Malignant disease of the parotid

Abstract

1. The histological material from 95 cases of malignant disease of the parotid treated at the Middlesex Hospital from January 1930 to August 1964 has been re-examined, and an attempt made to correlate the clinical course with the histological appearances. 2. During the same period, 548 other parotid tumours were removed in the hospital, giving a ratio of malignant to other tumours of 1 to 5-8. 3. Most of the 47 patients with tumours classified as carcinoma have died of the disease, and differences in the clinical course between the different cell types of carcinoma are minor. 4. Most of the 32 patients with tumours classified as mucoepidermoid, cylindromatous, and acinic cell tumours have remained well and free of disease. 5. In 18 cases there was histological evidence of the development of the carcinoma in relation to pre-existing primary or recurrent mixed tumours, and in 2 cases to cylindromatous tumours. In addition, there were 5 cases with a historv of inert tumour for 10 years or more before the development of the carcinoma. Thus in 25 out of the 47 cases of carcinoma there was either histological or clinical evidence of the origin of the tumour in relation to a tumour of lesser malignancy. 6. All 6 patients with tumours classified as “mixed tumour with suspicious local area” remained well and free of disease. 7. There were 6 cases of secondary tumours of the parotid, one a lymph-borne melanoma, and the other 5 blood-borne tumours. In 2 of the latter, the tumours of the parotid were regarded as primary both clinically and pathologically, and the correct diagnosis was only made in light of the post-mortem findings. 8 Correct surgical treatment of the primary tumour should cure most cases of mucoepidermoid, cylindromatous, and acinic cell tumours. 9. The only immediate hope for substantial improvement in the results of treatment of carcinoma of the parotid is by a reduction of its incidence by adequate surgical treatment of tumours of lesser degree of malignancy. The authors wish to gratefully acknowledge receipt of a grant from the British Empire Cancer Campaign for Research for the expenses of this work. © 1965, The British Empire Cancer Campaign for Research. All rights reserved.