Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery

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...

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Autores principales:	Michele Grasso, Massimo Fusconi, Fabrizio Cialente, Giulia de Soccio, Massimo Ralli, Antonio Minni, Griselda Agolli, Marco de Vincentiis, Marc Remacle, Paolo Petrone, Domenico Di Maria, Vito D’Andrea, Antonio Greco
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	superficial parotidectomy pleomorphic adenoma parotid capsule recurrence of pleomorphic adenoma intraoperative spillage Medicine R
Acceso en línea:	https://doaj.org/article/478a3a84d3ab4c9283e11d54e4550807
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spelling	oai:doaj.org-article:478a3a84d3ab4c9283e11d54e45508072021-11-25T18:02:11ZRupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery10.3390/jcm102253682077-0383https://doaj.org/article/478a3a84d3ab4c9283e11d54e45508072021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5368https://doaj.org/toc/2077-0383Background: 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.Michele GrassoMassimo FusconiFabrizio CialenteGiulia de SoccioMassimo RalliAntonio MinniGriselda AgolliMarco de VincentiisMarc RemaclePaolo PetroneDomenico Di MariaVito D’AndreaAntonio GrecoMDPI AGarticlesuperficial parotidectomypleomorphic adenomaparotid capsulerecurrence of pleomorphic adenomaintraoperative spillageMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5368, p 5368 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	superficial parotidectomy pleomorphic adenoma parotid capsule recurrence of pleomorphic adenoma intraoperative spillage Medicine R
spellingShingle	superficial parotidectomy pleomorphic adenoma parotid capsule recurrence of pleomorphic adenoma intraoperative spillage Medicine R Michele Grasso Massimo Fusconi Fabrizio Cialente Giulia de Soccio Massimo Ralli Antonio Minni Griselda Agolli Marco de Vincentiis Marc Remacle Paolo Petrone Domenico Di Maria Vito D’Andrea Antonio Greco Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery
description	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.
format	article
author	Michele Grasso Massimo Fusconi Fabrizio Cialente Giulia de Soccio Massimo Ralli Antonio Minni Griselda Agolli Marco de Vincentiis Marc Remacle Paolo Petrone Domenico Di Maria Vito D’Andrea Antonio Greco
author_facet	Michele Grasso Massimo Fusconi Fabrizio Cialente Giulia de Soccio Massimo Ralli Antonio Minni Griselda Agolli Marco de Vincentiis Marc Remacle Paolo Petrone Domenico Di Maria Vito D’Andrea Antonio Greco
author_sort	Michele Grasso
title	Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery
title_short	Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery
title_full	Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery
title_fullStr	Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery
title_full_unstemmed	Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery
title_sort	rupture of the pleomorphic adenoma of the parotid gland: what to know before, during and after surgery
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/478a3a84d3ab4c9283e11d54e4550807
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Rupture of the Pleomorphic Adenoma of the Parotid Gland: What to Know before, during and after Surgery

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