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Open Access 01-12-2022 | Magnetic Resonance Imaging | Research

Magnetic resonance imaging of parotid gland tumors: a pictorial essay

Authors: Soung Yung Kim, Urs Borner, Jung-Hyun Lee, Franca Wagner, Dechen W. Tshering Vogel

Published in: BMC Medical Imaging | Issue 1/2022

Abstract

Imaging of parotid gland tumors is challenging due to the wide variety of differential diagnoses. Malignant parotid tumors can have very similar features to benign ones, such as slow growth and displacement instead of infiltration of neighboring structures. Malignant and benign tumors may therefore not be clinically distinguishable. Correct characterization of parotid tumors (i.e., benign or malignant) determines preoperative treatment planning and is important in optimizing the individualized surgical plan. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluation of suspected parotid gland lesions and differentiation between benign and malignant lesions. Certain conventional MRI features can suggest whether a mass is more likely to be a benign or low-grade malignancy or a high-grade malignancy and adding diffusion-weighted imaging or advanced MRI techniques like perfusion can aid in this distinction. Morphological features seen on MRI, such as low signal on T2-w, infiltrative changes or ill-defined margins, change over time and diffusion restriction can point to the malignant nature of the lesion. MRI is useful for detection and localization of the lesion(s), and associated findings like perineural spread of tumor, lymph node involvement and infiltrative changes of the surrounding tissues. In this pictorial essay, we present selected images of a variety of benign and malignant parotid tumors and emphasize the MRI features that may be useful in their characterization.

Gao M, Hao Y, Huang MX, Ma DQ, Chen Y, Luo HY, et al. Salivary gland tumours in a northern Chinese population: a 50-year retrospective study of 7190 cases. Int J Oral Maxillofac Surg. 2017;46(3):343–9. https://doi.org/10.1016/j.ijom.2016.09.021.CrossRefPubMed

Del Signore AG, Megwalu UC. The rising incidence of major salivary gland cancer in the United States. Ear Nose Throat J. 2017;96(3):E13–6. https://doi.org/10.1177/014556131709600319.CrossRefPubMed

Abdel Razek AAK, Mukherji SK. State-of-the-art imaging of salivary gland tumors. Neuroimaging Clin N Am. 2018;28(2):303–17. https://doi.org/10.1016/j.nic.2018.01.009.CrossRefPubMed

Gökçe E. Multiparametric magnetic resonance imaging for the diagnosis and differential diagnosis of parotid gland tumors. J Magn Reson Imaging. 2020;52(1):11–32. https://doi.org/10.1002/jmri.27061.CrossRefPubMed

Thoeny HC. Imaging of salivary gland tumours. Cancer Imaging. 2007;7(1):52–62. https://doi.org/10.1102/1470-7330.2007.0008.CrossRefPubMedPubMedCentral

Eneroth CM, Zetterberg A. Malignancy in pleomorphic adenoma. A clinical and microspectrophotometric study. Acta Otolaryngol. 1974;77(6):426–32. https://doi.org/10.3109/00016487409124645.CrossRefPubMed

Soler R, Bargiela A, Requejo I, Rodríguez E, Rey JL, Sancristan F. Pictorial review: MR imaging of parotid tumours. Clin Radiol. 1997;52(4):269–75. https://doi.org/10.1016/s0009-9260(97)80052-9.CrossRefPubMed

Kessler AT, Bhatt AA. Review of the major and minor salivary glands, part 2: neoplasms and tumor-like lesions. J Clin Imaging Sci. 2018;8:48. https://doi.org/10.4103/jcis.JCIS_46_18.CrossRefPubMedPubMedCentral

Peter Klussmann J, Wittekindt C, Florian Preuss S, Al Attab A, Schroeder U, Guntinas-Lichius O. High risk for bilateral Warthin tumor in heavy smokers—review of 185 cases. Acta Otolaryngol. 2006;126(11):1213–7. https://doi.org/10.1080/00016480600740605.CrossRefPubMed

10.

Minami M, Tanioka H, Oyama K, Itai Y, Eguchi M, Yoshikawa K, et al. Warthin tumor of the parotid gland: MR-pathologic correlation. AJNR Am J Neuroradiol. 1993;14(1):209–14.PubMedPubMedCentral

11.

Rassekh CH, Cost JL, Hogg JP, Hurst MK, Marano GD, Ducatman BS. Positron emission tomography in Warthin’s tumor mimicking malignancy impacts the evaluation of head and neck patients. Am J Otolaryngol. 2015;36(2):259–63. https://doi.org/10.1016/j.amjoto.2014.11.008.CrossRefPubMed

12.

