Search Results (279)

Background: Parotid gland tumors pose diagnostic and surgical challenges due to their histological heterogeneity and proximity to the facial nerve. This study aimed to evaluate clinicopathological features and postoperative outcomes with a specific focus on facial nerve function in patients undergoing parotidectomy. Methods: This retrospective study included 314 patients who underwent parotidectomy between 2008 and 2024 at a tertiary center. Demographic data, tumor histology, and postoperative complications—particularly facial nerve paralysis within the first three months—were analyzed. Histopathological features including capsular, perineural, and lymphovascular invasion were also assessed. Results: Of all cases, 79% were benign, 14.6% malignant, and 6.4% non-neoplastic. Pleomorphic adenoma and Warthin tumor were the most common benign entities, while mucoepidermoid carcinoma was the most frequent malignancy. Malignant tumors were associated with higher rates of positive surgical margins (44.2% vs. 12.5%, p < 0.001), capsular invasion (25% vs. 7%, p < 0.001), and tumor necrosis (22% vs. <1%, p < 0.001). Facial paralysis occurred in 4.4% of patients, largely transient and significantly associated with malignant tumors (p < 0.001) and extensive lymph node dissection (p < 0.001). Capsular invasion and necrosis were rare in benign lesions but still observed, especially in pleomorphic adenoma. Conclusions: Histopathologic aggressiveness markers were associated with malignant disease and postoperative facial nerve dysfunction. These findings support a risk-stratified approach to follow-up: all patients undergo universal early assessment at two weeks and three months, after which surveillance intensity may be individualized according to histopathologic features—such as necrosis, perineural invasion, capsular invasion, or positive margins. Full article

Mumps virus (MuV) is a single-stranded, negative-sense RNA virus of the Family Paramyxoviridae. MuV is a highly contagious human pathogen that causes primarily mild symptoms, including hallmark swelling of the parotid glands. Severe cases can occur, leading to neurological complications, including deafness, meningitis, and encephalitis. The mumps vaccine, now included in combination with measles and rubella vaccines (MMR), was first made available in the 1960s. After its introduction, mumps incidence dropped dramatically to less than 500 cases annually in the US. However, even with long-standing vaccination programs, MuV continues to challenge the landscape of public health due to a resurgence of cases in the past several decades and a still present lack of approved antiviral drugs and treatments available for the disease. This review will explore the biology of MuV, focusing on how MuV replicates and interacts with the host immune system. Recent studies have also shed light on the role of protein phosphorylation in regulating viral RNA synthesis—particularly the dynamic interactions between the nucleoprotein (NP) and phosphoprotein (P)—offering new insights into how the virus controls its replication machinery both mechanistically and through utilizing host cell advantages. We also examine how the immune system responds to mumps infection and vaccination, and how those responses may vary across viral genotypes. Although the Jeryl Lynn vaccine strain has played a key role in controlling mumps for decades, outbreaks among vaccinated individuals have raised questions about the present vaccine’s efficacy against circulating and emerging genotypes and if novel strategies will be required to prevent future outbreaks. We review current epidemiological data, highlighting shifts in MuV transmission and genotype distribution, and discuss the need for updated or genotype-matched vaccines. By connecting molecular virology with real-world trends in disease spread and vaccine performance, this review aims to support ongoing efforts to strengthen mumps control strategies and inform the development of next-generation vaccines. Full article

Background: Epidemiological studies on benign epithelial salivary gland tumors are challenging due to their rarity, pathological heterogeneity, variable tumor locations, and the limited national data collection in Romania. Our study aimed at the evaluation of benign epithelial salivary gland tumors collected over fifteen years in a tertiary center, in order to characterize their demographic and histopathological profiles and to contribute to their diagnostic and therapeutic strategies. Materials and Methods: A retrospective analysis of 404 cases of benign epithelial salivary gland tumors diagnosed in “Sf. Spiridon” County Hospital, Iasi, from 2010 to 2024, has been performed. Results: The analyzed cases showed a slight female predominance (52.97%) and a mean patient age of 54.55 ± 14.207 years. Tumor frequency increased progressively with age, peaking in the sixth and seventh decades of life. The most common histological types were pleomorphic adenoma (62.62%) and Warthin tumor (29.95%), both types showing a predominant parotid gland involvement (88.51%). The recurrences were rare, being registered only in 1.58% of pleomorphic adenomas. A significant association between tumor histological type and both gender (p < 0.001) and age group (p < 0.001) was registered, while no significant correlation between gender and age group (p = 0.288) or between tumor location and gender or age group (p = 0.382; p = 0.383) was found. Conclusions: The frequency of pleomorphic adenoma is increasing, showing an age-related distribution and parotid gland propensity. Key morphological features in each histological type support a better preoperative stratification, a more confident margin assessment, and an individualized extent of excision with function preservation. Full article

