Review Article
Salivary gland malignancies in children

https://doi.org/10.1016/j.ijporl.2013.11.001Get rights and content

Abstract

With an annual incidence of less than 1 per million, salivary gland malignancies in children are rare, constituting less than 10% of pediatric head and neck cancer. Although over 20 histologic types of salivary gland cancer have been reported in adults, a smaller number have been observed in the pediatric population. Mucoepidermoid carcinoma is the most common histologic type, followed by acinic cell carcinoma. Since the majority of salivary gland carcinomas are diagnosed at an early stage, the overall prognosis is often favorable with complete surgical resection. To date, no prospective or retrospective data comparing outcomes of surgery alone versus multimodality therapy in the management of salivary gland malignancies in the pediatric population exists. Consequently, management decisions are made on a case-by-base basis, taking prognosis, treatment-related morbidity, and long-term sequelae into account.

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.

References (40)

  • C.A. North et al.

    Carcinoma of the major salivary glands treated by surgery or surgery plus postoperative radiotherapy

    Int. J. Radiat. Oncol. Biol. Phys.

    (1990)
  • C.H. Terhaard et al.

    The role of radiotherapy in the treatment of malignant salivary gland tumors

    Int. J. Radiat. Oncol. Biol. Phys.

    (2005)
  • T. Bölling et al.

    Hypothyroidism after head-and-neck radiotherapy in children and adolescents: preliminary results of the registry for the evaluation of side effects after radiotherapy in childhood and adolescence (RiSK)

    Int. J. Radiat. Oncol. Biol. Phys.

    (2011)
  • W.W. Huh et al.

    Pediatric sarcomas and related tumors of the head and neck

    Cancer Treat. Rev.

    (2011)
  • P.O. Vedrine et al.

    Mucoepidermoid carcinoma of salivary glands in the pediatric age group: 18 clinical cases, including 11 second malignant neoplasms

    Head Neck

    (2006)
  • D.L. Callender et al.

    Salivary gland neoplasms in children

    Arch. Otolaryngol. Head Neck Surg.

    (1992)
  • M. Guzzo et al.

    Salivary gland neoplasms in children: the experience of the Istituto Nazionale Tumori of Milan

    Pediatr. Blood Cancer

    (2006)
  • M.E. Kupferman et al.

    Outcomes of pediatric patients with malignancies of the major salivary glands

    Ann. Surg. Oncol.

    (2010)
  • L. Laikui et al.

    Epithelial salivary gland tumors of children and adolescents in west China population: a clinicopathologic study of 79 cases

    J. Oral Pathol. Med.

    (2008)
  • P. Bradley et al.

    Paediatric salivary gland epithelial neoplasms

    ORL. J. Otorhinolaryngol. Relat. Spec.

    (2007)
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