parotid tumors

Discussion in 'MRCS Forum' started by Javed., Jan 24, 2008.

  1. Javed.

    Javed. Guest

    Q. A 33-year-old woman seeks assistance because of a swelling of her right parotid gland. Biopsy is performed and reveals acinar carcinoma. In your discussion regarding, which of the following statements regarding malignant parotid tumors is correct?

    a- Acinar carcinoma is a highly aggressive malignant tumour of the parotid gland
    b- Squamous carcinoma of the parotid gland exhibits only moderately malignant behaviour
    c- Regional node dissection for occult metastases is not indicated for malignant parotid tumours because of their low incidence and the morbidity of lymphadenectomy
    d- Facial nerve preservation should be attempted when the surgical margins of resection are free of tumor
    e- Total parotidectomy (superficial and deep portions of the gland) is indicated for malignant tumors
  2. Javed.

    Javed. Guest

    Answer: d. (Schwartz, 7/e, pp 656-662) Acinar, adenoid cystic, and low grades of Mucoepidermoid carcinomas exhibit moderately malignant behaviour. Undifferentiated, squamous and high grades of Mucoepidermoid carcinomas are considered highly malignant tumors. Regional node dissection is indicated for malignant tumors because of the high (up to 50%) incidence of occult regional metastases. Facial nerve preservation should be attempted when the margins are adequate and the tumor is well localized. The minimal appropriate procedure for parotid carcinoma is a superficial parotidectomy with nerve preservation. The nerve must be partially or totally sacrificed if the tumor directly involves the nerve trunk or its branches.

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