Background: Intraoperative rupture of the capsule of a pleomorphic adenoma is reported to be associated with an increased recurrence rate. For many years, we have noted few recurrences among patients who experienced rupture of the capsule during surgery. Therefore, we asked "How often has surgical rupture of the capsule of a mixed parotid tumor resulted in recurrence among our patients?" This study is a summary of our clinical observations and not a methodologic one.
Methods: The medical records of 346 patients operated on between 1965 and 1981 were reviewed. The surgical notes and histopathologic descriptions were examined with special reference to the relationship between surgical margins and tumor capsule. Satisfactory follow-up was obtained from 238 patients primarily operated on in our department. The average observation time was 18 years. None of our patients received postoperative irradiation.
Results: Six (2.5%) patients had a recurrence 7 to 18 years postoperatively (mean 11.8 years). This recurrence rate is of the same order of magnitude as other reports. Rupture of the capsule with macroscopic spillage of tumor cells occurred in 26 patients and two (8%) of them developed recurrent tumors. Surgical dissection close to the capsule was performed in 87 cases, with one recurrence. In the remaining 121 patients the surgical dissections were done without visualizing the tumor capsule. Three (2.5%) of these cases developed recurrent tumor. The 8% recurrence rate after capsule rupture is not statistically different from the 2% for the other patients. There was also no difference in recurrence rate between patients with microscopic positive or negative surgical resection margins.
Conclusions: We question whether spillage of tumor cells from a pleomorphic adenoma plays such an important role in the development of recurrent tumors as has been previously postulated. We also question the justification and benefit of postoperative radiotherapy for patients with this benign disease.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/hed.2880160302 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical Features, Risk Factors and Outcomes following Surgery for Late Intraocular Lens Decentration in the Dead Bag Syndrome.
Am J Ophthalmol
January 2025
Raghudeep Eye Hospital, Laden Cataract and IOL research centre, Ahmedabad, India 380052.
Purpose: To evaluate demographic profile, risk factors and outcomes following intraocular lens (IOL) exchange surgery for late decentration of IOLs in the dead bag syndrome DESIGN: Prospective, interventional case series PARTICIPANTS: 46 eyes (43 patients) with late decentration/dislocation of IOLs and spontaneous posterior capsule rupture in a clear and relatively intact capsular bag. None of the eyes had significant zonular weakness.
Methods: Study conducted at Raghudeep Eye Hospital, India.
An autopsy case of encapsulated acute subdural hematoma presenting as an acute-on-chronic spontaneous subdural hematoma.
Leg Med (Tokyo)
January 2025
Division of Legal Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan; Center of Cause of Death Investigation, Faculty of Medicine, Niigata University, Niigata, Japan.
Subdural hematoma (SDH) is bleeding between the dura mater and the brain surface, often visualized as a crescent-shaped lesion on computed tomography (CT). However, some SDHs can appear as a biconvex hyperdense lesion mimicking an acute epidural hematoma. Encapsulated acute SDH (EASDH), a rare subtype characterized by a fresh hematoma within the subdural fibrous capsule, presents with similar CT findings.
View Article and Find Full Text PDFMicrorheometric study of damage and rupture of capsules in simple shear flow.
J Fluid Mech
December 2024
Université de Technologie de Compiègne, CNRS, Biomechanics and Bioengineering, Compiégne, France.
Capsules, which are potentially-active fluid droplets enclosed in a thin elastic membrane, experience large deformations when placed in suspension. The induced fluid-structure interaction stresses can potentially lead to rupture of the capsule membrane. While numerous experimental studies have focused on the rheological behavior of capsules until rupture, there remains a gap in understanding the evolution of their mechanical properties and the underlying mechanisms of damage and breakup under flow.
View Article and Find Full Text PDFOpen Ankle Injury without Associated Fracture or Dislocation Requiring Surgical Intervention: A Case Report.
J Orthop Case Rep
January 2025
Department of Orthopaedics, University of Toledo Medical Center, Ohio, USA.
Introduction: Bony and ligamentous ankle injuries are some of the most commonly treated injuries by orthopedic surgeons. Open ligamentous ankle injuries without an associated fracture or dislocation are rare and to our knowledge have only sparsely been described in the literature. We present a case and successful treatment of an open lateral ankle injury with capsular rupture and ligamentous damage without fracture or dislocation in a 22-year-old female.
View Article and Find Full Text PDFTranscriptome of capsular contracture around breast implants mimics allograft rejection: a matched case-control study.
Plast Reconstr Surg
December 2024
Copenhagen University Hospital, Department of Plastic Surgery and Burns Treatment, Rigshospitalet, Copenhagen, Denmark.
Background: Capsular contracture is a frequent and severe complication following breast implant surgery. Although several theories on the pathophysiology exist, the exact molecular mechanisms remain unclear. This study aimed to identify the specific genes, signaling pathways, and immune cells associated with capsular contracture.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!