Abstract
Background
Detailed clinical features other than parotid mass have not been investigated in detail for parotid tumors. Symptoms and signs are useful for the differentiation of benign versus malignant, and may also be of value to determine the grade of malignancy and histological type as well as the assessment of prognosis.
Methods
We reviewed symptoms and signs of 965 patients with benign tumors and 200 patients with malignant tumors. Symptoms and signs included pain/tenderness, adhesion to surrounding tissues, and facial nerve palsy. We reviewed the incidence in benign and malignant tumors, in histological type of benign tumors, and in grade and histology of malignant tumors. For each symptom or sign, covariates were analyzed, and their correlation with the prognosis was investigated.
Results
The incidence of symptoms and signs was significantly higher in malignant than benign tumors, and more frequent in higher grade of malignancy. Facial nerve palsy was observed in 18.0% of malignant tumor cases, while none occurred in benign tumor cases. Pain/tenderness was more commonly observed in adenoid cystic carcinoma, while adhesion to surrounding tissues and facial nerve palsy were most frequently noted in salivary duct carcinoma. The prognosis of patients with these symptoms and signs was significantly poor.
Conclusion
A detailed investigation of symptoms and signs in parotid gland tumors is the first step that leads to the diagnosis of malignant tumors. Symptoms and signs are also useful for estimating the grade of malignancy and histological type, and they are important information for predicting prognosis.
Similar content being viewed by others
References
El-Naggar AK, Chan JK, Grandis JR et al (2017) World Health Organization classification of tumours. Chapter 7, tumours of salivary glands. IARC press, Lyon, France, pp 160–202
Nishikado A, Kawata R, Haginomori SI et al (2018) A clinicopathological study of parotid carcinoma: 18 year review of 171 patients at a single institution. Int J Clin Oncol 23(4):615–624
Stodulski D, Mikaszewski B, Stankiewicz C (2012) Signs and symptoms of parotid gland carcinoma and their prognostic value. Int J Oral Maxillofac Surg 41(7):801–806
Wong DS (2001) Signs and symptoms of malignant parotid tumours: an objective assessment. R Coll Surg Edinb 46(2):91–95
Ellis GL, Auclair PL (2008) AFIP atlas of tumor pathology series 4: tumors of the salivary glands. ARP press, Washington DC, pp 27–48
Christe A, Waldherr C, Hallett R et al (2011) MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol 32:1202–1207
Burke CJ, Thomas RH, Howlett D (2011) Imaging the major salivary glands. Br J Oral Maxillofac Surg 49:261–269
Kelley DJ, Spiro RH (1996) Management of the neck in parotid carcinoma. Am J Surg 172(6):695–697
Jinnin T, Kawata R, Higashino M et al (2019) Patterns of lymph node metastasis and the management of neck dissection for parotid carcinomas: a single-institute experience. Int J Clin Oncol 24(6):624–631
Rafla S (1977) Malignant parotid tumors: natural history and treatment. Cancer 40(1):136–144
Pohar S, Gay H, Rosenbaum P et al (2005) Malignant parotid tumors: presentation, clinical/pathologic prognostic factors, and treatment outcomes. Int J Radiat Oncol Biol Phys 61(1):112–118
Vander Poorten VL, Balm AJ, Hilgers FJ et al (1999) The development of a prognostic score for patients with parotid carcinoma. Cancer 85(9):2057–2067
Spiro RH, Huvos AG, Strong EW (1974) Adenoid cystic carcinoma of salivary origin. A clinicopathologic study of 242 cases. Am J Surg 128(4):512–520
Borthne A, Kjellevol K, Kaalhus O et al (1986) Salivary gland malignant neoplasms: treatment and prognosis. Int J Radiat Oncol Biol Phys 12(5):747–754
Eneroth CM (1972) Facial nerve paralysis. A criterion of malignancy in parotid tumors. Arch Otolaryngol 95(4):300–304
Terhaard C, Lubsen H, Tan B et al (2006) Facial nerve function in carcinoma of the parotid gland. Eur J Cancer 42(16):2744–2750
Park W, Park J, Park SI et al (2019) Clinical outcomes and management of facial nerve in patients with parotid gland cancer and pretreatment facial weakness. Oral Oncol 89:144–149
Wierzbicka M, Kopeć T, Szyfter W et al (2012) The presence of facial nerve weakness on diagnosis of a parotid gland malignant process. Eur Arch Otorhinolaryngol 269(4):1177–1182
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Inaka, Y., Kawata, R., Haginomori, Si. et al. Symptoms and signs of parotid tumors and their value for diagnosis and prognosis: a 20-year review at a single institution. Int J Clin Oncol 26, 1170–1178 (2021). https://doi.org/10.1007/s10147-021-01901-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-021-01901-3