praveen Chandra Verma
    Indian Journal of Otolaryngology and Head & Neck Surgery, 2022, 74 : 2008 - 2013
  • [25] Multiple primary pleomorphic adenomas of the unilateral parotid gland
    Helmstaedter, V.
    Beutner, D.
    Drebber, U.
    Huttenbrink, K. B.
    Streppell, M.
    LARYNGO-RHINO-OTOLOGIE, 2007, 86 (06) : 448 - 450
  • [26] SUPER-FACIAL PAROTIDECTOMY FOR PLEOMORPHIC PAROTID ADENOMAS
    HAWE, MJG
    BELL, DM
    CLINICAL ONCOLOGY, 1982, 8 (03): : 207 - 213
  • [27] New genetic findings in parotid gland pleomorphic adenomas
    Wemmert, Silke
    Willnecker, Vivienne
    Brunner, Christian
    Wenzel, Gentiana Ioana
    Sauter, Birgit
    Meinelt, Heike
    Bartholme, Nadia
    Saada, Carolin
    Bohle, Rainer Maria
    Urbschat, Steffi
    Schick, Bernhard
    HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2013, 35 (10): : 1431 - 1438
  • [28] Oestrogen receptor β expression in pleomorphic adenomas of the parotid gland
    Wong, M. H. W.
    Dobbins, T. A.
    Tseung, J.
    Tran, N.
    Lee, C. S.
    O'Brien, C. J.
    Clark, J.
    Rose, B. R.
    JOURNAL OF CLINICAL PATHOLOGY, 2009, 62 (09) : 789 - 793
  • [29] DNA copy number alterations in pleomorphic adenomas and carcinoma ex-pleomorphic adenomas
    Senguven, B.
    Gultekin, E.
    High, A.
    Daly, C.
    Rabbitts, P.
    VIRCHOWS ARCHIV, 2012, 461 : S157 - S158
  • [30] BENIGN AND MALIGNANT PAROTID PLEOMORPHIC ADENOMAS - CT AND MR STUDIES
    SOM, PM
    SHUGAR, JMA
    SACHER, M
    STOLLMAN, AL
    BILLER, HF
    JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 1988, 12 (01) : 65 - 69