Kessler A, Handler S D
Assaf Harofeh Medical Center, Zerifin, Israel.
Int J Pediatr Otorhinolaryngol. 1994 Jun;29(3):195-202. doi: 10.1016/0165-5876(94)90166-x.
Fifteen salivary gland tumors were treated at The Children's Hospital of Philadelphia between 1982 and 1991. Eight of these lesions were malignant and 7 were benign. All of the benign tumors were pleomorphic adenomas. For these, superficial parotidectomy or excision of the submandibular gland was the treatment of choice. One child had recurrence 2 years after her initial surgery. Among the malignant lesions, mucoepidermoid carcinoma was diagnosed in 5 children, and acinic cell carcinoma in 3. Six malignant tumors involved the parotid gland, while 2 originated in the submandibular salivary gland. Superficial or total parotidectomy, or excision of the submandibular gland was performed, according to the nature and the location of the lesion. The facial nerve was sacrificed in one patient because of extensive involvement of the nerve. A 2-year survival rate of 100% was achieved, and all the patients were free of disease at the end of the follow-up period. Successful management of salivary gland lesions in children requires a high index of suspicion of possible malignancy and complete surgical removal as the initial treatment. Radiation therapy is recommended in the management of those patients with microscopic residual tumor and/or nodal involvement.
1982年至1991年间，费城儿童医院共治疗了15例涎腺肿瘤。其中8例为恶性，7例为良性。所有良性肿瘤均为多形性腺瘤。对于这些肿瘤，首选的治疗方法是腮腺浅叶切除术或下颌下腺切除术。一名儿童在初次手术后2年复发。在恶性病变中，5名儿童被诊断为黏液表皮样癌，3名儿童被诊断为腺泡细胞癌。6例恶性肿瘤累及腮腺，2例起源于下颌下涎腺。根据病变的性质和位置，进行了腮腺浅叶或全叶切除术，或下颌下腺切除术。一名患者因面神经广泛受累而牺牲了面神经。2年生存率达到100%，所有患者在随访期结束时均无疾病。儿童涎腺病变的成功管理需要高度怀疑可能的恶性肿瘤，并将完整的手术切除作为初始治疗方法。对于有微小残留肿瘤和/或淋巴结受累的患者，建议进行放射治疗。
