Pediatric parotid masses

Objective: To evaluate the incidence, types, and treatment outcomes of pedi atric parotid lesions. Design: Retrospective case review, histological tissue review, and literatu re review. Setting: Tertiary care center. Patients: All patients aged 18 years and younger with parotid masses evalua ted and treated at the Mayo Clinic, Rochester, Minn, from January 1, 1970, to December 31, 1997. Results: Parotid masses were identified in 118 children (60 boys and 58 gir ls). At diagnosis,the ages of patients were from birth through 18 years, an d 72 (61.0%) were aged 10 years and older. An asymptomatic mass was the mos t common presentation. Forty-three patients (36.4%) had infectious or infla mmatory lesions, 56 (47.5%) had benign lesions, and 19 (16.1%) had malignan t lesions. The most common benign lesions were pleomorphic adenoma (22.9%) and hemangioma (10.2%). The most common malignant lesions were mucoepidermo id carcinoma (6.8%) and acinic cell carcinoma (3.4%). The most common treat ment was total parotidectomy (40.7%). Surgical complications included tempo rary facial nerve weakness in 22 (18.6%) patients, permanent facial weaknes s in 11 (9.3%), and permanent paralysis in 2 (1.7%). Pleomorphic adenoma re curred in 4 (14.8%) of 28 patients and mucoepidermoid carcinoma in 3 (37.5% ) of 8 patients. One patient with adenoid cystic carcinoma died of the tumo r. Conclusions: Although pediatric parotid masses are unusual, they can repres ent a variety of pathological diagnoses, including malignancy. We advocate prompt evaluation and treatment of these masses, and suggest guidelines for their management, based on diagnosis.