Tumors of the salivary glands. MCSC patient history

News 08/03/2021

A 52-year-old patient with complaints of tumor formation of the left parotid region applied to the MCSC.  She had a massive tumor node in the area of the left parotid salivary gland, 8x6cm in size, deforming the contours of the face.  (photo 1,2).

Despite the large size of the tumor, there was no weakness (paresis) of facial muscles on the side of the tumor.

The examination revealed a mixed tumor (pleomorphic adenoma) of the left parotid salivary gland.

Surgeons of the Department of head and neck tumors performed elective surgical treatment in the amount of subtotal resection of the tumor of the left parotid gland with preservation of the integrity of the branches of the facial nerve (photo 3).

In the postoperative period, a satisfactory aesthetic and functional result was achieved without signs of facial nerve paralysis. The patient is discharged home.

According to the results of histological examination, a mixed tumor of the parotid salivary gland was confirmed. Experts continued dynamic observation:

• facial expressions of the patient are not broken;
• no signs of relapse were noted.

About 85% of salivary gland tumors affect the parotid glands, less commonly the submandibular and small salivary glands, and about 1% occur in the sublingual glands. 75-80% of tumors are benign.

Formation of this localization:

• can cause severe cosmetic deformation of the face;
• can disrupt the mobility of facial muscles;
• prone to malignancy and frequent relapses.

A feature of the parotid salivary gland is the passage of the branches of the facial nerve through the gland.

Treatment of benign tumors it consists in performing subtotal resection (removal of the superficial lobe) of the salivary gland in the projection of the branches of the facial nerve with its isolation and preservation, including the use of microsurgical techniques. This reduces the risk of its damage and the development of postoperative paresis of facial muscles. 

With a malignant tumor treatment is carried out according to Russian and international recommendations. The scope of the operation is determined by the results of the examination, depending on the prevalence of the tumor.

Often, the removal of the tumor is supplemented by the removal of regional lymph nodes in the neck, since they are the first barrier to the formation of metastases. According to the results of histological examination, the question of the need for further treatment is decided – radiation therapy or chemoradiotherapy.

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