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Pleomorphe Riesenadenome der Ohrspeicheldrüse

Epidemiologie, Diagnostik und Therapie

Epidemiology, diagnosis, and treatment of giant pleomorphic adenomas of the parotid gland

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Zusammenfassung

Nicht therapierte pleomorphe Adenome der Gl. parotis können über lange Zeiträume hinweg gigantische Ausmaße erreichen und mit einer erheblichen kosmetischen und funktionellen Beeinträchtigung der betroffenen Patienten einhergehen. Die in den letzten 80 Jahren publizierten Fälle (n=20) von derartigen Riesenadenomen (1,2–26,5 kg Tumorgewicht) zeigen, dass zu 90% Frauen betroffen sind. Der Zeitraum von der klinischen Manifestation des Tumors bis zur Therapie betrug durchschnittlich 20,7 Jahre. Das Durchschnittsalter der Patienten zum Zeitpunkt der Operation lag bei 58,9 Jahren. Eine maligne Entartung trat in 15,8% der Fälle auf. Die Gründe für die verzögerte Therapie sind wahrscheinlich einerseits in der Angst der Patienten vor dem Eingriff, andererseits in einer unzureichenden ärztlichen Beratung zu sehen. Am Fallbeispiel einer 77-jährigen Patientin mit einem 3,9 kg schweren, über 40 Jahre gewachsenen Tumor der linken Gl. parotis und einer Literaturübersicht werden die Besonderheiten der Diagnostik und Therapie von Riesenadenomen der Ohrspeicheldrüse dargestellt.

Abstract

Pleomorphic adenomas of the parotid gland can be slowly growing over the course of many years and may reach an enormous and disfiguring size associated with significant morbidity of the patients. To our knowledge, over the last 80 years 20 cases of giant pleomorphic adenomas (weight 1.2–26.5 kg) have been reported. These tumors occurred predominantly in women (90%). The mean period from initial clinical manifestation until definitive surgical treatment was 20.7 years. The mean age of the patients at the time of surgery was 58.9 years. Malignant transformation occurred in 15.8% of cases. It is likely that the reasons for delayed treatment are the patient’s fear of surgery on the one hand, and insufficient medical advise on the other. We report on a 77 year old female who had a 40-year history of a growing parotid tumor that weighed 3.9 kg after resection. The implications of this case for diagnosis and treatment of giant pleomorphic adenomas, and a review of the world literature on these unusual parotid tumors, are presented.

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Authors and Affiliations

  1. Abt. HNO-Heilkunde/Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland

    H. Maier, S. Frühwald, M. Tisch & K. J. Lorenz

  2. Abt. Radiologie, Bundeswehrkrankenhaus Ulm, -, Deutschland

    B. Danz

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  1. H. Maier
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  2. S. Frühwald
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  3. M. Tisch
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  4. B. Danz
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  5. K. J. Lorenz
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Correspondence to H. Maier.

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Maier, H., Frühwald, S., Tisch, M. et al. Pleomorphe Riesenadenome der Ohrspeicheldrüse. HNO 55, 812–818 (2007). https://doi.org/10.1007/s00106-006-1471-y

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