Mucoepidermoid carcinoma surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Surgery is the mainstay of therapy for mucoepidermoid carcinoma.[1]
Surgery
- Mucoepidermoid carcinoma (low-grade): complete surgical excision with sparing of the facial nerve.[1]
- Mucoepidermoid carcinoma (high-grade): parotidectomy with facial nerve sparing may be followed by radiotherapy.
- Clinically aggressive mucoepidermoid carcinoma tumors with facial nerve involvement will require radical surgery with sacrifice of the facial nerve and radiotherapy. [2]
- Primary nerve grafting using the sural nerve if possible is performed.
- Lymph node dissection is usually only performed for clinically or radiographically detected nodal metastasis.
Surgery is the main mode of treatment for malignant sublingual gland tumors, and different types of surgical interventions depends on the extent of the primary tumor. For small tumors which are restricted to the floor of the mouth, a wide surgical resection of involved sublingual and also the ipsilateral submandibular salivary gland has to done, as the ductal system is often affected even with limited resection [11]. In our case Low grade MEC in the floor of the mouth was surgically excised along with involved lymphnode. [3]
A combination of surgery, chemotherapy, and radiation therapy are used to treat Mucoepidermoid Carcinoma of Salivary Gland. The treatment may also depend upon the stage, overall health, age, and grade of the tumor. A universally acceptable tumor histological grading is currently unavailable.
The treatment measures for MEC of Salivary Gland may involve:[4]
Wide surgical excision with removal of the entire lesion is the standard treatment mode High-dose radiation therapy may be used after surgery, to destroy the remaining tumor cells When the tumor is at an inaccessible location, or is unsafe for surgical intervention, non-invasive procedures, such as chemotherapy and radiation therapy (using fast neutron-beam), may be considered Recurrent salivary gland tumors are also known to respond better to fast neutron-beam radiation therapy than other treatment modes Embolization is used to provide temporary relief from the symptoms, and reduce blood loss during a surgical procedure Clinical trial therapies (especially for stage IV disease) including therapeutic drugs, radiation, stem cell transplantation, and monoclonal antibodies, either singly or in combination of various therapies Post-operative care is important: A minimum activity level is to be ensured until the surgical wound heals Follow-up care with regular screening and check-ups are important, to watch for recurrence and any metastatic behavior[5]
Indications
- Indications for surgery for mucoepidermoid carcinoma, include:[6]
- Biological and histological features suitable for surgery
Gallery
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References
- ↑ 1.0 1.1 Mucoepidermoid Carcinoma Surgery. WikiBooks. https://en.wikibooks.org/wiki/Radiation_Oncology/Head_%26_Neck/Salivary_gland Accessed on February 17,2016
- ↑ Gedar Totuk OM, Demir MK, Yapicier O, Mestanoglu M (2017). "Low-Grade Mucoepidermoid Carcinoma of the Lacrimal Gland in a Teenaged Patient". Case Rep Ophthalmol Med. 2017: 2418505. doi:10.1155/2017/2418505. PMC 5727657. PMID 29318070.
- ↑ Rinaldo A, Shaha AR, Pellitteri PK, Bradley PJ, Ferlito A (January 2004). "Management of malignant sublingual salivary gland tumors". Oral Oncol. 40 (1): 2–5. PMID 14662408.
- ↑ Helmus C (August 1997). "Subtotal parotidectomy: a 10-year review (1985 to 1994)". Laryngoscope. 107 (8): 1024–7. PMID 9261001.
- ↑ Maloth AK, Nandan SR, Kulkarni PG, Dorankula SP, Muddana K (December 2015). "Mucoepidermoid Carcinoma of Floor of the Mouth - A Rarity". J Clin Diagn Res. 9 (12): ZD03–4. doi:10.7860/JCDR/2015/15595.6912. PMC 4717804. PMID 26813873.
- ↑ Rapidis, Alexander D.; Givalos, Nikolaos; Gakiopoulou, Hariklia; Stavrianos, Spyros D.; Faratzis, Gregory; Lagogiannis, George A.; Katsilieris, Ioannis; Patsouris, Efstratios (2007). "Mucoepidermoid carcinoma of the salivary glands". Oral Oncology. 43 (2): 130–136. doi:10.1016/j.oraloncology.2006.03.001. ISSN 1368-8375.