International Journal of Pediatric Otorhinolaryngology
Review ArticleSalivary gland malignancies in children
Section snippets
Epidemiology
Salivary gland malignancies account for approximately 1% of all cancers in the general population, with pediatric cases composing less than 5% of all salivary gland cancer [1], [2], [3], [4], [5], [6]. Overall, salivary gland malignancies in children comprise only 8–10% of pediatric head and neck cancer [7]. Although the annual incidence of pediatric salivary gland malignancies is less than 1 per million, a salivary gland neoplasm presenting in a child has a 50–60% probability of malignancy,
Presentation
Most children initially present between the ages of 10 and 16 years with palpable swelling in the salivary gland region. A slow growing, asymptomatic mass is often the only presenting sign with an average time to presentation of about 12–24 months [8], [12], [18]. Approximately half of patients will complain of recent onset of pain in the absence of infectious or inflammatory symptoms. Rarely, patients may present with cranial nerve palsy or tethering of the skin [8], [9], [19].
Evaluation
On physical
Therapeutic management
Complete surgical resection with adequate margins constitutes the mainstay of treatment for salivary gland malignancies in children. The roles of adjuvant chemotherapy and/or radiation therapy for combined treatment continue to evolve over time but no definitive guidelines have been established. Poor outcomes from salvage therapy suggest that the best chance for long-term control of salivary gland carcinomas is adequate initial treatment.
Parotidectomy with complete tumor resection and facial
Conclusion
Reported outcomes among children with salivary gland cancer are relatively encouraging, with observed five- and 10-year overall survival rates ranging between 80% and 95%. Prognosis is generally favorable in patients who are diagnosed at an early stage, whose tumors are low-grade, and who are treated by surgical resection with adequate margins. The propensity for late recurrence of salivary gland malignancies, particularly acinic cell carcinoma and adenoid cystic carcinoma reinforces the
Conflict of interest
None.
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