OBJECTIVE: Primary squamous cell carcinoma of the parotid gland (pPSCC) is a rare tumor, accounting for less than 3% of all parotid carcinomas. There is no general consensus on the management of this tumor, since clinical experience for pPSCC is minimal. Moreover, pPSCC is often misdiagnosed for metastatic cutaneous carcinoma. In our study, we focused on evaluating its biological and clinical characteristics, treatment results and prognosis. We proposed an update on diagnostic and therapeutic management of pPSCC.
METHODS: The retrospective cohort included 18 patients diagnosed and treated for pPSCC in three tertiary head and neck centers between 2008 and 2022. We retrospectively evaluated their prognosis and established a therapeutic recommendation after analyzing our own and previously published data.
RESULTS: Fourteen of 18 tumors were diagnosed in stage IV. Five-year overall survival was 36 months. Six patients received palliative therapy. Twelve patients underwent parotidectomy, neck dissection, and adjuvant radiotherapy. Remission was achieved in 8 patients (follow-up interval 3-56 months). One patient died with recurrent disease. The others are alive and in complete remission.
CONCLUSIONS: The definitive diagnosis of pPSCC must meet the histological and clinical criteria. First of all, the metastatic origin of the tumor must be excluded. Five-year survival of this very aggressive tumor does not exceed 50%. Without surgery, the prognosis is poor. The best results, irrespective of tumor stage, are achieved with surgery. Therefore, a total parotidectomy, neck dissection (therapeutic or elective) and adjuvant radiotherapy are indicated for all resectable tumors.

Background: Radiomics of salivary gland imaging can support clinical decisions in different clinical scenarios, such as tumors, radiation-induced xerostomia and sialadenitis. This review aims to evaluate the methodological quality of radiomics studies on salivary gland imaging. Material and Methods: A systematic search was performed, and the methodological quality was evaluated using the radiomics quality score (RQS). Subgroup analyses according to the first author\'s professional role (medical or not medical), journal type (radiological journal or other) and the year of publication (2021 or before) were performed. The correlation of RQS with the number of patients was calculated. Results: Twenty-three articles were included (mean RQS 11.34 ± 3.68). Most studies well-documented the imaging protocol (87%), while neither prospective validations nor cost-effectiveness analyses were performed. None of the included studies provided open-source data. A statistically significant difference in RQS according to the year of publication was found (p = 0.009), with papers published in 2021 having slightly higher RQSs than older ones. No differences according to journal type or the first author\'s professional role were demonstrated. A moderate relationship between the overall RQS and the number of patients was found. Conclusions: Radiomics application in salivary gland imaging is increasing. Although its current clinical applicability can be affected by the somewhat inadequate quality of the papers, a significant improvement in radiomics methodologies has been demonstrated in the last year.

Different surgical techniques have been proposed for parapharyngeal space tumors, including transcervical, transparotid, trans-mandibular, infratemporal, and transoral. The choice of the correct approach depends on the size, localization and nature of the tumor. The transoral approach can be used for benign prestyloid masses, such as tumors of the deep lobe of the parotid gland. It guarantees a short hospitalization without skin scars. The narrowed access represents the main limitation of this technique. This review will summarize and analyze the current knowledge about the transoral approach to parotid lesions. Thirty-seven studies were included in a qualitative and quantitative synthesis. The novelty of this review is the quantitative analyses of the clinical data reported in the included studies.

Pleomorphic adenoma (PA), the most common salivary gland tumor, is a benign tumor that carries a risk of malignant transformation to various histologies of carcinoma ex pleomorphic adenoma (CA exPA). Recently, genomic analyses have provided deeper insights into the molecular biology of salivary gland cancers. However, the molecular processes that underlie the progression from PA to CA exPA are largely unknown. In this study, we used RNAseq data from CA ex PA of myoepithelial (n = 24) or salivary duct histology (n = 6), de novo myoepithelial carcinoma (n = 16) and de novo salivary duct carcinoma (n = 10), and compared their constituent immune tumor microenvironments. We found that increasing levels of immune infiltration and activation were associated with a generally lower probability of cancer developing ex-PA, suggesting that immune surveillance may constrain the malignant transformation of benign salivary tumors. More immunologically infiltrated tumors were more likely to have developed de novo. Taken together, these data suggest a role for tumor escape from immune surveillance in the development of CA exPA. The immune-cold microenvironments of CA ex PA tumors may in part explain their more aggressive clinical behavior.

