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Parotid Benign Mixed Tumor
Bronwyn E. Hamilton, MD; H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Benign mixed tumor (BMT)
            • Synonyms

              • Pleomorphic adenoma
            • Definitions

              • Benign, histologically heterogeneous tumor of parotid
              • Epithelial, myoepithelial, and stromal components

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Nuclear Medicine Findings

                        • Other Modality Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Jiang JS et al: Added value of susceptibility-weighted imaging to diffusion-weighted imaging in the characterization of parotid gland tumors. Eur Arch Otorhinolaryngol. 277(10):2839-46, 2020
                                                2. Liu YJ et al: Imaging quality of PROPELLER diffusion-weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland. NMR Biomed. 33(5):e4282, 2020
                                                3. Ogle OE: Salivary gland diseases. Dent Clin North Am. 64(1):87-104, 2020
                                                4. Wu Q et al: Characterization of parotid gland tumors using T2 mapping imaging: initial findings. Acta Radiol. 61(5):629-35, 2020
                                                5. Choi JS et al: Identification of new genes of pleomorphic adenoma. Medicine (Baltimore). 98(51):e18468, 2019
                                                6. Elmokadem AH et al: Diagnostic accuracy of multiparametric magnetic resonance imaging for differentiation between parotid neoplasms. Can Assoc Radiol J. 70(3):264-72, 2019
                                                7. Mogen JL et al: Dynamic contrast-enhanced MRI to differentiate parotid neoplasms using golden-angle radial sparse parallel imaging. AJNR Am J Neuroradiol. 40(6):1029-36, 2019
                                                8. Razek AAKA: Multi-parametric MR imaging using pseudo-continuous arterial-spin labeling and diffusion-weighted MR imaging in differentiating subtypes of parotid tumors. Magn Reson Imaging. 63:55-9, 2019
                                                9. Kim BS et al: Diagnostic value of metabolic heterogeneity as a reliable parameter for differentiating malignant parotid gland tumors. Ann Nucl Med. 30(5):346-54, 2016
                                                10. Prasad RS: Parotid gland imaging. Otolaryngol Clin North Am. 49(2):285-312, 2016
                                                11. Dong Y et al: Diagnostic value of CT perfusion imaging for parotid neoplasms. Dentomaxillofac Radiol. 43(1):20130237, 2014
                                                12. Brennan PA et al: Is ultrasound alone sufficient for imaging superficial lobe benign parotid tumours before surgery? Br J Oral Maxillofac Surg. 50(4):333-7, 2012
                                                13. Christe A et al: MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol. 32(7):1202-7, 2011
                                                14. Dumitriu D et al: Ultrasonographic and sonoelastographic features of pleomorphic adenomas of the salivary glands. Med Ultrason. 12(3):175-83, 2010
                                                15. Yerli H et al: Diagnosing common parotid tumours with magnetic resonance imaging including diffusion-weighted imaging vs fine-needle aspiration cytology: a comparative study. Dentomaxillofac Radiol. 39(6):349-55, 2010
                                                16. Habermann CR et al: Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol. 30(3):591-6, 2009
                                                17. Lee YY et al: Imaging of salivary gland tumours. Eur J Radiol. 66(3):419-36, 2008
                                                18. Yabuuchi H et al: Parotid gland tumors: can addition of diffusion-weighted MR imaging to dynamic contrast-enhanced MR imaging improve diagnostic accuracy in characterization? Radiology. 249(3):909-16, 2008
                                                19. Bialek EJ et al: Role of ultrasonography in diagnosis and differentiation of pleomorphic adenomas: work in progress. Arch Otolaryngol Head Neck Surg. 129(9):929-33, 2003
                                                20. Nagel H et al: Analysis of the tumour suppressor genes, FHIT and WT-1, and the tumour rejection genes, BAGE, GAGE-1/2, HAGE, MAGE-1, and MAGE-3, in benign and malignant neoplasms of the salivary glands. Mol Pathol. 56(4):226-31, 2003
                                                21. O'Brien CJ: Current management of benign parotid tumors--the role of limited superficial parotidectomy. Head Neck. 25(11):946-52, 2003
                                                22. Sato T et al: Dynamic scintigraphy with thallium-201 chloride (Tl-201) for the diagnosis of tumors of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 92(2):228-35, 2001
                                                23. Hancock BD: Clinically benign parotid tumours: local dissection as an alternative to superficial parotidectomy in selected cases. Ann R Coll Surg Engl. 81(5):299-301, 1999
                                                24. Shimizu M et al: Statistical study for sonographic differential diagnosis of tumorous lesions in the parotid gland. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 88(2):226-33, 1999
                                                25. Ikeda K et al: The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma. AJNR Am J Neuroradiol. 17(3):555-9, 1996
                                                26. Phillips PP et al: Recurrent pleomorphic adenoma of the parotid gland: report of 126 cases and a review of the literature. Ann Otol Rhinol Laryngol. 104(2):100-4, 1995
                                                27. Joe VQ et al: Tumors of the parotid gland: MR imaging characteristics of various histologic types. AJR Am J Roentgenol. 163(2):433-8, 1994
                                                28. Takeichi N et al: Salivary gland tumors in atomic bomb survivors, hiroshima, japan. II. Pathologic study and supplementary epidemiologic observations. Cancer. 52(2):377-85, 1983
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Benign mixed tumor (BMT)
                                                          • Synonyms

