Mucoepidermoid carcinoma of the parotid gland in children - A 10-year experience

Objective: To determine the presentation, pathologic features, treatment outcome, and prognosis of mucoepidermoid carcinoma of the parotid gland in children. Design: Retrospective clinical and histopathologic study with institutional review board approval. Setting: Tertiary pediatric medical center. Patients: Seven children (4 girls and 3 boys) presented with mucoepidermoid carcinoma of the parotid gland between 1994 and 2004. Main Outcome Measures: Clinical presentation, pathologic features, treatment outcome, complications, local recurrence, distant metastasis, and overall survival. Results: All patients presented with an asymptomatic parotid mass. Initial treatment in 7 patients included total parotidectomy (n=3), superficial parotidectomy (n=3), transoral enucleation (n=1), and supraomohyoid neck dissection (n=1). Four patients required additional surgical procedures because of a close and/or positive margin, including revision parotidectomy (n=2), total parotidectomy (n=1), superficial parotidectomy (n=1), and supraomohyoid neck dissection (n=1). One patient required postoperative radiation therapy. No evidence of local recurrence or distant metastasis was noted with a mean follow-up of 3.4 years. Conclusions: Mucoepidermoid carcinoma of the parotid gland is very rare in children. Clinical stage and histologic grade are the main prognostic factors. Complete excision (superficial or total parotidectomy) with preservation of facial nerve is the treatment of choice. Neck dissection should be considered when there is clinical evidence of regional metastasis, high TNM stage, high histologic grade, and involvement of regional nodes. Because of the possibility of long-term adverse effects in pediatric patients, radiotherapy should be used only in selected cases. Long-term follow-up is essential to rule out late recurrence.