A dermoid cyst of the head and neck region is a relatively infrequent occurrence and accounts for only 6.9% of all dermoid cysts. Its anatomical distribution is the orbit, floor of the mouth, other midline and nose in the order of frequency. A dermoid cyst of the parotid gland is extremely rare, and due to this and the absence of pathognomonic findings, it is often difficult to diagnose preoperatively. Thus thorough and careful examination including ultrasonic study is needed to evaluate this lesion. It must be differentiated from malignant tumors and other cystic lesions. Dermoid cysts usually recur after simple excision, so it is mandatory to excise it completely with a parotidectomy. This paper presents two cases of parotid gland dermoid cyst with a brief review of the literature.
Adult ; Case Report ; Dermoid Cyst/*diagnosis/surgery ; Human ; Male ; Parotid Gland/pathology/radiography ; Parotid Neoplasms/*diagnosis/surgery ; Sialography ; Ultrasonography

Adult ; Female ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies

OBJECTIVE: To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal. METHOD: Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed. RESULT: There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later. CONCLUSION Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
Carcinoma, Adenoid Cystic ; diagnosis ; surgery ; Carcinoma, Basal Cell ; diagnosis ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; Ear Canal ; pathology ; Ear Neoplasms ; diagnosis ; surgery ; Humans ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Parotid Gland ; pathology ; Prognosis ; Retrospective Studies ; Temporal Bone ; surgery

OBJECTIVEThe aim of this study was to analyze the clinical characters, diagnosis and treatment of primary neoplasms in the parapharyngeal regions.

METHODSA total of 115 cases of primary neoplasms in the parapharyngeal regions were included in this study.

RESULTSDisorders of swallowing, breath or speaking were the common symptoms of neoplasms in parapharyngeal regions. The majority of neoplasms parapharyngeal regions were benign. 46 cases were from the deep lobe of the parotid, and 42 cases were neurogenic. CT or MRI provides useful information such as their sizes, shapes and extents. The relationship between the tumor and vessel was shown using super-selective angiography. All the tumors were resected completely by extra-oral approach through the posteroinferior incision of the mandible. The follow-up was carried out from 1 to 10 years, and the data indicated that 2 patients died, 18 cases were lost, and others had no recurrence.

CONCLUSIONCT and/or MRI are essentially useful for diagnosis and presurgical planning. Super-selective angiography can be used if the lesions involved carotid artery. Posteroinferior incision of the mandible is a simple, effective and safe approach for excision of neoplasms parapharyngeal regions.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; surgery ; Parotid Neoplasms ; diagnosis ; pathology ; surgery ; Pharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: To study the diagnosis and treatment of parotid Lymphoepithelioma-like carcinoma (LELC), and improve the rate of the diagnosis and treatment. METHOD: Eighteen cases with parotid LELC confirmed pathologically were collected in our department, and the clinical presentation, diagnosis, treatment and prognosis were retrospectively summarized and analyzed from 1982 to 2002. RESULT: All of these LELC patients were found in unilateral side. All cases received Epstein-Barr virus serological test except 2 cases because of refusing, and the testing result displayed: EBV-VCA-IGA positive rate in 93% (15/16); EBV-EA-IGA in 75% (12/ 16); EBV-DNA enzyme in 63% (10/16). Of 16 cases with facial nerve reserved, parotid superficial lobectomy were undertaken in 6 cases, resecting a majority of parotid in 5 cases, whole lobectomy in 5 cases. Facial never resection and whole lobectomy in 2 cases due to facial nerve trunk involved. Functional neck lymph dissection in superior and middle part was undertaken in 14 cases and radical neck lymph dissection in 4 cases, total neck lymph node metastasis rate was 67% (12/18). All of patients received radiotherapy to 50-70 Gy. The follow up were over 1 year, and local recurrence occurred in 2-4 years after operation for 4 cases and had to undergo reoperation. The 1, 3, 5 years survival rates of the 18 cases were 94% (17/18), 72% (13/18) and 50% (9/18), respectively. The chief Causes of death were distant metastasis and local recurrence. CONCLUSION There maybe be close relationship between occurrence of LELC and Epstein-Barr virus infection. Its histopathologic feature is similar to undifferentiated nasopharyngeal carcinoma and nasopharynx biopsy must be demanded before confirming diagnosis for eliminating metastasis focus. The neck lymph node metastasis rate of LELC is high and local invasion is strong. It is important to undergo enlarged local resection, neck lymph dissection and postoperative radiotherapy.
Adolescent ; Adult ; Aged ; Antigens, Viral ; analysis ; Carcinoma ; diagnosis ; surgery ; virology ; Female ; Herpesvirus 4, Human ; pathogenicity ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Parotid Neoplasms ; diagnosis ; surgery ; virology ; Prognosis ; Retrospective Studies ; Young Adult

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Biomarkers ; metabolism ; Carcinoma ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Keratins ; metabolism ; Membrane Proteins ; metabolism ; Middle Aged ; Mucin-1 ; metabolism ; Myoepithelioma ; metabolism ; pathology ; surgery ; Neoplasm Recurrence, Local ; Parotid Gland ; surgery ; Parotid Neoplasms ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism