Background: We assessed the cases of intraoperative spillage of primary pleomorphic adenomas (PPAs) of the parotid gland in the literature, comparing them with our own cases. We aim to explain how the surgeon should manage a spillage during surgery (i.e., how to avoid spreading the contents that are coming out of the tumor). We also aim to investigate whether or not spillage is linked to a higher rate of PPA recurrence. Methods: We collected surgical and pathological reports, taking data on capsular ruptures and the spillage of tumors. Results: Intraoperative tumor spillage and tumor rupture occurred in 34/202 cases. There were three recurrences after a mean of 3.7 years (mean follow-up duration: 10.3 years). One recurrence happened to a patient who had an intraoperative tumor spillage, and two more recurrences happened to patients who did not have spillage. Conclusion: We believe that the real number of the events of spillage is underestimated and underreported by surgeons. Capsular rupture must always be avoided, and secure resection margins must always be pursued, independent of the type of parotidectomy being performed. Features that increase the risk of recurrence are an intraoperative rupture and the presence of satellite nodules (as recorded in the pathologist’s report). In these cases, patients need a longer follow-up period.

Rupture of the pleomorphic adenoma of the parotid gland: what to know before, during and after surgery / Grasso, Michele; Fusconi, Massimo; Cialente, Fabrizio; de Soccio, Giulia; Ralli, Massimo; Minni, Antonio; Agolli, Griselda; de Vincentiis, Marco; Remacle, Marc; Petrone, Paolo; Di Maria, Domenico; D’Andrea, Vito; Greco, Antonio. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:22(2021). [10.3390/jcm10225368]

Rupture of the pleomorphic adenoma of the parotid gland: what to know before, during and after surgery

Grasso, Michele
Primo
;
Fusconi, Massimo
Secondo
;
Cialente, Fabrizio;de Soccio, Giulia;Ralli, Massimo;Minni, Antonio;Agolli, Griselda;de Vincentiis, Marco;D’Andrea, Vito
Penultimo
;
Greco, Antonio
Ultimo
2021

Abstract

Background: We assessed the cases of intraoperative spillage of primary pleomorphic adenomas (PPAs) of the parotid gland in the literature, comparing them with our own cases. We aim to explain how the surgeon should manage a spillage during surgery (i.e., how to avoid spreading the contents that are coming out of the tumor). We also aim to investigate whether or not spillage is linked to a higher rate of PPA recurrence. Methods: We collected surgical and pathological reports, taking data on capsular ruptures and the spillage of tumors. Results: Intraoperative tumor spillage and tumor rupture occurred in 34/202 cases. There were three recurrences after a mean of 3.7 years (mean follow-up duration: 10.3 years). One recurrence happened to a patient who had an intraoperative tumor spillage, and two more recurrences happened to patients who did not have spillage. Conclusion: We believe that the real number of the events of spillage is underestimated and underreported by surgeons. Capsular rupture must always be avoided, and secure resection margins must always be pursued, independent of the type of parotidectomy being performed. Features that increase the risk of recurrence are an intraoperative rupture and the presence of satellite nodules (as recorded in the pathologist’s report). In these cases, patients need a longer follow-up period.
2021
superficial parotidectomy; pleomorphic adenoma; parotid capsule; recurrence of pleomorphic adenoma; intraoperative spillage
01 Pubblicazione su rivista::01a Articolo in rivista
Rupture of the pleomorphic adenoma of the parotid gland: what to know before, during and after surgery / Grasso, Michele; Fusconi, Massimo; Cialente, Fabrizio; de Soccio, Giulia; Ralli, Massimo; Minni, Antonio; Agolli, Griselda; de Vincentiis, Marco; Remacle, Marc; Petrone, Paolo; Di Maria, Domenico; D’Andrea, Vito; Greco, Antonio. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:22(2021). [10.3390/jcm10225368]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1612173
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