In the lateral neck area (LNA), the parotid glands and submandibular glands can be diagnosed with various lesions, especially cysts and tumors of different etiology. In the submandibular area, many lesions are related to salivary stones and some inflammations, causing a secondary gland enlargement. When no sialolithiasis is present, a close relation to other local inflammation causes, IgG4, or related chronic sclerosing disease should be estimated. Ultrasound evaluation seems to be sufficient to indicate any occurrence of salivary retention, inflammation, dilatation of ducts, and gland swelling, and to confirm the initial diagnosis of sialolithiasis or sialadenitis. Any possible tumor formation or tumor-like solid mass evaluation requires adequate computed tomography or magnetic resonance imaging. A very important question should be raised if clinical symptoms like neck asymmetry, submandibular swelling, and solid-mass formation always correspond with radiological as well as some worrisome oncological symptoms. On the other hand, when radiological imaging is insufficient or lacking, a fine needle biopsy would be useful. Problems arise when any signs of potential disease or other tumor-like lesions are inconclusive or indicate inflammation, and possible treatment options are limited. Secondly, when patient anamnesis and blood examination are normal, but a worrisome tumor-like appearance progresses in time, a serious question about improved diagnostics and scheduling for surgery should be raised. Not all cases of elevated serum IgG4 levels correspond with IgG4 lesions and the typical spectrum of those diseases, and therefore histopathological examination of excised lesion provides the scope of the following disease intensity. In the following interesting images, it is worth noticing that radiological, clinical, needle biopsy, and cytological examinations do not always correlate with each other, and in some cases, an open surgery should be considered to improve the diagnosis. Full article

Background/Objectives: The multitude of histological and genetic features of salivary gland malignancies (SGMs) hampers the ability of the doctors’ board to make a clear and quick decision on how aggressively treatment should be initiated. Despite treatment guidelines, it is difficult to determine the appropriate extent and invasiveness of surgery based on preliminary patient data. The aim of this study is to define the factors that have a significant impact on the oncological outcome of SGM treatment and to create an algorithm for finding the combinations of predictors with a particularly unfavorable impact on survival. Methods: A multicenter retrospective analysis was conducted on 2653 patients with salivary gland tumors (SGTs), including 229 with SGMs (parotid 204/229 = 89.1%; submandibular 25/229 = 10.9%), treated at seven Polish university departments from 2015 to 2022. All patients, except those with malignant lymphoma, underwent surgery followed by radiotherapy. Seventeen potential survival-impacting variables were analyzed: thirteen preoperative and four surgical specimens. The preoperative group aids in deciding surgical aggressiveness, while the postoperative group supports decisions on adjuvant treatment escalation. The main outcome measures were disease-free survival (DFS) and overall survival (OS). Results: SGMs constituted 8.63% of all SGTs, with 204 (89%) in the parotid and 25 (11%) in the submandibular glands. The average age was 63.38 years, with a male predominance (54%). Clinical and radiological signs of malignancy were reported in 45.4% and 54.6% of patients, respectively, with facial nerve palsy reported in 13%. Postoperative specimens revealed 23 histological types, and R0 resections were achieved in 168/229 cases (73%). Fifty-six patients (24.5%) died of cancer within five years. Significant survival factors included gender, urban residence, previous chemical and radiation exposure, clinical malignancy symptoms, pT-stage, pN-stage, clinical stage, and resection margins. Conclusions: The prognosis for SGM remains unsatisfactory, which would suggest more aggressive treatment; thus, carefully collected clinical data could support the decision-making process. Significantly worse survival has been demonstrated in the presence of unfavorable clinical factors, so defining new elements of medical history may be a step towards improving treatment outcomes. Full article

