Clinical Presentation,Management,and Outcome of High-Grade Mucoepidermoid Carcinoma of the Parotid Gland

OBJECTIVE: To describe clinical features of high-grade (HG) mucoepidermoid carcinoma (MEC) of the parotid gland and assess clinical outcomes of one surgical management approach.

DESIGN/SETTING/METHODS: Retrospective case series in a tertiary care academic institution. Pathology records were reviewed from 1977 to 1997, identifying patients with parotid HG MEC. Available medical records were reviewed for data on clinical features, treatment, and outcome.

RESULTS: Increased stage, increased T stage, presence of neck metastasis, and distant metastasis were all associated with poor outcome. Wide local excision and postoperative radiation (XRT) provided 82% local control. XRT alone for N0 disease provided 86% regional control, while XRT and neck dissection yielded 74% control in N+ cases.

CONCLUSION: High-grade MEC of the parotid gland is an aggressive disease that frequently presents at advanced stage. Parotidectomy with modified radical neck dissection and postoperative XRT provides reasonable local and regional control for patients with N+ disease. Elective selective neck dissection and radiation should be considered for T3 and T4 tumors with N0 status.