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妊娠期唾液腺肿瘤——治疗策略

Salivary Gland Tumors in Pregnancy-Treatment Strategies.

作者信息

Wierzbicka Małgorzata, Radomska Katarzyna, Pietruszewska Wioletta, Stodulski Dominik, Mikaszewski Bogusław, Markowski Jarosław, Burduk Paweł, Woźniak Aldona, Lubiński Jakub, Rzepakowska Anna

机构信息

Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, 51-124 Wroclaw, Poland.

Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland.

出版信息

J Clin Med. 2025 Apr 30;14(9):3136. doi: 10.3390/jcm14093136.

Abstract

: The management of salivary gland tumors (SGTs) during pregnancy is a subject that has received scant attention in the medical literature. While treatment recommendations for cancer therapy in pregnancy have been delineated, those for benign tumors remain unspecified. The present inquiry focuses on the number of women of reproductive age with SGTs and the optimal diagnostic and treatment strategies for tumors occurring during pregnancy. : This was a retrospective multicenter cohort study based on data from the Polish Salivary Network Database, collected between 2018 and 2022. From a total of 2653 patients with salivary gland tumors (SGTs), we identified 1313 women, including 300 of reproductive age (16-42 years). Among them, six cases of SGTs diagnosed during pregnancy were included for detailed analysis. Ethical approval was obtained for this study. : Among the 300 women of reproductive age, 285 had benign SGTs and 15 had malignant SGTs. Six tumors were diagnosed during pregnancy: four benign (pleomorphic adenomas) and two malignant (salivary duct carcinoma and mucoepidermoid carcinoma). All benign tumors were monitored during pregnancy and surgically treated postpartum. One malignant tumor was resected postpartum, while the second showed a rapid progression in late pregnancy and required early intervention. Individual case details highlighted the diagnostic and therapeutic complexity in this population. : A standard diagnostic protocol, incorporating ultrasounds and a fine-needle aspiration biopsy, is recommended during pregnancy. For cases in which the clinical and imaging characteristics suggest a benign origin, surveillance is proposed. Conversely, surgical resection is recommended for malignant SGTs, irrespective of the gestational stage. The potential for the malignant transformation of benign tumors during pregnancy in young women underscores the necessity for surgical intervention prior to planned conception.

摘要

孕期唾液腺肿瘤(SGTs)的管理是医学文献中鲜有关注的一个主题。虽然已经明确了孕期癌症治疗的推荐方案,但对于良性肿瘤的治疗建议仍未明确。本研究聚焦于患有SGTs的育龄女性数量以及孕期发生肿瘤的最佳诊断和治疗策略。

这是一项基于波兰唾液腺网络数据库2018年至2022年收集的数据的回顾性多中心队列研究。在总共2653例唾液腺肿瘤患者中,我们确定了1313名女性,其中包括300名育龄女性(16 - 42岁)。其中,纳入了6例孕期诊断为SGTs的病例进行详细分析。本研究获得了伦理批准。

在300名育龄女性中,285例患有良性SGTs,15例患有恶性SGTs。孕期诊断出6例肿瘤:4例良性(多形性腺瘤)和2例恶性(涎腺导管癌和黏液表皮样癌)。所有良性肿瘤在孕期进行监测,产后进行手术治疗。1例恶性肿瘤产后切除,而另1例在孕晚期迅速进展,需要早期干预。个别病例细节凸显了该人群诊断和治疗的复杂性。

建议孕期采用包括超声和细针穿刺活检的标准诊断方案。对于临床和影像学特征提示为良性起源的病例,建议进行监测。相反,无论妊娠阶段如何,对于恶性SGTs均建议手术切除。年轻女性孕期良性肿瘤发生恶性转化的可能性强调了在计划受孕前进行手术干预的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a10/12072509/9b7276c26997/jcm-14-03136-g001.jpg

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