The aim of this study was to compare treatment modalities, pathological and clinical characteristics, and outcomes in patients with metastasis in a parotid gland. The medical records of 34 patients who received treatment for metastasis in the parotid gland over a twenty-year period were evaluated. Patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) metastasis were retrospectively reclassified using the P/N and N1S3 staging system. Patients with neck metastasis showed a significantly poorer prognosis (P = 0.025). Univariate analysis also revealed that extent of parotidectomy and type of neck dissection did not influence recurrence free survival (RFS) and overall survival (OS). When comparing the usefulness of the P/N and S1N3 staging systems, a positive correlation was observed between the P stage and the N1S3 stage in both RFS and OS. The extent of parotidectomy and concomitant neck dissection is still under discussion. Total parotidectomy and modified radical neck dissection did not improve RFS and OS. N1S3 is a less complex classification and possesses a higher predictive value when compared to the P/N staging system.

Angiosarcomas are rare, accounting for only 1-2% of sarcomas in the head and neck region. We present an extremely rare case of primary non-radiation-induced angiosarcoma of the parotid with epithelioid morphology which required a tertiary center second opinion for its histological characteristics. We discuss the presentation, imaging, diagnosis, characteristics, and pathway of this case. As parotid lumps are common, a surgical sieve is required to rule out other possible conditions. Early correct diagnosis is crucial in conditions such as angiosarcomas due to their quick metastatic potential.

We present the case of a 71-year-old man who, after undergoing postoperative radiotherapy for epithelial carcinoma, developed progressively enlarging erythema. Initially, the condition resembled radiation dermatitis or erysipelas, and topical steroids and antibacterial agents were administered without success. A biopsy was performed for further evaluation, revealing a cutaneous invasion of parotid carcinoma. The lesion continued to enlarge, leading to dysphagia and ultimately necessitating a tracheostomy.

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BACKGROUND: Basal cell adenoma is a rare, benign epithelial tumour of the salivary gland, comprising only 1-2 % of all salivary gland tumours. Predominantly found in the parotid gland, basal cell adenoma can also occur in minor salivary glands and are often confused with other benign and malignant salivary gland tumours. A thorough histopathological examination can provide a definitive diagnosis.
METHODS: A 65-year-old woman presented with a painless mass in the right infra-auricular region. Imaging revealed a well-defined hypodense lesion in the deep lobe of the right parotid gland, initially suspected as mucoepidermoid carcinoma. Fine needle aspiration was inconclusive, leading to the decision to perform a total conservative parotidectomy. Histopathology confirmed basal cell adenoma, characterized by cystic areas filled with mucoid material and basaloid cells arranged in trabecular and tubular patterns.
CONCLUSIONS: Basal cell adenoma was classified as a distinct entity by the WHO in 1991. Cytologically, they imitate both benign and malignant salivary as well as non-salivary gland tumours. The histological hallmark of basal cell adenoma involves basaloid cells with small round nuclei showing no atypia, scant pale cytoplasm, and distinct peripheral palisading. Treatment involves surgical removal, with a more radical approach for certain variants such as the membranous type.
CONCLUSIONS: This case highlights the clinical, radiological, and histopathological features of basal cell adenoma, emphasizing the importance of accurate diagnosis and appropriate surgical management. Early detection and appropriate treatment are crucial for optimizing patient outcomes in basal cell adenoma management.

Salivary gland tumors are highly variable in clinical presentation and histology. The World Health Organization (WHO) classifies 22 types of malignant and 11 types of benign tumors of the salivary glands. Diagnosis of salivary gland tumors is based on imaging (ultrasound, magnetic resonance imaging) and fine-needle aspiration biopsy, but the final diagnosis is based on histopathological examination of the removed tumor tissue. In this pilot study, we are testing a new approach to identifying peptide biomarkers in saliva that can be used to diagnose salivary gland tumors. The research material for the peptidomic studies was extracts from washings of neoplastic tissues and healthy tissues (control samples). At the same time, saliva samples from patients and healthy individuals were analyzed. The comparison of the peptidome composition of tissue extracts and saliva samples may allow the identification of potential peptide markers of salivary gland tumors in patients\' saliva. The peptidome compositions extracted from 18 tumor and 18 healthy tissue samples, patients\' saliva samples (11 samples), and healthy saliva samples (8 samples) were analyzed by LC-MS tandem mass spectrometry. A group of 109 peptides was identified that were present only in the tumor tissue extracts and in the patients\' saliva samples. Some of the identified peptides were derived from proteins previously suggested as potential biomarkers of salivary gland tumors (ANXA1, BPIFA2, FGB, GAPDH, HSPB1, IGHG1, VIM) or tumors of other tissues or organs (SERPINA1, APOA2, CSTB, GSTP1, S100A8, S100A9, TPI1). Unfortunately, none of the identified peptides were present in all samples analyzed. This may be due to the high heterogeneity of this type of cancer. The surprising result was that extracts from tumor tissue did not contain peptides derived from salivary gland-specific proteins (STATH, SMR3B, HTN1, HTN3). These results could suggest that the developing tumor suppresses the production of proteins that are essential components of saliva.

