Parotid gland tumors. Clinicopathologic study.

The clinical findings and histologic features of 154 parotid gland tumors treated at the Health Sciences Centre, Winnipeg, Canada, from 1957 to 1970 were reviewed. The study illustrates a wide variation in the natural history and degree of malignancy of parotid tumors. Approximately 80 per cent were benign; among these, mixed tumors were by far the commonest. For most benign tumors, the recommended surgical treatment is wide local excision with an adequate margin of normal glandular tissue, except when subtotal or conservative total parotidectomy is required because of the size or location of the tumor. The facial nerve should be visualized and preserved. This approach prevents recurrences and minimizes facial nerve injury, since risk of neural injury increases with the extent of the surgical procedure. Total removal of the gland on the basis of the multicentricity or malignant transformation of these tumors is not supported by the findings of this study. For malignant tumors a more radical procedure, that is, subtotal or total parotidectomy with or without node dissection, with sacrifice of the facial nerve if necessary is advisable, depending on the type and anatomic location of the tumor.