title: Surgical management of pleomorphic adenoma of parotid gland in elderly patients: role of morphological features.
abstract: The neoplasms of the salivary glands account for 2% of head and neck tumors and the most common form is the Pleomorphic adenoma (PA). Parotid gland is affected from 80% to 90% of cases. In elderly these tumors occur mostly in females. These benign tumors are composed of epithelial and myoepithelial cells that are arranged with various morphological patterns and subtypes. The classification of these tumors is also based on the amount and nature of the stroma. In literature there is an almost complete consensus that, in the major salivary glands, PAs are enclosed by a layer of fibrous tissue often called "capsule" but there is disagreement about the form, extension and thickness of this layer. The treatment is surgical and there are two main different surgical approaches: an enucleation (local dissection) or so-called subtotal superficial parotidectomy and lateral or superficial total parotidectomy. Histopathological characteristics of PAs especially of capsular alterations such as thin capsule areas, capsule-free regions, capsule penetration, satellite nodules and pseudopodia in the different subtypes are important for the choice of surgical treatment and the first explanation for tumor recurrence. In our study we describe a morphological features of 84 cases of pleomorphic adenoma of parotid gland from elderly patients treated by a surgical "enucleation like" method called nucleoresection.
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy. Electronic address: germano.guerra@unimol.it.
authors.forename: Germano
authors.initials: G
authors.lastname: Guerra
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Italy. Electronic address: domenico.testa@unina2.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Testa
authors.affiliation: Department of Public Health, University of Naples "Federico II", Naples, Italy. Electronic address: montagna@unina.it.
authors.forename: Stefania
authors.initials: S
authors.lastname: Montagnani
authors.affiliation: Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy. Electronic address: domenicotafuri@inwind.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tafuri
authors.affiliation: Department of Surgical, Oncologic and Oral Sciences, University of Palermo, Palermo, Italy. Electronic address: francescosalzano@unipa.it.
authors.forename: Francesco Antonio
authors.initials: FA
authors.lastname: Salzano
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy. Electronic address: aldorocca@hotmail.it.
authors.forename: Aldo
authors.initials: A
authors.lastname: Rocca
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy. Electronic address: bramato@unina.it.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.affiliation: Department of Neuroscience Reproductive and Dentistry Sciences, University of Naples "Federico II", Naples, Italy. Electronic address: giovanni.salzano@hotmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Salzano
authors.affiliation: Department of Neuroscience Reproductive and Dentistry Sciences, University of Naples "Federico II", Naples, Italy. Electronic address: giovanni.dellaversana@unina.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Dell'Aversana Orabona
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Italy. Electronic address: pasquale.piombino@unina.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Piombino
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Italy. Electronic address: gaetano.motta@unina2.it.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Motta
mesh_terms: D008949:Adenoma, Pleomorphic / Q000473:pathology* / Q000601:surgery; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery
keywords: Capsule; Image analysis software; Nucleoresection surgical approach; Parotid gland; Pleomorphic adenoma