title: Unexpected Detection of Parotid Gland Malignancy during Primary Extracapsular Dissection.
abstract: OBJECTIVE
  To evaluate the oncologic and functional outcome in cases in which a false preoperative working hypothesis "benign parotid tumor" led to a primary extracapsular dissection being performed rather than a traditional, more radical surgical modality.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  METHODS
  The records of all patients treated for malignant tumors of the parotid gland between 2006 and 2012 were retrospectively studied. Patients were excluded from our study sample for insufficient data or if their histories indicated manifestation of malignant tumors without primary parotid origin (squamous cell carcinomas, lymphomas, melanomas), revision surgery, as well as concomitant or past malignant tumors. Consequently, a total of 29 patients with 30 primary malignant tumors of the parotid gland formed our study sample (14 men, 15 women; male:female ratio, 0.93:1; mean age, 55.4 years; range, 14-85 years).
  
  
  RESULTS
  Of 30 cases, 22 had low-grade tumors. Further tumor cells were detected in only the histology specimens of the parotid in 3 of the 25 cases treated subsequently with completion parotidectomy. Five patients received adjuvant radiation. Five-year disease-specific survival was 100%; local disease control was 96.6%. Of 30 cases, 28 had House-Brackmann I after tumor treatment; the other 2 cases had a slight paralysis (House-Brackmann II).
  
  
  CONCLUSIONS
  Beginning with the "false" working hypothesis and performing an extracapsular dissection in unsuspected cases seems to have no adverse impact on patients' survival and postoperative quality of life in cases in which definitive histology reveals malignancy.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany konstantinos.mantsopoulos@uk-erlangen.de.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Mantsopoulos
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Velegrakis
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Iro
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D015331:Cohort Studies; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D004210:Dissection / Q000379:methods; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000473:pathology / Q000601:surgery; D010306:Parotid Gland / Q000473:pathology* / Q000601:surgery*; D010307:Parotid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: benign tumors; extracapsular dissection; facial nerve; parotid gland; survival