Hornung Benita, Constantinidis Jannis, Thimsen Vivian, Agaimy Abbas, Koch Michael, Gostian Antoniu-Oreste, Sievert Matti, Müller Sarina Katrin, Iro Heinrich, Mantsopoulos Konstantinos
Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
1st Deparment of ORL, Head & Neck Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
J Clin Med. 2021 Dec 28;11(1):142. doi: 10.3390/jcm11010142.
The aim of this study was to investigate the histopathologic findings in parotid and parapharyngeal pleomorphic adenomas and draw conclusions concerning the surgical strategy.
Retrospective study of medical charts of patients with resected pleomorphic adenomas (PA) between 2005 and 2020 at two tertiary medical referral centers. Histologic specimens were reexamined by an experienced head and neck pathologist. Patients with insufficient/incomplete data were excluded from our study sample.
A total of 844 patients formed our study sample (291 men, 553 women, average age 48.9 years); 786 cases had a PA in the parotid gland (PG) (93.1%), and the remaining 58 cases had a PA in the parapharyngeal space (PS) (6.9%). Recurrences were detected in 8/844 cases (7/786 in the PG, 1/58 in the PS, 0.94% in total) with a mean follow-up time of 86.7 months (10-189 months) with no statistically significant differences between the study groups ( = 0.527). Our analysis showed that parapharyngeal pleomorphic adenomas are characterized by a lower incidence of an intact anatomical capsule (71.4% vs. 82.6%, = 0.035) and a remarkably more frequent occurrence of satellite nodules (20.7% vs. 7.5%, < 0.001).
The more challenging histopathologic profile of parapharyngeal pleomorphic adenomas points towards the fact that parapharyngeal surgery should remain in the hands of experienced surgeons at high-volume centers.
本研究旨在调查腮腺和咽旁多形性腺瘤的组织病理学表现，并得出有关手术策略的结论。
对2005年至2020年期间在两个三级医疗转诊中心接受多形性腺瘤（PA）切除术的患者病历进行回顾性研究。组织学标本由一位经验丰富的头颈病理学家重新检查。数据不足/不完整的患者被排除在我们的研究样本之外。
共有844名患者构成我们的研究样本（男性291名，女性553名，平均年龄48.9岁）；786例在腮腺（PG）中有PA（93.1%），其余58例在咽旁间隙（PS）中有PA（6.9%）。在8/844例患者中检测到复发（PG中7/786例，PS中1/58例，总计0.94%），平均随访时间为86.7个月（10 - 189个月），研究组之间无统计学显著差异（ = 0.527）。我们的分析表明，咽旁多形性腺瘤的特征是完整解剖包膜的发生率较低（71.4%对82.6%， = 0.035），卫星结节的出现频率明显更高（20.7%对7.5%， < 0.001）。
咽旁多形性腺瘤更具挑战性的组织病理学特征表明，咽旁手术应仍由高容量中心经验丰富的外科医生进行。