Background: Congenital cheek sinuses are exceedingly rare craniofacial anomalies, typically present at birth and often misdiagnosed due to their resemblance to dermal pits or dimples. Only a few cases have been reported in the literature. This case is notable for its histopathological confirmation as a type II first branchial cleft anomaly containing an accessory tragus, highlighting the embryologic and clinical overlap between congenital cheek sinuses and branchial cleft anomalies. Case presentation: We report a three-year-old boy presenting with a congenital dimple along the right nasolabial fold. The lesion was present since birth and occasionally discharged clear fluid but had no history of infection or inflammation. Imaging demonstrated a subcutaneous tract without communication to the oral cavity or parotid gland. Under general anesthesia, surgical excision was performed, and the sinus tract was dissected in continuity to a cartilaginous remnant. Histopathologic analysis confirmed the presence of an accessory tragus consistent with a type II first branchial cleft anomaly. The patient’s postoperative recovery was uneventful, and at three months’ follow-up, there was no recurrence and an excellent cosmetic outcome. Conclusions: This case emphasizes the importance of considering branchial cleft anomalies in the differential diagnosis of congenital cheek sinuses. Although these lesions may appear benign and superficial, histopathological confirmation is critical for accurate classification. Complete surgical excision remains the definitive treatment, ensuring both diagnostic clarity and favorable aesthetic results. Increased awareness of such rare anomalies can improve diagnostic accuracy and surgical planning, particularly with respect to their potential proximity to critical facial structures. Full article

Human filariasis caused by Wuchereria bancrofti and Brugia malayi continues to circulate within Northern and Central Thailand and Southern Thailand, respectively. Major clinical presentations comprise lymphedema of extremities, hydrocele, funiculitis, orchitis, and tropical pulmonary eosinophilia. Microfilaria in other organs is rare. We report an unusual case of a 48-year-old woman from Southern Thailand with parotid filariasis presenting with chronic parotid gland enlargement. Wuchereria bancrofti microfilaria was observed within cytologic smear samples from the swollen left parotid gland and subsequently confirmed via a positive filaria immunoblot. The patient’s condition was successfully resolved through administration of a triple regimen consisting of three antiparasitic medications. Full article

Breast cancer rarely metastasizes to the parotid gland. Early recognition in patients with a history of malignancy is critical for timely diagnosis and treatment. We report the case of a 60-year-old female who presented with a two-month history of a left periauricular mass, 18 months after completing treatment for breast carcinoma. Despite the patient’s oncologic history, initial evaluation by our maxillofacial surgery service showed no evidence of distant metastasis, and we initially ruled out metastatic disease. Clinical evaluation, contrast-enhanced computed tomography (CT), fine-needle aspiration cytology (FNAC), PET-CT, and histopathological analysis were performed. Given the persistent and progressive nature of the mass, surgical excision was undertaken to obtain a definitive diagnosis and provide local control. Immunohistochemical analysis of the resected mass and adjacent node confirmed metastatic breast carcinoma infiltrating the parotid parenchyma and an intra-parotid lymph node, with strong positivity for progesterone receptor (PR) and carcinoembryonic antigen (CEA). Unfortunately, several months later, the patient developed pulmonary metastases and subsequently died. Full article

Objectives: To evaluate the loss of quality of life (QoL) in patients with chronic obstructive sialadenitis (COS) using the Chronic Obstructive Sialadenitis Questionnaire (COSQ). Methods: The COSQ was administered to patients diagnosed with COS, with the diagnosis confirmed by sialendoscopy. Epidemiological data, obstructive causes and potentially obstructive entities were collected. QoL was assessed using the COSQ. Results: A total of 344 glands in 278 patients with COS were analyzed. Most patients were women (71.94%), and the main obstructive cause was stenosis (47.96%), followed by lithiasis, lack of papilla distensibility (LPD), and mucus plug. Stenosis was significantly more frequent in the parotid gland and in women, whereas lithiasis predominated in the submandibular gland and in men. The mean COSQ score was 30.55 and it was significantly higher in women (p < 0.005), parotid gland (p < 0.005), and in long-standing cases (p < 0.05). Stenosis and LPD were the obstructive causes with the greatest impact on QoL (p < 0.005), while lithiasis had the least impact. Potentially Obstructive Entities (POEs), such as eosinophilic sialodochitis, Sjögren’s syndrome, or radioiodine-induced sialadenitis, were associated with a notable loss of QoL. Likewise, patients without associated POEs presented significantly lower COSQ values (p < 0.05). Conclusions: COS significantly affects QoL, particularly in women and in cases of parotid gland, stenosis, and LPD. Lithiasis has the least impact on QoL. It is important to standardize a thorough evaluation of COS using validated tools such as the COSQ, which are fundamental for understanding the disease and predicting the outcomes of therapeutic interventions. Full article

