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As is the case with adults, primary tumours of the salivary glands in children comprise a heterogeneous collection of different histological types. This paper presents a retrospective review of primary salivary gland tumours in children treated over the course of 20 years (2000 to 2020) at Children’s Hospital Colorado in the USA. Fifty children were included: 39 (78%) with benign lesions and 11 (22%) with malignant lesions. Pleomorphic adenoma was the most common benign tumour (36/39, 92%) with acinic cell carcinoma the most common malignancy (7/11, 64%). The former observation is in keeping with existing data but the frequency of acinic cell carcinoma is somewhat at variance with national US data that reports mucoepidermoid carcinoma to be the most common paediatric salivary gland malignancy. One patient treated for a low-grade acinic cell carcinoma developed local recurrence eight years after initial resection, highlighting the need for long-term follow-up of certain subtypes of salivary gland malignancies. With regards to preoperative investigations, it is interesting to note that needle biopsies yielded a correct diagnosis in only 50% of malignancies treated. Seventeen percent of the biopsies were inaccurate and 33% were non-diagnostic. The non-diagnostic rate for benign pathologies was 20%, with no inaccurate results recorded. This data provides useful information for counselling the parents of children with salivary gland lumps, especially with regards to the benefits as well as potential limitations – of needle biopsies in children with salivary gland lesions. In particular, a non-diagnostic needle biopsy result cannot be interpreted as reassuring – in this series, 40% of non-diagnostic needle biopsies were ultimately associated with a malignant diagnosis.

Paediatric primary salivary gland tumors.
Jesberg P, Monzon A, Gitomer SA, Herrmann BW.
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Christopher Burgess

Musgrove Park Hospital, Taunton, UK.

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