Tratamiento quirúrgico de las neoplasias en la glándula parótida / Surgical treatment of the neoplasmsof the parotid gland

Objetivo: Caracterizar a pacientes con diagnóstico de neoplasias en glándula parótida, según el procedimiento quirúrgico efectuado, la técnica de identificación del nervio facial, y la relación de los hallazgos patológicos definitivos con los estudios de muestreo histológico preoperatorio. Métodos: Estudio multidisciplinario, multiinstitucional, descriptivo, cuantitativo y retrospectivo de 26 pacientes con diagnóstico de neoplasias en glándula parótida entre el año 2018 al 2023. Se dividieron de acuerdo a la histología en benignas y malignas. Las distintas frecuencias fueron expresadas en número y porcentaje. Se calculó la sensibilidad y especificidad de la punción con aguja fina como prueba de muestreo histológico. Resultados: Categoría benigna: 16 pacientes (61,5% %). El resto de la serie, diez pacientes, de la categoría de tumores malignos (38,5%). La lobectomía superficial parotídea fue el procedimiento más frecuente en las neoplasias benignas (75%) y malignas (60%). La técnica anterógrada de identificación del nervio facial fue la más común. Entre 25% a 30% de parálisis temporales en ambos grupos. La sensibilidad y especificidad de la punción con aguja fina para el diagnóstico de neoplasias benignas fue de 92,3% y 50%, el porcentaje de falsos negativos de 5,8%. Conclusión: La lobectomía superficial de la glándula parótida y la técnica anterógrada representaron el procedimiento quirúrgico y la técnica de identificación del nervio facial más frecuentemente realizado en ambas categorías. La baja especificidad de la punción con aguja fina y el porcentaje de falsos negativos representaron algunas de las dificultades a afrontar para decidir la extensión del tratamiento quirúrgico(AU)

Objective: To evaluate the surgical procedure, technique identification of nerve facial and correlate the pathological findings withthe preoperative histological sampling studies, in patients with neoplasms parotid underwent surgery. Methods: Study multi-institutiona, multi-disciplinary, descriptive y quantitative of 26 patients with neoplasm parotid between the years 2018 to 2023. We divided in two categories benign and malignant. The frequency was expressed in number and percentage. It was calculated the sensibility and specificity of the fine needle puncture. Results: Category benign: 16 patients (61,5% %). Malignant, ten patients (38,5%). The lobectomy superficial was the surgical procedure more frequent in the neoplasm benign (75%) and malignant (60%). The anterograde technique of identification of nerve facial was the more common. Between 25% and 30% presents facial palsytemporal. The sensibility and specificity of the fine needle puncture were 92,3% y 50%, the percentage of false negatives was 5,8%. Conclusion: In this study the lobectomy superficial and anterograde technique were the surgical procedure and technique of identification of nerve facial more frequent in both categories. The low specificity of fine needle puncture and the percentage of false negatives were some of the difficulties to affront in the decision of the surgery exten(AU)

Post-parotidectomy facial nerve rehabilitation outcomes: Comparison between benign and malignant neoplasms.

BACKGROUND: Facial nerve dysfunction can be a devastating trouble for post-parotidectomy patients. OBJECTIVE: To assess rehabilitation outcomes concerning patients with post-parotidectomy facial nerve dysfunction, comparing benign versus malignant neoplasms. METHODS: Prospective study enrolling adults who underwent parotidectomy with facial nerve sparing between 2016 and 2020. The Modified Sunnybrook System (mS-FGS) was used for facial assessments. Physiotherapy began on the first post-operative day with a tailored program of facial exercises based on Neuromuscular Retraining, to be performed at home 3 times/day. From the first outpatient consultation, Proprioceptive Neuromuscular Facilitation was added to the treatment of cases with moderate or severe facial dysfunctions. RESULTS: Benign and malignant groups had a statistically significant improvement in mS-FGS (p < 0.001 and p = 0.005, respectively). There was no significant difference between groups regarding treatment duration or number of physiotherapy sessions performed. The history of previous parotidectomy resulted in more severe initial dysfunctions and worse outcome. Age over 60 years and initially more severe dysfunctions impacted the outcome. CONCLUSION: Patients with benign and malignant parotid neoplasms had significant and equivalent improvement in postoperative facial dysfunction following an early tailored physiotherapy program, with no significant difference in the final facial score, treatment duration, or number of sessions required.

Experimental apical periodontitis alters salivary biochemical composition and induces local redox state disturbances in the salivary glands of male rats.

OBJECTIVES: The objective was to evaluate the effects of experimental apical periodontitis on the inflammatory, functional, biochemical, and redox parameters of the parotid and submandibular glands in rats. MATERIALS AND METHODS: Twenty 12-week-old male Wistar rats were randomly divided into two groups (n = 10): a control group and apical periodontitis group. After 28 days, the saliva was collected for salivary flow rate and biochemistry composition. Both glands were sampled for quantification of the tumor necrosis factor-alpha (TNF-α) and biochemical analyses of redox state. RESULTS: TNF-α concentrations were higher in both salivary glands adjacent to the periapical lesions in animals with apical periodontitis and also compared to the control group. The apical periodontitis group increased the salivary amylase, chloride, potassium, calcium, and phosphate. The total oxidant capacity increased in the parotid gland adjacent to the periapical lesions in the same rat and compared to the control group. Conversely, the total antioxidant capacity of the parotid glands on both sides in the apical periodontitis group was lower than that in the control group. Furthermore, glutathione peroxidase activity increased in the submandibular gland adjacent to the apical periodontitis group compared to the control group. CONCLUSIONS: Experimental apical periodontitis alters salivary biochemical composition, in addition to increasing inflammatory marker and inducing local disturbances in the redox state in the parotid and submandibular glands of male rats. CLINICAL RELEVANCE: Apical periodontitis could exacerbate the decline in oral health by triggering dysfunction in the salivary glands.

CFTR expression in human salivary gland acinar cells.

The key role of CFTR in secretory epithelia has been extensively documented. Additionally, CFTR plays a significant role in ion absorption in exocrine glands, including salivary and sweat glands. Most of the knowledge about CFTR expression comes from animal models such as the mouse or the rat, but there is limited information about CFTR expression in human tissues. In the present study, we assessed the expression of CFTR in human submandibular and parotid glands. Consistent with findings in rodent salivary glands, our immunolocalization studies show that CFTR is expressed in duct cells. However, CFTR expression in human salivary glands differs from that in rodents, as immunolocalization and single-cell RNA sequencing analysis from a previous study performed in the human parotid gland revealed the presence of CFTR protein and transcripts within a distinct cell cluster. Based on cell marker expression, this cluster corresponds to acinar cells. To obtain functional evidence supporting CFTR expression, we isolated human parotid acinar cells through collagenase digestion. Acinar cells displayed an anion conductance that was activated in response to cAMP-increasing agents and was effectively blocked by CFTRInh172, a known CFTR blocker. This study provides novel evidence of CFTR expression within acinar cells of human salivary glands. This finding challenges the established model positioning CFTR exclusively in duct cells from exocrine glands.NEW & NOTEWORTHY This study addresses the uncertainty about the impact of CFTR on human salivary gland function. We found CFTR transcripts in a subset of duct cells known as ionocytes, as well as in acinar cells. Isolated human parotid acinar cells exhibited Cl- conductance consistent with CFTR activity. This marks the first documented evidence of functional CFTR expression in human salivary gland acinar cells.

Evaluation of photobiomodulation therapy (PBMT) on salivary flow and composition in head and neck cancer patients undergoing radiation therapy.

OBJECTIVE: Assess the impact of photobiomodulation therapy (PBMT) on xerostomia, salivary flow rate (SFR) and composition in patients undergoing radiotherapy (RT) for head and neck cancer (HNC). STUDY DESIGN: Thirty patients undergoing RT (65 Gy) for HNC were enrolled. Saliva and xerostomia evaluations collected pre- and post-PBMT-RT. PBMT involved irradiation of extra and intraoral points, 15-20 sessions, 2-3 times/week. SFR, trace elements, total protein, alkaline phosphatase, xerostomia, and pH were analyzed. RESULTS: The average age was 60.7 years. After treatment, there was not a significant reduction in SFR and there was no difference on xerostomia. Significant reductions in Al, Cd, Fe, Ni, P, and Sb concentrations were observed, along with a significant increase in Mg concentration. Sample data were organized into 3 groups based on a self-organizing map. Low concentrations of Al, As, Co, Cr, Cu, Fe, Mn, Mo, S, Sr, and Zn were the primary discriminatory factors for group A, while group B consisted of post-PBMT-RT samples with high concentrations of Ca, K, Mg, Na, and S. CONCLUSIONS: PBMT prevented a significant reduction in SFR and xerostomia induced by radiation therapy. These findings suggest that PBMT prevents salivary gland damage minimizing the decline in salivary flow.

Bilateral intra-lymph node Warthin's tumor as a potential diagnostic pitfall mimicking metastatic carcinoma.

Warthin's tumor (WT) is a benign and frequent salivary gland tumor primarily affecting the parotid gland. In some cases, this tumor can involve the extra parotid region and affect cervical lymph nodes. Fine-needle aspiration can be the first step in the diagnostic approach to lymphadenopathy; however, specimens from intra-nodal WT can present a potential pitfall, leading to a misdiagnosis of metastasis. Here, we report an unusual case of a patient with bilateral WT in parotid lymph nodes misdiagnosed as metastases. In addition, we highlight the cytopathological aspects of WT to alert cytopathologists about this challenging diagnosis.

3D radiotherapy in the parotid gland and its dosimetric relationship with salivary flow and quality of life in patients with head and neck cancer

Aim: Hyposalivation and dry mouth affect the quality of life in patients with Head and Neck Cancer, who did the treatment with radiotherapy. Thus this study has the objective to evaluate the dosimetric relationship between 3D radiotherapy and changes in salivary flow, xerostomia and quality of life in patients with head and neck cancer according to the volume of the irradiated parotid gland. Methods: 23 patients with cancer in the head and neck area and in need of 3D radiotherapy were followed up during radiotherapy treatment, and the parotid gland (PG) design was also performed in radiotherapy planning. Questionnaires were carried out to determine xerostomia and quality of life, while the salivary flow was determined through calculations regarding the collection and weighing of saliva. Such data were collected in three moments: before the beginning of the radiotherapy treatment (D0), in the middle of the treatment (D1) and at the end of it (D2). The numerical variables are represented by measures of central tendency and measures of dispersion. Results: when associating the salivary flow, the xerostomia questionnaire and the OHIP-14, a statistically significant difference was found (p-value <0.001), as well as when comparing some volumes of irradiated PG with the OHIP-14. However, no relationship was found between dosimetric data, xerostomia and hyposalivation. Conclusion: patients undergoing 3D radiotherapy for malignant neoplasms in the head and neck region had decreased salivary flow, increased complaints of dry mouth and decreased quality of life. However, it was not possible to establish a statistically significant correlation between these findings and the volumes of irradiated parotids

Avaliação das manifestações clínicas e microscópicas dos linfomas em glândulas salivares maiores / Assessment of clinical and microscopic manifestations of lymphomas in major salivary glands

Os subtipos de linfomas não Hodgkin representam 2,8% de todos os novos casos de câncer no mundo, sendo o terceiro grupo mais comum de neoplasias malignas da região de cabeça e pescoço. As glândulas salivares maiores representam o terceiro sítio extranodal mais acometido pelo linfoma na região da cabeça e pescoço; entretanto, nas glândulas salivares maiores é muito raro, representando aproximadamente 1,7­3,1% de todas as neoplasias das glândulas salivares, acometendo a maioria dos casos as glândulas parótidas (79%), seguidas pelas glândulas submandibulares (18%) e sublinguais (1%). Os subtipos mais comuns são linfoma do tecido linfoide associado à mucosa (MALT), o linfoma folicular (FL) e o linfoma difuso de grandes células B (DLBCL), e a frequência destas neoplasias está associado com a ocorrência simultânea de condições sistêmicas que predispõem ao desenvolvimento de neoplasias linfoides como a Síndrome de Sjögren (SS). Entretanto, a literatura sobre linfomas em glândulas maiores permanece muito escassa e impede que conheçamos de forma apropriada as características destes pacientes. Assim, o objetivo deste estudo é avaliar as manifestações clínicas e microscópicas dos linfomas em glândulas salivares maiores. Para isto, foram recuperados de forma retrospectiva dos arquivos de patologia de algumas instituições todos os casos diagnosticados como linfomas acometendo estes sítios anatômicos. Foram coletados os dados clínicos referentes ao sexo, idade, localização, apresentação clínica, tempo de evolução, status, estadiamento e ocorrência da SS, e as informações histopalógicas foram coletadas de blocos de parafina e lâminas em hematoxilina e eosina e imuno-histoquímicas acessíveis. Os resultados obtidos foram avaliados de forma descritiva. As séries compreenderam de 7 casos de linfomas em glândula sublingual, 16 casos em glândula submandibular e 12 casos em glândula parótida. Clinicamente, os linfomas apresentam-se como aumento de volume assintomático, sendo os subtipos mais frequentes os de células B maduras de baixo grau (MALT, FL, MCL), mas subtipos de alto grau também foram observados (LDGCB, SOE). Dois pacientes, um de linfoma de células do manto (LCM) e outro de LDGCB,SOE em glândula sublingual apresentaram como doença disseminada, e apenas três casos de linfoma MALT em glândula parótida apresentam a SS. O tratamento dependeu do microscópico e estágio do tumor, variando de cirurgia, regimes quimioterápicos com R-CHOP e radioterapia. O prognóstico foi favorável principalmente para os casos de baixo grau (MALT,FL), e apenas dois pacientes de sublingual (LDGCB,SOE, MCL) e três de submandibular (LDGCB,SOE, linfoma plasmablastico e MALT) faleceram após o diagnóstico. Neste estudo concluímos que os linfomas em glândulas salivares maiores são afetados principalmente por neoplasias de células B maduras de baixo grau (MALT, FL, MCL) e esses pacientes devem passar por uma avaliação sistêmica criteriosa para determinar se a doença se trata de uma neoplasia primária ou disseminada.

Non-Hodgkin's lymphomas account for 2.8% of all new cancer cases worldwide and are the third most common group of malignant neoplasms in the head and neck region. The major salivary glands represent the third most common extranodal site affected by lymphoma in the head and neck region; however, in the major salivary glands it is very rare, representing approximately 1.7-3.1% of all salivary gland neoplasms, affecting most cases in the parotid glands (79%), followed by the submandibular glands (18%) and sublingual glands (1%). The most common subtypes are mucosa- associated lymphoid tissue lymphoma (MALT), follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL), and the frequency of these neoplasms is associated with the simultaneous occurrence of systemic conditions that predispose to the development of lymphoid neoplasms such as Sjögren's Syndrome(SS). However, the literature on lymphomas in major glands remains very scarce and prevents us from properly understanding the characteristics of these patients. Therefore, the aim of this study was to evaluate the clinical and microscopic manifestations of lymphomas in the major salivary glands. To this end, all cases diagnosed as lymphomas affecting these anatomical sites were retrospectively retrieved from the pathology archives of a number of institutions. Clinical data was collected on gender, age, location, clinical presentation, time of evolution, status, staging and occurrence of SS, and histopathological information was collected from paraffin blocks and slides in hematoxylin and eosin and accessible immunohistochemistry. The results obtained were evaluated descriptively. The series comprised 7 cases of lymphomas in the sublingual gland, 16 cases in the submandibular gland and 12 cases in the parotid gland. Clinically, the lymphomas presented as asymptomatic enlargement, with the most frequent subtypes being low-grade mature B-cells (MALT, FL, MCL), but high- grade subtypes were also observed (LDGCB, SOE). Two patients, one with mantle cell lymphoma (MCL) and the other with LDGCB,SOE in the sublingual gland presented with disseminated disease, and only three cases of MALT lymphoma in the parotid gland presented with SS. Treatment depended on the microscopic subtype and stage of the tumor, ranging from surgery to chemotherapy regimens with R-CHOP and radiotherapy. Prognosis was mainly favorable for low-grade cases (MALT,FL), and only two sublingual patients (LDGCB,SOE, MCL) and three submandibular patients (LDGCB,SOE, plasmablastic lymphoma and MALT) died after diagnosis. In this study we conclude that lymphomas in the major salivary glands are mainly affected by low- grade mature B-cell neoplasms (MALT, FL, MCL) and these patients should undergo a careful systemic evaluation to determine whether the disease is a primary or disseminated neoplasm.

Post-parotidectomy facial nerve function: comparison between original and modified Sunnybrook Facial Grading Systems.

BACKGROUND: Facial nerve dysfunction is the principal postoperative complication related to parotidectomy. OBJECTIVE: To test the hypothesis that the modified Sunnybrook Facial Grading System (mS-FGS) is superior to the original S-FGS in the assessment of facial nerve function following parotidectomy. METHODS: Prospective, longitudinal study evaluating patients with primary or metastatic parotid neoplasms undergoing parotidectomy with facial nerve-sparing between 2016 and 2020. The subjects were assessed twice, on the first postoperative day and at the first outpatient evaluation, 20-30 days post-surgery. Facial assessments were performed using the original and modified (plus showing the lower teeth) versions of the Sunnybrook System and documented by pictures and video recordings. Intra- and inter-rater agreements regarding the assessment of the new expression were analyzed. RESULTS: 101 patients were enrolled. In both steps, the results from the mS-FGS were significantly lower (p < 0.001). Subjects with a history of previous parotidectomy and those who underwent neck dissection had more severe facial nerve impairment. The mandibular marginal branch was the most frequently injured, affecting 68.3% of the patients on the first postoperative day and 52.5% on the first outpatient evaluation. Twenty patients (19.8%) presented an exclusive marginal mandibular branch lesion. The inter-rater agreement of the new expression assessment ranged from substantial to almost perfect. The intra-rater agreement was almost perfect (wk = 0.951). CONCLUSION: The adoption of the Modified Sunnybrook System, which includes evaluation of the mandibular marginal branch, increases the accuracy of post-parotidectomy facial nerve dysfunction appraisal.

ANTECEDENTES: A disfunção do nervo facial é a principal complicação pós-operatória relacionada à parotidectomia. OBJETIVO: Testar a hipótese de que o sistema Sunnybrook de graduação facial modificado (mS-FGS) é superior ao S-FGS original na avaliação da função do nervo facial após parotidectomia. MéTODOS:: Estudo longitudinal prospectivo avaliando o pós-operatório de pacientes com neoplasias parotídeas primárias ou metastáticas, submetidos à parotidectomia com preservação do nervo facial, entre 2016 e 2020. Os indivíduos foram avaliados duas vezes, no primeiro dia de pós-operatório e na primeira avaliação ambulatorial, 20-30 dias após a cirurgia. As avaliações faciais foram realizadas usando as versões original e modificada (que incluem mostrar os dentes inferiores) do sistema Sunnybrook e documentadas por fotos e vídeos. Foram adicionalmente analisadas as concordâncias intra e interexaminadoras da avaliação da nova expressão. RESULTADOS: Cento e um pacientes foram incluídos. Em ambas as etapas, os resultados do mS-FGS foram significativamente menores (p < 0,001). Indivíduos com história de parotidectomia prévia e aqueles submetidos ao esvaziamento cervical apresentaram comprometimento mais grave do nervo facial. O ramo marginal mandibular foi o mais afetado, acometendo 68,3% dos pacientes no primeiro dia de pós-operatório e 52,5% na primeira avaliação ambulatorial. Vinte pacientes (19,8%) apresentaram lesão exclusiva do ramo marginal mandibular. A concordância interexaminadores da avaliação da nova expressão variou de substancial a quase perfeita. A concordância intraexaminador foi quase perfeita (wk = 0,951). CONCLUSãO:: A adoção do sistema Sunnybrook modificado, que inclui a análise do ramo marginal mandibular, aumenta a precisão da avaliação da disfunção do nervo facial pós-parotidectomia.

Alterations in salivary biochemical composition and redox state disruption induced by the anticonvulsant valproic acid in male rat salivary glands.

OBJECTIVE: To investigate the effects of the anticonvulsant valproic acid (VPA) on salivary glands in male rat using biochemical, functional, histomorphometric, and redox state parameters. MATERIALS AND METHODS: Twenty-four male Wistar rats were randomly distributed into three groups (n = 8 per group): Control (0.9% saline solution), VPA100 (100 mg/kg), and VPA400 (400 mg/kg). After 21 consecutive days of treatment with by intragastric gavage. Pilocarpine-induced saliva was collected to determine salivary flow rate, pH, buffering capacity, and biochemical composition. Analyses of histomorphometric parameters and redox balance markers were performed on the parotid and submandibular glands. RESULTS: Salivary flow rate, pH, buffering capacity, total protein, potassium, sodium, and chloride were similar between groups. However, phosphate and calcium were reduced in VPA400, while amylase was increased in both VPA100 and VPA400. We did not detect significant differences in the areas of acini, ducts, and connective tissue in the salivary glands between the groups. There were no significant changes in the redox status of the submandibular glands. In turn, in the parotid glands we detected reduced total oxidizing capacity and lipid peroxidation, measured as thiobarbituric acid reactive substances (TBARs) and higher uric acid concentration in both the VPA100 and VPA400 groups, and increased superoxide dismutase (SOD) in the VPA400 group. CONCLUSION: Chronic treatment with VPA modified the salivary biochemical composition and caused disruption in the redox state of the parotid gland in rats.

The effects of eugenol on histological, enzymatic, and oxidative parameters in the major salivary glands and pancreas of healthy male Wistar rats.

OBJECTIVE: We evaluated the effects of eugenol on histological, enzymatic, and oxidative parameters in the pancreas, parotid, submandibular, and sublingual glands of healthy male rats. DESIGN: Twenty-four adult Wistar rats were assigned into four groups (n = 6/group). Control rats received 2% Tween-20 (eugenol vehicle), whereas the other animals received 10, 20, and 40 mg kg-1 eugenol through gavage daily for 60 d. Major salivary and pancreatic glands were weighed and preserved fixed for microscopic analysis and frozen for in vitro assays. RESULTS: Eugenol did not alter glands' weight and serum amylase activity regardless of the concentration. The highest dose of eugenol caused an increase in pancreatic amylase activity and a reduction of lipase activity from serum and pancreas. Eugenol at 40 mg kg-1 diminished the activity of SOD and FRAP in the submandibular gland and CAT and FRAP in the sublingual gland. However, it did not exert any effect on GST regardless of the gland. Additionally, 40 mg kg-1 eugenol increased MDA levels in pancreatic, parotid, and submandibular glands and NO levels in the sublingual. The concentrations of eugenol induced distinct responses in the glands regarding the activity of Na+/K+, Mg2+, and total ATPase activity. They also affected histomorphometrical and histochemistrical parameters in the submandibular gland only. CONCLUSIONS: Results indicated that 40 mg kg-1 eugenol altered most of the biochemical and oxidatived parameters of digestive glands. Only submandibular glands presented histological changes after eugenol exposure suggesting potential implications for its function.

Clinicopathological profile of sclerosing polycystic adenoma/adenosis: A systematic review.

In this systematic review, we aimed to evaluate the clinicopathological profile of sclerosing polycystic adenoma (SPA). PubMed, Scopus, EMBASE, Lilacs, Web of Science, and gray literature were searched to access cases of SPA in salivary glands. One hundred and thirty cases of SPA were found across 61 selected articles. SPA affected mainly the parotid gland of adults with a mean age of 44.6 years old, with a slight preference for females. The lesion was usually presented as a painless firm mass with a long period of evolution. Histologically, they are well-delimitated lesions composed of acinar and ductal elements with a variety of cytomorphologic features surrounded by a densely collagenized stroma. PI3K was the most common gene mutation related to SPA. SPA is a benign condition that mainly affects the parotid gland of female patients and it is usually treated by surgical resection with a good prognosis.

Clinicopathological study and survival outcomes of sialoblastoma: A systematic review.

