Sialoblastoma of salivary glands in children: chemotherapy should be discussed as an alternative to mutilating surgery

Int J Pediatr Otorhinolaryngol. 2010 Aug;74(8):942-5. doi: 10.1016/j.ijporl.2010.01.026.

Abstract

Sialoblastoma is a very rare congenital salivary gland tumor. No consensus has been reached concerning the treatment of this tumor due to its rarity. The treatment of reference is surgery, which can be mutilating, in the case of a locally invasive tumor. The treatment of metastatic disease is also controversial. The authors report a new case of a 6-year-old girl with a progressively growing left parotid mass since birth. The first cytological diagnosis was that of pleomorphic adenoma. Due to local progression, superficial parotidectomy was performed at the age of 3.5 years and revealed a diagnosis of sialoblastoma. Six months later, local recurrence and lung metastasis were treated by neoadjuvant chemotherapy with a very good partial response on the local recurrence and the lung metastasis, allowing complete parotidectomy with sacrifice of the facial nerve. Bilateral lung biopsies after adjuvant chemotherapy showed total necrosis. No recurrence was observed with a follow-up of 1 year. This case and a review of the literature confirm the very good chemosensitivity of this tumor and argue in favor of neoadjuvant chemotherapy for locally invasive tumors rather than extensive mutilating surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenoma, Pleomorphic / congenital
  • Adenoma, Pleomorphic / pathology
  • Adenoma, Pleomorphic / therapy*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Biopsy, Needle
  • Child
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary*
  • Magnetic Resonance Imaging
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Staging
  • Rare Diseases
  • Risk Assessment
  • Salivary Gland Neoplasms / congenital
  • Salivary Gland Neoplasms / pathology
  • Salivary Gland Neoplasms / therapy*
  • Salivary Glands / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome