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Pediatric parotid masses
L J Orvidas1, J L Kasperbauer, J E Lewis
1Department of Otorhinolaryngology, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA. orvidas.laura@mayo.edu
Insights
Pediatric parotid masses, though uncommon, encompass diverse diagnoses including malignancy. Prompt evaluation and tailored treatment are crucial for optimal outcomes in children with these lesions.
Area of Science:
- Pediatric Otolaryngology
- Head and Neck Surgery
- Pediatric Oncology
Background:
- Parotid masses in children are rare but can present with various pathologies.
- Understanding the incidence and types of pediatric parotid lesions is essential for effective management.
Purpose of the Study:
- To determine the incidence, types, and treatment outcomes of pediatric parotid lesions.
- To establish management guidelines for pediatric parotid masses based on diagnosis.
Main Methods:
- Retrospective case review of pediatric patients with parotid masses.
- Histological and literature review to classify lesions and assess outcomes.
- Analysis of data from a tertiary care center over a 28-year period.
Main Results:
- 118 pediatric patients (birth to 18 years) were identified with parotid masses.
- Benign lesions (47.5%) and infectious/inflammatory lesions (36.4%) were most common; malignant lesions occurred in 16.1%.
- Pleomorphic adenoma and hemangioma were the most frequent benign tumors, while mucoepidermoid carcinoma was the most common malignancy. Surgical complications included facial nerve weakness.
Conclusions:
- Pediatric parotid masses require prompt evaluation and treatment due to potential malignancy.
- Management strategies should be guided by the specific pathological diagnosis.
- Further research may refine treatment protocols for these rare conditions.
Objective:
To evaluate the incidence, types, and treatment outcomes of pediatric parotid lesions.
Design:
Retrospective case review, histological tissue review, and literature review.
Setting:
Tertiary care center.
Patients:
All patients aged 18 years and younger with parotid masses evaluated and treated at the Mayo Clinic, Rochester, Minn, from January 1, 1970, to December 31, 1997.
Results:
Parotid masses were identified in 118 children (60 boys and 58 girls). At diagnosis, the ages of patients were from birth through 18 years, and 72 (61.0%) were aged 10 years and older. An asymptomatic mass was the most common presentation. Forty-three patients (36.4%) had infectious or inflammatory lesions, 56 (47.5%) had benign lesions, and 19 (16.1%) had malignant lesions. The most common benign lesions were pleomorphic adenoma (22.9%) and hemangioma (10.2%). The most common malignant lesions were mucoepidermoid carcinoma (6.8%) and acinic cell carcinoma (3.4%). The most common treatment was total parotidectomy (40.7%). Surgical complications included temporary facial nerve weakness in 22 (18.6%) patients, permanent facial weakness in 11 (9.3%), and permanent paralysis in 2 (1.7%). Pleomorphic adenoma recurred in 4 (14.8%) of 28 patients and mucoepidermoid carcinoma in 3 (37.5%) of 8 patients. One patient with adenoid cystic carcinoma died of the tumor.
Conclusions:
Although pediatric parotid masses are unusual, they can represent a variety of pathological diagnoses, including malignancy. We advocate prompt evaluation and treatment of these masses, and suggest guidelines for their management, based on diagnosis.