Clinicopathological pattern of malignant parotid gland tumors in Saudi Arabia

Objectives: To report our experience of varied presentations and diverse histopathological spectrum of parotid gland malignancies. Methods: This retrospective analysis incorporated patients with histological evidence of malignant parotid tumors at King Khalid University Ho spital, Riyadh, Saudi Arabia over a 20-year period from 1984 through 2004. The medical records ofthese patients were analyzed for their demographic characteristics, clinical features, operations performed, and pathological diversity. Results: Thirry-rwo patients comprised this study group . There is a male preponderance over females with a ratio of 2.2: 1 (22 men and 10 women) and mean age of 51.8 (range 28-81 years). A painless lump was the most frequent clinical man ifestation observed in 23 (71.8 %) patients followed by facial nerve dysfunction in 14 (43.7%) patients. Parotidectomy was performed in 22 (68.7%) patients : 16 superficial and 6 total. A partial facial nerve sacrifice was undertaken in 14 (43.7%), and total nerve sacrifice in 9 (28.1%) patients . Four (12.5%) patients presented with cervical lymph node metastases necessitating radical neck dissection. Nine (28.1 %) patients had mucoepidermoid carcinom a, 8 (25%) adeno id cystic carcinoma, 6 (18.7%) adenocarcinoma, not otherwise specified, and 2 (6.2%) were reported to have carcinoma in pleomorphic adenoma. Twenty (62.5%) specimens revealed high-grade aggressive lesions, and out of these, 19 (59.3%) patients presented with stage III/IV disease. Conclusion: Malignant parotid tumors are exceedingly rare, occurring at a relatively earlier age group with male preponderance, and invariably declare at a late clinical stage in our community. Histopathological features hallmark a locally advanced disease with an aggressive behavior.