Barnes LEJ, Reichart P. Oncocytoma. In: Barnes LEJ, Reichart P, Sidransky D, editors. World Health Organization classification of tumors: pathology and genetics, head and neck tumors. Lyon: IARC Press; 2005. p. 242–3.

13.

Hammami B, Thabet W, Kallel R, Boudawara T, Mnejja M, Charfeddine I. Bilateral multifocal nodular oncocytic hyperplasia of the parotid gland: a rare entity. Pathologica. 2021;113(2):131–5. https://doi.org/10.32074/1591-951x-140.CrossRefPubMedPubMedCentral

14.

Hagino K, Tsunoda A, Ishihara A, Kishimoto S, Suzuki T, Hara A. Oncocytoma in the parotid gland presenting a remarkable increase in fluorodeoxyglucose uptake on positron emission tomography. Otolaryngol Head Neck Surg. 2006;134(4):708–9. https://doi.org/10.1016/j.otohns.2005.03.076.CrossRefPubMed

15.

Chaubal R, Tavri O, Sawant A, Singh C. Infantile hemangioendothelioma of the parotid gland. J Clin Imaging Sci. 2017;7:5. https://doi.org/10.4103/2156-7514.199056.CrossRefPubMedPubMedCentral

16.

Paparo F, Massarelli M, Giuliani G. A rare case of parotid gland lipoma arising from the deep lobe of the parotid gland. Ann Maxillofac Surg. 2016;6(2):308–10. https://doi.org/10.4103/2231-0746.200335.CrossRefPubMedPubMedCentral

17.

Tong KN, Seltzer S, Castle JT. Lipoma of the parotid gland. Head Neck Pathol. 2020;14(1):220–3. https://doi.org/10.1007/s12105-019-01023-3.CrossRefPubMed

18.

Orell SR, Klijanienko J. Head and neck; salivary glands. In: Orell SR, Sterrett GF, editors. Orell and Sterrett’s fine needle aspiration cytology. 5th ed. London: Churchill Livingstone; 2012. p. 38–76.CrossRef

19.

Ellis GL. Lymphoid lesions of salivary glands: malignant and benign. Med Oral Patol Oral Cir Bucal. 2007;12(7):E479–85.PubMed

20.

Kato H, Kawaguchi M, Ando T, Aoki M, Kuze B, Matsuo M. CT and MR imaging findings of non-neoplastic cystic lesions of the parotid gland. Jpn J Radiol. 2019;37(9):627–35. https://doi.org/10.1007/s11604-019-00858-8.CrossRefPubMed

21.

Joshi J, Shah S, Agarwal D, Khasgiwal A. Benign lymphoepithelial cyst of parotid gland: review and case report. J Oral Maxillofac Pathol. 2018;22(Suppl 1):S91–7. https://doi.org/10.4103/jomfp.JOMFP_252_17.CrossRefPubMedPubMedCentral

22.

Christe A, Waldherr C, Hallett R, Zbaeren P, Thoeny H. MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol. 2011;32(7):1202–7. https://doi.org/10.3174/ajnr.A2520.CrossRefPubMedPubMedCentral

23.

Lowe LH, Stokes LS, Johnson JE, Heller RM, Royal SA, Wushensky C, et al. Swelling at the angle of the mandible: imaging of the pediatric parotid gland and periparotid region. Radiographics. 2001;21(5):1211–27. https://doi.org/10.1148/radiographics.21.5.g01se171211.CrossRefPubMed

24.

Kashiwagi N, Dote K, Kawano K, Tomita Y, Murakami T, Nakanishi K, et al. MRI findings of mucoepidermoid carcinoma of the parotid gland: correlation with pathological features. Br J Radiol. 2012;85(1014):709–13. https://doi.org/10.1259/bjr/55639432.CrossRefPubMedPubMedCentral

25.

Sigal R, Monnet O, de Baere T, Micheau C, Shapeero LG, Julieron M, et al. Adenoid cystic carcinoma of the head and neck: evaluation with MR imaging and clinical-pathologic correlation in 27 patients. Radiology. 1992;184(1):95–101. https://doi.org/10.1148/radiology.184.1.1319079.CrossRefPubMed

26.

Rosero DS, Alvarez R, Gambó P, Alastuey M, Valero A, Torrecilla N, et al. Acinic cell carcinoma of the parotid gland with four morphological features. Iran J Pathol. 2016;11(2):181–5.PubMedPubMedCentral

27.

