Malignant parotid tumors in patients under 20 years of age

Since 1944, 26 patients with parotid cancer who were under 20 years of age have been seen and treated at the University of Texas M.D. Anderson Hospital and Tumor Institute at Houston by a single group of surgeons with a similar therapeutic approach. Follow-up data were obtained in all patients up to 26 years. Mucoepidermoid and adenocarcinomas were the most common histologic cell types. None of the 26 patients initially had either facial nerve paralysis or palpable nodal metastasis. Initial treatment for 21 of the 26 patients consisted of a parotidectomy and neck dissection. The overall absolute two-year survival and above-clavicle control was 88%. A poor prognosis correlated well with adverse tumor criteria such as poor differentiation histologically, nodal metastasis, nerve invasion, and locally invasive disease. Aggressive local-regional treatment is recommended since only two patients died of distant metastasis as the sole manifestation of their treatment failure. The use of postoperative irradiation must be carefully selected in these young patients since severe irradiation complications developed in three of the five long-term survivors.