A Study on Therapeutic Parotidectomy in Patients with Non-melanoma Cutaneous Carcinoma in the Temporal Region of the Head and Face

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  • 頭部・顔面非メラノーマ皮膚悪性腫瘍における耳下腺リンパ節郭清の検討
  • 臨床 頭部・顔面非メラノーマ皮膚悪性腫瘍における耳下腺リンパ節郭清の検討
  • リンショウ トウブ ・ ガンメン ヒメラノーマ ヒフ アクセイ シュヨウ ニ オケル ジカセン リンパセツカクセイ ノ ケントウ

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<p>The optimal method for parotidectomy in patients with non-melanoma cutaneous carcinoma of the head and face region has still not been clarified. To clarify the optimal procedure for therapeutic parotidectomy, we reviewed the medical records of patients with non-melanoma cutaneous carcinoma. Between 2006 and 2010, we treated four cases of cutaneous carcinoma with metastasis to the parotid area. The site of origin of the cutaneous carcinoma was the temporal region of the head in three of these patients and the eyelid in the fourth patient. All four patients had metastatic lymph nodes in the parotid area. Two of the four patients had lymph node metastasis in both the parotid and cervical areas. None of the patients had facial palsy before the surgery. Facial nerve-preserving total parotidectomy (FNP-TP) with or without neck dissection was performed in all patients. Postoperative histopathological examination revealed occult metastasis of the lymph nodes in the deep and superficial lobes of the parotid gland in two of the patients. None of the patients received postoperative adjuvant radiation therapy or chemotherapy and all survived for more than five years without recurrence. From these results, it is considered that FNP-TP (elective dissection of the deep lobe of the parotid gland) may be the appropriate choice of procedure for therapeutic parotidectomy in patients with cutaneous carcinoma of the temporal area of the face and neck with metastatic lymph nodes in the parotid area. Furthermore, this procedure may allow avoidance of postoperative adjuvant radiotherapy in some cases.</p>

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