Vidyadhara S, Shetty AP, Rajasekaran S. Widespread metastases from acinic cell carcinoma of parotid gland. Singapore Med J. 2007;48(1):e13–5.PubMed

28.

Kato H, Kanematsu M, Mizuta K, Ito Y, Hirose Y. Carcinoma ex pleomorphic adenoma of the parotid gland: radiologic-pathologic correlation with MR imaging including diffusion-weighted imaging. AJNR Am J Neuroradiol. 2008;29(5):865–7. https://doi.org/10.3174/ajnr.A0974.CrossRefPubMedPubMedCentral

29.

Tagnon BB, Theate I, Weynand B, Hamoir M, Coche EE. Long-standing mucosa-associated lymphoid tissue lymphoma of the parotid gland: CT and MR imaging findings. AJR Am J Roentgenol. 2002;178(6):1563–5. https://doi.org/10.2214/ajr.178.6.1781563.CrossRefPubMed

30.

Jackson AE, Mian M, Kalpadakis C, Pangalis GA, Stathis A, Porro E, et al. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the salivary glands: a multicenter, international experience of 248 patients (IELSG 41). Oncologist. 2015;20(10):1149–53. https://doi.org/10.1634/theoncologist.2015-0180.CrossRefPubMedPubMedCentral

31.

Zhu L, Wang P, Yang J, Yu Q. Non-Hodgkin lymphoma involving the parotid gland: CT and MR imaging findings. Dentomaxillofac Radiol. 2013;42(9):20130046. https://doi.org/10.1259/dmfr.20130046.CrossRefPubMedPubMedCentral

32.

Bron LP, Traynor SJ, McNeil EB, O’Brien CJ. Primary and metastatic cancer of the parotid: comparison of clinical behavior in 232 cases. Laryngoscope. 2003;113(6):1070–5. https://doi.org/10.1097/00005537-200306000-00029.CrossRefPubMed

33.

Clark J, Wang S. Metastatic cancer to the parotid. Adv Otorhinolaryngol. 2016;78:95–103. https://doi.org/10.1159/000442129.CrossRefPubMed

34.

Lam PD, Kuribayashi A, Imaizumi A, Sakamoto J, Sumi Y, Yoshino N, et al. Differentiating benign and malignant salivary gland tumours: diagnostic criteria and the accuracy of dynamic contrast-enhanced MRI with high temporal resolution. Br J Radiol. 2015;88(1049):20140685. https://doi.org/10.1259/bjr.20140685.CrossRefPubMedPubMedCentral

35.

Abdel Razek AA, Samir S, Ashmalla GA. Characterization of parotid tumors with dynamic susceptibility contrast perfusion-weighted magnetic resonance imaging and diffusion-weighted MR imaging. J Comput Assist Tomogr. 2017;41(1):131–6. https://doi.org/10.1097/rct.0000000000000486.CrossRefPubMed

36.

Shi YJ, Li XT, Zhang XY, Zhu HT, Liu YL, Wei YY, et al. Non-gaussian models of 3-Tesla diffusion-weighted MRI for the differentiation of pancreatic ductal adenocarcinomas from neuroendocrine tumors and solid pseudopapillary neoplasms. Magn Reson Imaging. 2021;83:68–76. https://doi.org/10.1016/j.mri.2021.07.006.CrossRefPubMed

37.

Yerli H, Agildere AM. Parotid gland tumors: advanced imaging technologies. Cancer Imaging. 2008. https://doi.org/10.1016/B978-012374212-4.50135-8.CrossRef

38.

Kim SY, Beer M, Tshering Vogel DW. Imaging in head and neck cancers: update for non-radiologist. Oral Oncol. 2021;120:105434. https://doi.org/10.1016/j.oraloncology.2021.105434.CrossRefPubMed

39.

Gabelloni M, Faggioni L, Attanasio S, Vani V, Goddi A, Colantonio S, et al. Can magnetic resonance radiomics analysis discriminate parotid gland tumors? A pilot study. Diagnostics. 2020;10:900. https://doi.org/10.3390/diagnostics10110900.CrossRefPubMedCentral

Title: Magnetic resonance imaging of parotid gland tumors: a pictorial essay
Authors: Soung Yung Kim
Urs Borner
Jung-Hyun Lee
Franca Wagner
Dechen W. Tshering Vogel
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Parotid Gland Tumor
Published in: BMC Medical Imaging / Issue 1/2022
Electronic ISSN: 1471-2342
DOI: https://doi.org/10.1186/s12880-022-00924-0

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Magnetic resonance imaging of parotid gland tumors: a pictorial essay

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