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[Cylindroma of the parotid gland. Apropos of 11 cases]
Y Lacomme1, F Dhermain, E Serrano
1Clinique d'ORL et de Chirurgie Maxillo-Faciale, Hôpital Rangueil, Toulouse.
Abstract:
Few studies have been exclusively devoted to date to parotid cylindromas, essentially because of their rarity and their very slow progression. However, these tumours have a serious prognosis. Although local control appears to be better with complementary radiotherapy, the vital prognosis depends entirely on the presence or absence of distant metastases, essentially pulmonary. The analysis of 11 cases of parotid cylindroma leads the authors to propose a rational management. When the tumour is localised, particularly to the superficial lobe, careful total parotidectomy with preservation of the facial nerve is performed; neck dissection is only performed in the presence of obvious lymph node involvement. Postoperative irradiation is not systematically indicated. In the case of a voluminous tumour or in an obviously incomplete resection, deliberate sacrifice of the facial nerve is not essential, as radiotherapy allows good local control. Extensive mutilating operations do not appear to be justified. Chemotherapy requires the use of more effective drugs than those used at the present time. The complete remission rate in the present series was 60% at six years, but a much longer observation period is required, as the very delayed appearance of metastases is always possible.