Sialoblastoma is a rare malignant salivary gland tumor. The aim of this study was to review the available published data on sialoblastoma in a comprehensive analysis of its clinicopathologic characteristics, treatment, and outcomes. An unrestricted electronic search was performed in the following databases: MEDLINE/PubMed, EMBASE, Scopus, Web of science, and gray literature databases. Eligibility criteria included publications with sufficient clinical, imaging, and histopathological information to confirm the diagnosis of sialoblastoma. Data were evaluated descriptively and analytically. A total of 52 studies met the eligibility criteria. In total, 62 patients were evaluated. There was no gender predilection, with the parotid being the most affected primary site (n = 28; 45.2%). In the log-rank test, there was a significant increase in disease-associated survival in patients younger than 1 year of age (82.8% vs. 44.4%; p = 0.003), individuals with lesions in major salivary glands (79.4% vs. 38.5%; p = 0.005), patients without metastases (77.8% vs. 14.3%; p = 0.011), encapsulated lesions (85.7% vs. 0%; p < 0.0001), congenital lesions (83.3% vs. 25.0%; p < 0.0001), and lesions that do not show perineural invasion (89.5% vs. 40%; p = 0.035). Kaplan-Meier curves estimated overall survival and disease-free survival at 5 years of 95.5% and 68.1%, respectively. In the multivariate Cox regression model, only the presence of metastasis was identified as an independent prognostic factor (hazard ratio [HR] = 9.81; p = 0.010). Although sialoblastoma presents good prognosis, the tumor has a high recurrence rate.

Large congenital facial teratoma.

This case report discusses a presentation of a giant facial teratoma, a rare congenital neoplasm. Head and neck locations of the tumour uncommonly distort the face and may be associated with functional problems. We present a case of teratoma arising from the right parotid extending to the extracranial regions, successfully managed by surgical resection. Reviewing this case with the supporting body of literature anticipates further investigation to address patients' needs more thoroughly.

Agenesia of salivary glands: incidental findings in multidetector computerized tomography.

Agenesis of the salivary glands is an extremely uncommon finding, and in the majority of cases, it is associated with facial syndromes or malformations. Reports in the literature have, however, indicated that agenesis of the major salivary glands can occur in isolation, and this anomaly is believed to occur due to a failure in the developmental process. Herein, we present two cases of isolated unilateral agenesis of major salivary glands.

Oligometastatic breast cancer to parotid gland with complete response.

Breast cancer metastatic to parotid gland is a very rare condition which tend to confer poor prognosis and challenging approaches. Oligometastatic breast cancer is usually defined as advanced breast cancer with less or equal than 5 metastatic lesions. We report a case of oligometastatic HER-2 breast cancer to parotid gland and lymph nodes which presented with left hemifacial swelling with erythema and enlargement of cervical and axillary lymph nodes. After 6 cycles of Docetaxel plus Trastuzumab the patient had complete response that was complemented with posterior surgical removal of primary tumor followed by radiotherapy directed to plastron, left supraclavicular and cervical drainage. The patient is still on Trastuzumab therapy and is free of disease in the last two years. We discuss the presentation and approach of a patient with metastatic breast cancer to parotid gland in the oligometastatic scenario.

Brooke-Spiegler Syndrome with Parotid Gland Involvement.

A 60-year-old black man, working in construction sector, was referred to dermatology clinic for having multiple hardened and asymptomatic tumors on the scalp, face, and trunk for more than 40 years. There was a progressive increase in the number and size of lesions, causing significant aesthetic and functional impairment. In his family history, a son had numerous normochromic papules on the centrofacial region with a diagnosis of multiple trichoepithelioma. The deceased mother of our patient presented lesions similar to those of her grandson but without a confirmatory diagnosis. (SKINmed. 2023;21:47-50).

Preliminary ionome of the parotoid gland secretion from Rhinella jimi toad.

The cururu toad (Rhinella jimi) is an anuran belonging to the fauna of the Brazilian northeast region, which releases a secretion with toxins from your parotoid glands. Although it has some information about secondary metabolites and proteins, the elemental composition of the released secretion is unknown. Therefore, this is the first report on the ionome of the secretion of the parotoid glands from R. jimi, investigating the influences of abiotic factors such as biome, seasonality, and gender. ICP-MS was used for measurements combined with principal component analysis (PCA). A screening of the secretion sample detected 68 elements which the total concentration of 18 elements was determined. PCA revealed that biome and seasonality factors have a greater influence on the ionomic profile of parotoid secretion. The presence of toxic metals in the secretion samples indicates that the R. jimi toad can be considered a potential bioindicator. These findings may contribute to understanding the metabolism, lifestyle, and interaction of the R. jimi toad with environmental factors as well as open new perspectives to investigate the relationships of the ionome with other biomolecules, for example, metalloproteins and their physiological functions.