Inservice Exam - 2005
Head Neck Tumor

In infants, salivary gland hemangiomas most commonly arise in which of the following structures?

(A) Minor salivary gland
(B) Parotid gland
(C) Sublingual gland
(D) Submandibular gland


The correct response is Option B.

Among salivary gland hemangiomas, 90% arise in the parotid gland. The remaining 10% arise in the minor salivary gland, sublingual gland, or submandibular gland.

Parotid hemangiomas typically affect four times as many female patients as male patients. About 25% of parotid hemangiomas are bilateral, and about 50% of affected patients have a cutaneous lesion at birth. Parotid hemangiomas often ulcerate during the early proliferative phase and typically involve nearby structures, including the ear, lip, subglottal region, eye, and nose.

Pharmacotherapy with corticosteroids, interferon, or both is effective in most infants with parotid hemangioma. Surgical treatment is reserved for patients who do not respond to pharmacologic management and for those who require reconstruction during the involutional phase. Occasionally, patients require tracheostomy for management of airway complications. In one study, 30% of patients with parotid hemangioma did not require medical or surgical intervention.

References:
1. Greene AK, Rogers GF, Mulliken JB. Management of parotid hemangioma in 100 children. Plast Reconstr Surg. 2004;113:53.
2. Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies. Curr Probl Surg. 2000;37:519..