Rahbar Reza, Grimmer J Fredrik, Vargas Sara O, Robson Caroline D, Mack Jennifer W, Perez-Atayde Antonio R, Marcus Karen J, Grier Holcombe E, Healy Gerald B, McGill Trevor J
Department of Otolaryngology, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Arch Otolaryngol Head Neck Surg. 2006 Apr;132(4):375-80. doi: 10.1001/archotol.132.4.375.
To determine the presentation, pathologic features, treatment outcome, and prognosis of mucoepidermoid carcinoma of the parotid gland in children.
Retrospective clinical and histopathologic study with institutional review board approval.
Tertiary pediatric medical center.
Seven children (4 girls and 3 boys) presented with mucoepidermoid carcinoma of the parotid gland between 1994 and 2004.
Clinical presentation, pathologic features, treatment outcome, complications, local recurrence, distant metastasis, and overall survival.
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.
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.
确定儿童腮腺黏液表皮样癌的临床表现、病理特征、治疗结果及预后。
经机构审查委员会批准的回顾性临床和组织病理学研究。
三级儿科医疗中心。
1994年至2004年间，7名儿童（4名女孩和3名男孩）被诊断为腮腺黏液表皮样癌。
临床表现、病理特征、治疗结果、并发症、局部复发、远处转移及总生存率。
所有患者均表现为无症状的腮腺肿块。7例患者的初始治疗包括全腮腺切除术（n = 3）、浅叶腮腺切除术（n = 3）、经口摘除术（n = 1）和肩胛舌骨上颈清扫术（n = 1）。4例患者因手术切缘接近和/或阳性而需要额外的手术，包括腮腺改良切除术（n = 2）、全腮腺切除术（n = 1）、浅叶腮腺切除术（n = 1）和肩胛舌骨上颈清扫术（n = 1）。1例患者需要术后放疗。平均随访3.4年，未发现局部复发或远处转移的证据。
儿童腮腺黏液表皮样癌非常罕见。临床分期和组织学分级是主要的预后因素。保留面神经的完整切除（浅叶或全腮腺切除术）是首选治疗方法。当有区域转移的临床证据、高TNM分期、高组织学分级和区域淋巴结受累时，应考虑行颈清扫术。由于儿科患者可能出现长期不良反应，放疗仅应在特定病例中使用。长期随访对于排除晚期复发至关重要。
