Diagnostic and therapeutic approach to sialoblastoma: Report of a case

The natural history of a rare parotid tumor, the sialoblastoma (embryoma) i s reported. It is a blastematous neoplasm said to recapitulate the epitheli al differentiation of a gland at various stages of development. The tumor B rew in a period of 5 years (from shortly after birth until it was excised) to a firm asymptomatic mass measuring 5 cm in greatest diameter. With a dia gnosis of adenoid cystic carcinoma (a common misdiagnosis), the patient was referred to the reporting institution, where the diagnosis was revised. Fi ve months later, completion parotidectomy for presumed recurrence failed to demonstrate residual tumor. One year later, the patient appears to be free of disease. The authors propose that sialoblastomas should be regarded nei ther as benign nor malignant, but as one single disease with local infiltra tive potential. Based on this concept, sialoblastomas can be treated with e arly conservative surgery alone, provided that free margins are obtained. J Pediatr Surg 34:1875-1877. Copyright (C) 1999 by W.B. Saunders Company.