Background: Salivary gland sarcoidosis is a rare manifestation of systemic sarcoidosis that poses a challenge in terms of its diagnosis due to its similarities to disorders such as Sjögren’s syndrome, other granulomatous diseases, and infections. Objective: To systematically review reported cases of salivary gland sarcoidosis and summarize clinical presentation, diagnostic methods, treatments, and outcomes. Methods: We conducted a systematic search of PubMed, Scopus, Embase, ScienceDirect, and Medline for case reports and case series published up to April 2025. This review was registered with PROSPERO (CRD42024629263) and was conducted following PRISMA guidelines. Variables assessed included age, sex, presenting symptoms, location, duration of symptoms, treatment approaches, and outcomes. Study quality assessment was assessed using The Joanna Briggs Institute (JBI) Critical Appraisal tools. Results: A total of 28 articles involving 39 participants met the inclusion criteria, with a mean age of 42.7 years. Salivary gland sarcoidosis predominantly affected female patients (66.7%). The parotid gland was the most frequently involved site (82.1%). Common presenting features included glandular swelling that is usually painless, xerostomia, and facial palsy. Sarcoidosis was newly diagnosed in 82.1% of cases, primarily through histopathological examination revealing non-caseating granulomas. Systemic corticosteroids were the most common treatment. Outcomes were favorable in nearly all cases, with complete resolution post treatment or spontaneous remission without treatment. Conclusions: Salivary gland sarcoidosis predominantly affects middle-aged women, typically presenting as a painless parotid swelling and often serving as the initial sign of systemic disease. Diagnosis requires histopathological confirmation via biopsy, as serum ACE levels are insufficient alone. The prognosis is excellent, with most patients responding favorably to corticosteroids or even experiencing spontaneous resolution. This condition must be considered in differential diagnoses for persistent salivary gland swellings to ensure accurate diagnosis and prevent unnecessary interventions. Full article

Warthin’s tumor is a benign salivary gland neoplasm that can exhibit intense FDG uptake, potentially mimicking malignant lesions on oncologic imaging. We report a case of a 78-year-old man undergoing staging for suspected lung cancer, in whom a hypermetabolic lesion was incidentally detected in the left parotid gland on [¹⁸F]FDG PET/CT. Correlation with prior salivary scintigraphy, MRI, and CT supported the likelihood of Warthin’s tumor, which was subsequently confirmed by fine-needle aspiration cytology. This case illustrates how multimodality imaging can provide complementary diagnostic information that helps characterize the parotid lesion, but not replace cytologic confirmation. Recognition of characteristic imaging features, an understanding of each modality’s diagnostic strengths and limitations, and cytologic confirmation when indicated are essential to avoid misinterpretation and optimize patient management. Full article

Background/Objectives: Despite the relative rarity of salivary gland tumours (SGT), they are a complex and challenging pathology. This is primarily due to the complexity of surgical treatment, the difficulty of diagnosis, and the sometimes ambiguous prognosis. Methods: This retrospective study examined parotid gland tumors in patients admitted for diagnosis and treatment at the Municipal Hospital of Timisoara–Oral and Maxillofacial Surgery Clinic, Romania, from 2016 to 2023, with the objective of verifying the hypothesis regarding the increasing incidence of benign tumors in the major salivary glands, particularly the parotid gland. Results: A total of 207 consecutive parotid nodular lesion cases were analysed, with 186 having a histopathological analysis. The findings encompass demographic patterns, temporal dynamics, histopathological profiles, malignancy characteristics, and statistical associations. The cohort was evenly distributed by sex (102 females, 105 males) with a median age of 58 years (IQR: 46–69). The largest age group was ≥60 years (n = 99; 47.8%), followed by 40–59 years (n = 76; 36.7%) and <40 years (n = 32; 15.5%). No significant sex difference in age distribution was observed. Annual case volumes showed a high plateau between 2017–2019 (40–41 cases/year), then fell sharply during the pandemic (2020–2022), reaching a nadir in 2021 (11 cases). A partial rebound occurred in 2023 (21 cases). The relative proportion of malignant diagnoses remained stable between pre-pandemic (20.0%) and pandemic/post-pandemic (8.9%) intervals, consistent with prioritization of oncologic surgeries during service restrictions. Benign tumors predominated (n = 126; 60.9%), led by pleomorphic adenoma (n = 64; 50.8% of benign) and Warthin tumor (n = 59; 46.8% of benign). Malignant tumors accounted for 31 cases (15.0%), most commonly squamous cell carcinoma (n = 6), mucoepidermoid carcinoma (n = 6), and adenocarcinoma of salivary origin (n = 5). Mann–Whitney U tests confirmed no significant differences in median age between malignant and benign cases, or between pre-pandemic and pandemic/post-pandemic intervals. Odds ratios suggested clinically relevant but non-significant increases in malignancy risk for males (OR ≈ 2.1) and for patients ≥60 years (OR ≈ 1.2). Linear regression of annual case counts revealed a downward slope of –3.5 cases/year (p ≈ 0.074), driven by the sharp pandemic-era decline. Conclusions: This study illustrates that, despite a significant decrease in surgical case volume during the COVID-19 pandemic, the relative distribution of parotid tumor pathology remained stable. Malignant lesions mostly occurred in older patients and males, with no statistically significant differences seen among demographic or clinical subgroups. The preservation of consistent malignancy detection rates, despite limited surgical capacity, underscores the efficacy of oncologic prioritization under healthcare disruptions. Full article

