Surgical Treatment of Cancer of the Orbit with Lymph Node Metastasis of Parotid Gland

Choi, Eun Chang; Kim, Chul Ho; Lim, Young Chang; Son, Eun Jin

Abstract

BACKGROUND AND OBJECTIVES: Malignant orbital tumors represent a diverse group of neoplasms such as malignant salivary tumors, squamous cell carcinoma, sarcoma, melanoma etc. A number of orbital tumors have a potential for lymphatic metastasis, but only a little information about the lymphatic drainage and treatment for malignant orbital tumors has been published. The purpose of this study was to review lymphatic spread of malignant orbital tumors and its surgical treatment of orbital cancer when metastasized to the parotid gland.
MATERIALS AND METHODS
Five orbital cancer patients with lymph node metastasis of parotid gland were evaluated retrospectively. They had been treated by resection of primary tumor, parotidectomy, neck dissection and postoperative radiotherapy (except one case) from 1994 to 2000. Histopathology revealed squamous cell carcinoma in three patients, malignant melanoma in one and rhabdomyosarcoma in one.
RESULTS
There were no complications postoperatively. Four cases had metastasis to intraglandular lymph nodes in the parotid gland and only one case had metastasis to preauricular lymph node. Two cases had metastasis to preglandular lymph nodes and prevascular lymph nodes in the level I lymph node. Three were NED (no evidence of disease), rhabdomyosarcoma case was DOD (died of disease) due to recurrence in submental area and breast and malignant melanoma case was AWD (alive with disease).
CONCLUSION
Most orbital cancers with lymph nodes of the parotid gland have metastasis to intraglandular lymph nodes, but some of them does to extraglandular lymph nodes also. The examination of the parotid gland and the cervical lymph node must be considered in orbital cancers that have a potential for lymphatic metastasis. The results of this study indicates the need to include deep lobe and extraglandular lymph node of parotid gland for surgical removal of disease.