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Laura J. Orvidas, MD; Jan L. Kasperbauer, MD; Jean E. Lewis, MD; Kerry D. Olsen, MD; Timothy G. Lesnick, MS

Arch Otolaryngol Head Neck Surg. 2000;126:177-184.

Objective  To evaluate the incidence, types, and treatment outcomes of pediatric parotid lesions.

Design  Retrospective case review, histological tissue review, and literature review.

Setting  Tertiary care center.

Patients  All patients aged 18 years and younger with parotid masses evaluated and treated at the Mayo Clinic, Rochester, Minn, from January 1, 1970, to December 31, 1997.

Results  Parotid masses were identified in 118 children (60 boys and 58 girls). At diagnosis, the ages of patients were from birth through 18 years, and 72 (61.0%) were aged 10 years and older. An asymptomatic mass was the most common presentation. Forty-three patients (36.4%) had infectious or inflammatory lesions, 56 (47.5%) had benign lesions, and 19 (16.1%) had malignant lesions. The most common benign lesions were pleomorphic adenoma (22.9%) and hemangioma (10.2%). The most common malignant lesions were mucoepidermoid carcinoma (6.8%) and acinic cell carcinoma (3.4%). The most common treatment was total parotidectomy (40.7%). Surgical complications included temporary facial nerve weakness in 22 (18.6%) patients, permanent facial weakness in 11 (9.3%), and permanent paralysis in 2 (1.7%). Pleomorphic adenoma recurred in 4 (14.8%) of 28 patients and mucoepidermoid carcinoma in 3 (37.5%) of 8 patients. One patient with adenoid cystic carcinoma died of the tumor.

Conclusions  Although pediatric parotid masses are unusual, they can represent a variety of pathological diagnoses, including malignancy. We advocate prompt evaluation and treatment of these masses, and suggest guidelines for their management, based on diagnosis.

From the Department of Otorhinolaryngology (Drs Orvidas, Kasperbauer, and Olsen), Division of Anatomic Pathology (Dr Lewis), and Section of Biostatistics (Mr Lesnick), Mayo Clinic and Mayo Foundation, Rochester, Minn.

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