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Is surgical excision of lipomas arising from the parotid gland systematically required?

机译:是否需要系统切除腮腺引起的脂肪瘤?

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摘要

Lipomas arising from the parotid gland are very rare. We report a 10-year experience in a single institution (La Timone University Hospital of Marseille, France). Among 614 parotidectomies for neoplasms performed from 1998 to 2008, 12 lipomas were identified. A retrospective analysis based on medical records was made. Evaluation, analysis and current management of lipomas of the parotid gland are described. Lipomas accounted for 2% of all parotid neoplasms and 2.6% of benign tumors in our series. The median age of patients was 60 years with a M/F sex ratio of 5–1. The main presentation was a soft asymptomatic, slow-growing, mobile mass although 30% had an indurated mass on palpation. Diagnosis of lipoma, based on the results of imaging, was made preoperatively in all cases. The mean tumor duration prior to excision was 11.5 months. The surgical decision was made regarding increased swelling with functional/esthetic discomfort in 83% of cases. Partial parotidectomy was performed in most cases. Postoperative complications occurred in 16% of cases although no permanent complication was observed. No recurrence was observed in our series. Histologically, 92% of tumors were classic lipomas. Lipomas can be clinically misleading since 30% of patients in our series showed an indurated mass on palpation. Preoperative imaging, especially MRI, is the cornerstone of their management as it allows very accurate lipoma diagnosis. Since in our series, diagnosis of lipoma had been made preoperatively in all cases, the surgical excision could be delayed and finally surgical decision has been made for esthetic and/or functional considerations in more than 80% of cases.
机译:腮腺引起的脂肪瘤非常罕见。我们报告在单一机构(法国马赛拉蒂莫内大学医院)拥有10年的经验。在1998年至2008年进行的614例腮腺切除术中,鉴定出12例脂肪瘤。根据病历进行回顾性分析。描述了腮腺脂肪瘤的评估,分析和当前处理方法。在我们的系列中,脂瘤占所有腮腺肿瘤的2%和良性肿瘤的2.6%。患者的中位年龄为60岁,男/女性别比为5-1。主要表现为软无症状,生长缓慢,可移动的肿块,尽管有30%的触诊有硬结块。术前根据影像学结果诊断脂肪瘤。切除前的平均肿瘤持续时间为11.5个月。做出手术决定时有83%的患者因功能/美学不适而肿胀。大多数情况下进行腮腺部分切除术。尽管未观察到永久性并发症,但仍有16%的病例发生了术后并发症。在我们的系列中未观察到复发。从组织学上讲,92%的肿瘤是经典的脂肪瘤。脂瘤在临床上可能会产生误导,因为我们系列中30%的患者在触诊时显示出硬块。术前影像检查,尤其是MRI,是其管理的基石,因为它可以非常准确地诊断脂肪瘤。由于在我们的系列文章中,所有病例均在术前进行了脂肪瘤的诊断,手术切除可能会延迟,并且最终出于美观和/或功能方面的考虑而做出手术决定的病例超过了80%。

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