Mucoepidermoid carcinoma (MEC) of salivary gland is a disease characterized by high rate of diatant metastasis, and associated with poor outcomes. However, the molecular mechanisms underlying the MEC remain poorly understand. Here, we simultaneously detected, for the first time, the expression profiles of mRNAs, lncRNAs, and circRNAs in four pairs of MEC and matched non-carcinoma tissues by microarrays. A total of 3612 mRNA, 3091 lncRNAs, and 284 circRNAs were altered during the pathogenesis of MEC. The functions of these differentially expressed RNAs were predicted by Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Co-expression networks of lncRNA-mRNA and circRNA-miRNA were conducted to uncovered the hidden ceRNA mechanisms. Moreover, NONHSAT154433.1 that associated with ADAM12 and hsa_circ_0012342 were further screened and confirmed using qRT-PCR analysis. In conclusion, this study provides a systematic perspective on the potential function of non-coding RNAs (ncRNAs) in the molecular mechanisms of MEC. Among these, NONHSAT154433.1 and hsa_circ_0012342 might be served as potential prognostic biomarkers and therapeutic target of MEC.

To assess the diagnostic accuracy of fine-needle aspiration (FNA) of the parotid and submandibular glands.
Case series with chart review.
Tertiary referral academic center.
Retrospective analysis was performed for all parotid and submandibular gland FNAs from a single center from 2001 to 2014. There were 1283 FNAs performed for 1076 patients. Of these, 343 cases had surgical follow-up (parotid gland, n = 272; submandibular gland, n = 71). Cases were included where the patient had a preoperative FNA, followed by surgical excision. Correlation of preoperative FNA results to final surgical pathology was performed, with measures of diagnostic accuracy computed.
Malignancy was identified in 29.0% of parotid tumors and 42.3% of submandibular tumors, based on final pathology. FNA was nondiagnostic due to insufficient cellularity for evaluation in 22 of 343 cases (6.4%) and indeterminate in 39 of 343 cases (11.4%). Diagnostic accuracy in the parotid and submandibular glands for distinguishing benign from malignant pathology was determined as follows, respectively: sensitivity, 75.0% and 91.3%; specificity, 95.1% and 94.1%; positive predictive value, 84.9% and 91.3%; and negative predictive value, 91.2% and 94.4%.
FNA has high accuracy in identifying malignancy in parotid and submandibular gland lesions when performed at a high-volume center. Preoperative FNA results provide otolaryngologists with valuable diagnostic information that may influence the surgical management of salivary gland tumors. FNA, in conjunction with cross-sectional imaging, is useful in counseling patients for a complete informed consent.

We report a rare translocation involving chromosomes 1q23 and 3p21 regions in a basaloid salivary carcinoma. Our case together with a previously reported instance of translocation involving chromosome 1q 21-24 region defines a specific chromosomal segment that may house a gene associated with the development of a subset of basaloid salivary tumors.

OBJECTIVE: To investigate and analyze the typical CT findings of salivary gland lymphoepithelial carcinoma.
METHODS: CT findings in 8 patients with lymphoepithelial carcinoma (LEC) in salivary gland were studied retrospectively. Surgical resection was performed in all cases.
RESULTS: 8 cases were subdivided to primary tumor and secondary tumor. In primary tumor group, 5 were localized in the parotid gland, 2 were found in the submandibular glands; 6 lesions had with homogeneous density, 1 was associated with cystic degeneration and 1 with calcification; the margins of lesions in 5 cases were poorly defined, while well-defined in 2. On enhanced CT: obvious enhancement was achieved in all of the 7 solitary lesions, among which 4 were homogenously enhanced while the other 3 had heterogeneous enhancement. In the 2 cases of nodules in deep lobe, retromandibular vein was affected; 7 patients had positive Epstein-Barr virus (EBV) test, with Ki-67 measurements ranged from 40% to 80%. 1 patient had LEC secondary to Benign Lymphoepithelial Lesion (BLEL), with involvement of bilateral parotid glands; the lesion was manifested as multiple differently-sized nodules, with partial cystic change, all of the nodules had clear margins, and obvious ring-shape enhancement was seen in the nodules with cystic change; the patient with secondary LEC had negative EBV test and a Ki-67 value of 20%.
CONCLUSIONS: In most cases, LEC was primary and occurred in the parotid glands. The probable diagnosis could be made based upon Dual-phase contrast-enhanced CT scan findings combined with positive expression of EBV.