Malignant tumors of the salivary glands are rare, accounting for approximately 1–7% of all head and neck tumors. The parotid gland is the most commonly affected gland. An accurate preoperative diagnosis distinguishing between malignant and benign tumors is necessary for the appropriate management of patients. The aim of this review is to analyze the results of the most recent literature studying the use of radiomics in malignant tumors of the parotid gland. A comprehensive literature review was performed using the PubMed/MEDLINE, EMBASE and Cochrane Library databases, in accordance with the PRISMA review criteria (from 2020 to July 2025). The final analysis comprised a total of six articles and 560 patients. Four studies evaluated the role of Magnetic Resonance Imaging (MRI), one of Computed Tomography (CT) and one of Positron Emission Tomography/Computed Tomography (PET/CT). Radiomics models achieved good overall diagnostic performance, with AUC values ranging from 0.769 to 0.952 across studies, although methodological heterogeneity prevented data pooling. The results of this review indicate that radiomics has the potential to play an important role in the management of malignant tumors of the parotid gland. Nevertheless, the absence of clear and standardized protocols does not allow the comparison of results. Further studies are necessary to confirm these findings. Full article

The submandibular glands (SMGs), along with the parotid and sublingual glands, generate the majority of saliva and play critical roles in maintaining oral and systemic health. Despite their physiological importance, long-term therapeutic options for salivary gland dysfunction remain limited, highlighting the need for a deeper molecular understanding of SMG biology, particularly in humans. To address this knowledge gap, we have performed transcriptomic- and epigenomic-based analyses and molecular characterization of the human SMG. Our integrated analysis of multiorgan RNA-sequencing datasets has identified an SMG-enriched gene expression signature comprising 289 protein-coding and 75 long non-coding RNA (lncRNA) genes that include both known regulators of salivary gland function and several novel candidates ripe for future exploration. To complement these transcriptomic studies, we have generated chromatin immunoprecipitation sequencing (ChIP-seq) datasets of key histone modifications on human SMGs. Our epigenomic analyses have allowed us to identify genome-wide enhancers and super-enhancers that are likely to drive genes and regulatory pathways that are important in human SMG biology. Finally, comparative analysis with mouse and human SMG and other tissue datasets reveals evolutionary conserved gene and regulatory networks, underscoring fundamental mechanisms of salivary gland biology. Collectively, this study offers a valuable knowledge-based resource that can facilitate targeted research on salivary gland dysfunction in human patients. Full article

Background: The majority of parotid gland tumors are benign, while malignant forms are uncommon, affecting fewer than 1 in 100,000 individuals. The main challenge resides in the histopathological complexity and the clinical overlap between benign and malignant parotid tumors, which frequently results in misdiagnosis. Aim: The objective of this research was to evaluate the clinical and histopathological characteristics of parotid gland tumors at a Romanian healthcare center. Materials and methods: A five-year retrospective study was conducted, with the inclusion criterion being the presence of complete clinical, pathological, and surgical records. Results: Of 156 patients included in the study, 67.3% were found to have benign lesions (male/female ratio 1.14:1), and there was a slight male predominance (53.3%). Partial parotidectomy was the most common surgical intervention for benign parotid tumors (59.6%), whereas total parotidectomy was predominantly indicated for malignant tumors, with facial nerve sacrifice occurring in 20% of cases to ensure complete tumor excision. Patients with benign tumors were found to be younger. Malignant tumors were commonly diagnosed at stage III (36.4%), indicative of more advanced disease at the time of diagnosis. Clinical diagnosis showed a high specificity of 96.9%, indicating high accuracy in malignancy suspicion, yet the sensitivity of 56% indicates that a significant number of malignancies were not detected during the initial evaluation. Tumor size was found to be influenced by gender and correlated with surgical methods, suggesting that patient characteristics and tumor biology may impact surgical strategy. Conclusions: This retrospective study highlights differences in gender, tumor size, and surgical approach between benign and malignant parotid gland tumors, offering valuable contributions in terms of diagnostic accuracy and treatment patterns despite a limited number of malignant cases. Full article