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A 10-Year Experience

Reza Rahbar, DMD, MD; J. Fredrik Grimmer, MD; Sara O. Vargas, MD; Caroline D. Robson, MB, ChB; Jennifer W. Mack, MD; Antonio R. Perez-Atayde, MD; Karen J. Marcus, MD; Holcombe E. Grier, MD; Gerald B. Healy, MD; Trevor J. McGill, MD

Arch Otolaryngol Head Neck Surg. 2006;132:375-380.

Objective  To determine the presentation, pathologic features, treatment outcome, and prognosis of mucoepidermoid carcinoma of the parotid gland in children.

Design  Retrospective clinical and histopathologic study with institutional review board approval.

Setting  Tertiary pediatric medical center.

Patients  Seven children (4 girls and 3 boys) presented with mucoepidermoid carcinoma of the parotid gland between 1994 and 2004.

Main Outcome Measures  Clinical presentation, pathologic features, treatment outcome, complications, local recurrence, distant metastasis, and overall survival.

Results  All patients presented with an asymptomatic parotid mass. Initial treatment in 7 patients included total parotidectomy (n = 3), superficial parotidectomy (n = 3), transoral enucleation (n = 1), and supraomohyoid neck dissection (n = 1). Four patients required additional surgical procedures because of a close and/or positive margin, including revision parotidectomy (n = 2), total parotidectomy (n = 1), superficial parotidectomy (n = 1), and supraomohyoid neck dissection (n = 1). One patient required postoperative radiation therapy. No evidence of local recurrence or distant metastasis was noted with a mean follow-up of 3.4 years.

Conclusions  Mucoepidermoid carcinoma of the parotid gland is very rare in children. Clinical stage and histologic grade are the main prognostic factors. Complete excision (superficial or total parotidectomy) with preservation of facial nerve is the treatment of choice. Neck dissection should be considered when there is clinical evidence of regional metastasis, high TNM stage, high histologic grade, and involvement of regional nodes. Because of the possibility of long-term adverse effects in pediatric patients, radiotherapy should be used only in selected cases. Long-term follow-up is essential to rule out late recurrence.

Author Affiliations: Departments of Otolaryngology (Drs Rahbar, Grimmer, Marcus, Healy, and McGill), Pathology (Drs Vargas and Perez-Atayde), Radiology (Drs Robson and Marcus), Oncology (Drs Mack and Grier), and Radiation Oncology (Dr Marcus), Children's Hospital, Harvard Medical School, Boston, Mass.

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