                                                            • Pleomorphic adenoma
                                                          • Definitions

                                                            • Benign, histologically heterogeneous tumor of parotid
                                                            • Epithelial, myoepithelial, and stromal components

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Angiographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Other Modality Findings

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Jiang JS et al: Added value of susceptibility-weighted imaging to diffusion-weighted imaging in the characterization of parotid gland tumors. Eur Arch Otorhinolaryngol. 277(10):2839-46, 2020
                                                                                              2. Liu YJ et al: Imaging quality of PROPELLER diffusion-weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland. NMR Biomed. 33(5):e4282, 2020
                                                                                              3. Ogle OE: Salivary gland diseases. Dent Clin North Am. 64(1):87-104, 2020
                                                                                              4. Wu Q et al: Characterization of parotid gland tumors using T2 mapping imaging: initial findings. Acta Radiol. 61(5):629-35, 2020
                                                                                              5. Choi JS et al: Identification of new genes of pleomorphic adenoma. Medicine (Baltimore). 98(51):e18468, 2019
                                                                                              6. Elmokadem AH et al: Diagnostic accuracy of multiparametric magnetic resonance imaging for differentiation between parotid neoplasms. Can Assoc Radiol J. 70(3):264-72, 2019
                                                                                              7. Mogen JL et al: Dynamic contrast-enhanced MRI to differentiate parotid neoplasms using golden-angle radial sparse parallel imaging. AJNR Am J Neuroradiol. 40(6):1029-36, 2019
                                                                                              8. Razek AAKA: Multi-parametric MR imaging using pseudo-continuous arterial-spin labeling and diffusion-weighted MR imaging in differentiating subtypes of parotid tumors. Magn Reson Imaging. 63:55-9, 2019
                                                                                              9. Kim BS et al: Diagnostic value of metabolic heterogeneity as a reliable parameter for differentiating malignant parotid gland tumors. Ann Nucl Med. 30(5):346-54, 2016
                                                                                              10. Prasad RS: Parotid gland imaging. Otolaryngol Clin North Am. 49(2):285-312, 2016
                                                                                              11. Dong Y et al: Diagnostic value of CT perfusion imaging for parotid neoplasms. Dentomaxillofac Radiol. 43(1):20130237, 2014
                                                                                              12. Brennan PA et al: Is ultrasound alone sufficient for imaging superficial lobe benign parotid tumours before surgery? Br J Oral Maxillofac Surg. 50(4):333-7, 2012
                                                                                              13. Christe A et al: MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol. 32(7):1202-7, 2011
                                                                                              14. Dumitriu D et al: Ultrasonographic and sonoelastographic features of pleomorphic adenomas of the salivary glands. Med Ultrason. 12(3):175-83, 2010
                                                                                              15. Yerli H et al: Diagnosing common parotid tumours with magnetic resonance imaging including diffusion-weighted imaging vs fine-needle aspiration cytology: a comparative study. Dentomaxillofac Radiol. 39(6):349-55, 2010
                                                                                              16. Habermann CR et al: Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol. 30(3):591-6, 2009
                                                                                              17. Lee YY et al: Imaging of salivary gland tumours. Eur J Radiol. 66(3):419-36, 2008
                                                                                              18. Yabuuchi H et al: Parotid gland tumors: can addition of diffusion-weighted MR imaging to dynamic contrast-enhanced MR imaging improve diagnostic accuracy in characterization? Radiology. 249(3):909-16, 2008
                                                                                              19. Bialek EJ et al: Role of ultrasonography in diagnosis and differentiation of pleomorphic adenomas: work in progress. Arch Otolaryngol Head Neck Surg. 129(9):929-33, 2003
                                                                                              20. Nagel H et al: Analysis of the tumour suppressor genes, FHIT and WT-1, and the tumour rejection genes, BAGE, GAGE-1/2, HAGE, MAGE-1, and MAGE-3, in benign and malignant neoplasms of the salivary glands. Mol Pathol. 56(4):226-31, 2003
                                                                                              21. O'Brien CJ: Current management of benign parotid tumors--the role of limited superficial parotidectomy. Head Neck. 25(11):946-52, 2003
                                                                                              22. Sato T et al: Dynamic scintigraphy with thallium-201 chloride (Tl-201) for the diagnosis of tumors of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 92(2):228-35, 2001
                                                                                              23. Hancock BD: Clinically benign parotid tumours: local dissection as an alternative to superficial parotidectomy in selected cases. Ann R Coll Surg Engl. 81(5):299-301, 1999
                                                                                              24. Shimizu M et al: Statistical study for sonographic differential diagnosis of tumorous lesions in the parotid gland. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 88(2):226-33, 1999
                                                                                              25. Ikeda K et al: The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma. AJNR Am J Neuroradiol. 17(3):555-9, 1996
                                                                                              26. Phillips PP et al: Recurrent pleomorphic adenoma of the parotid gland: report of 126 cases and a review of the literature. Ann Otol Rhinol Laryngol. 104(2):100-4, 1995
                                                                                              27. Joe VQ et al: Tumors of the parotid gland: MR imaging characteristics of various histologic types. AJR Am J Roentgenol. 163(2):433-8, 1994
                                                                                              28. Takeichi N et al: Salivary gland tumors in atomic bomb survivors, hiroshima, japan. II. Pathologic study and supplementary epidemiologic observations. Cancer. 52(2):377-85, 1983