Objective:To explore the safety and aesthetic effect of modified Z-shaped cosmetic incision in parotid benign tumor resection. Methods:A prospective study was conducted. A total of 44 patients with benign parotid tumor resection were randomly divided into experimental group（n=22） and control group（n=22）. The experimental group underwent modified Z-shaped cosmetic incision, while the control group underwent the traditional S-shaped incision. The surgical duration, hospital stay, complications and maxillofacial aesthetics were compared between the two groups. Results:There was no significant difference in gender, age, surgical method, pathological type between the experimental group and the control group（P>0.05）. The maxillofacial aesthetics and surgical duration of the two groups was statistically significant（P<0.05）, while there was no statistically significant difference in terms of hospitalization days, surgical complications and Vancouver scar scale score （P>0.05）. Conclusion:The modified Z-shaped cosmetic incision has a better effect on improving the maxillofacial aesthetics after benign parotid tumor resection, and compared with the traditional S-shaped incision, the safety is consistent, so it is worthy of clinical promotion and application.
目的：探讨改良Z形美容切口在腮腺良性肿瘤切除术中的安全性和美学效果。 方法：采用前瞻性研究，将44例行腮腺良性肿瘤切除术的患者随机分为试验组（22例）和对照组（22例）。试验组采用改良Z形美容切口，对照组采用传统S形切口，比较2组在手术时长、住院天数、并发症以及颌面部美观方面的统计学差异。 结果：试验组和对照组在性别、年龄、手术方式、病理类型比较，差异无统计学意义（P>0.05）；2组对手术持续时间、视觉模拟评分进行比较，差异有统计学意义（P<0.05），但住院天数、手术并发症及温哥华瘢痕量表评分比较，差异无统计学意义（P>0.05）。 结论：改良Z形美容切口在改善腮腺良性肿瘤切除术后颌面部美观方面的效果更好，且与传统S形切口相比较，安全性一致，因此值得临床推广和应用。.

Oncocytic lesions represent a group of benign and potentially precancerous tumors characterized by the accumulation of oncocytes, which are large, granular, and eosinophilic cells. Diagnosing oncocytic lesions in the parotid gland typically involves a combination of imaging techniques, such as ultrasound, Computed Tomography (CT) scans, and Magnetic Resonance Imaging (MRI). Fine-needle aspiration (FNA) biopsy with histopathological examination remains the primary diagnostic tool for these lesions. Accurate diagnosis is crucial for appropriate management decisions. Treatment options for oncocytic lesions in the parotid gland include surgery, conservative management, and radiation therapy (RT). However, in the head and neck region, radiation doses can be a double-edged sword. While RT is a treatment modality, low radiation doses can promote the development of oncocytic lesions in the parotid gland. The prognosis for patients with oncocytic lesions is generally favorable, especially when the lesions are benign and appropriately managed. Current research focuses on the molecular mechanisms underlying oncocytic lesions in response to low-dose radiation exposure. The development of these lesions following low radiation doses represents a significant clinical concern. This manuscript provides a comprehensive overview of the current knowledge regarding oncocytic lesions in the parotid gland, including risk factors, diagnosis, treatment options, and ongoing research, offering valuable insights for clinicians and researchers.

BACKGROUND: Warthin tumor (WT) is the second most common benign tumor in salivary gland. It has a slow growth rate and most frequently occurs in the parotid gland. Most patients present with an incidental finding of a painless mass inferior/anterior to the ear. Besides the epithelial component of the tumor, WT is characteristically associated with lymphoid stroma that is considered benign. While there have been a few reports of malignant transformation of the lymphoid components in WT, cases of WT concomitant with mantle cell lymphoma (MCL) are extremely rare. To the best of our knowledge, two cases have been described in the English literature. Herein, we report a case of WT concomitant with MCL in a 70-year-old female patient, and emphasize the importance of careful examination of lymphoid stroma in WT so that concurrent lymphoma is not missed.
METHODS: A 70-year-old Chinese woman with a 40-year history of cigarette smoking presented with a one year history of a right submaxillary mass with recent enlargement.
METHODS: Cervical ultrasound (US) and computed tomography (CT) scans of the neck revealed a well-circumscribed mass in the right parotid with a maximum diameter of 3.1 cm. Surgical resection of the mass was performed. Histopathological examination revealed a characteristic double-layer of neoplastic epithelium with prominent lymphoid stroma, suggesting WT. In addition, morphology and immunohistochemistry studies confirmed the coexistence of MCL. Thereafter, the final diagnosis of this case was WT concomitant with MCL.
METHODS: The patient was staged as stage I after clinical assessment. Due to the slow growth of parotid lesions, close observation was decided with periodic clinical and radiological monitoring.
RESULTS: Currently, the patient demonstrates a stable disease by clinical evaluation.
CONCLUSIONS: To the best of our knowledge, reported cases of WT concomitant with MCL are very rare. This case highlights the importance of a comprehensive assessment of the lymphoid stroma of WT to avoid missed diagnosis of a lymphoma component in a collision tumor.

OBJECTIVE: To establish a radiomics nomogram based on MRI radiomics features combined with clinical characteristics for distinguishing pleomorphic adenoma (PA) from warthin tumor (WT).
METHODS: 294 patients with PA (n = 159) and WT (n = 135) confirmed by histopathology were included in this study between July 2017 and June 2023. Clinical factors including clinical data and MRI features were analyzed to establish clinical model. 10 MRI radiomics features were extracted and selected from T1WI and FS-T2WI, used to establish radiomics model and calculate radiomics scores (Rad-scores). Clinical factors and Rad-scores were combined to serve as crucial parameters for combined model. Through Receiver operator characteristics (ROC) curve and decision curve analysis (DCA), the discriminative values of the three models were qualified and compared, the best-performing combined model was visualized in the form of a radiomics nomogram.
RESULTS: The combined model demonstrated excellent discriminative performance for PA and WT in the training set (AUC=0.998) and testing set (AUC=0.993) and performed better compared with the clinical model and radiomics model in the training set (AUC=0.996, 0.952) and testing model (AUC=0.954, 0.849). The DCA showed that the combined model provided more overall clinical usefulness in distinguishing parotid PA from WT than another two models.
CONCLUSIONS: An analytical radiomics nomogram based on MRI radiomics features, incorporating clinical factors, can effectively distinguish between PA and WT.