Table 1.
The clinical findings, pathologic features and treatment outcomes of the occult neoplasm of facial nerve
| Patient | Sex/age | Final diagnosis | Time to referral (mo) | Initial HB grade | Suspected occult neoplasm | Diagnostic Procedure | Recurrence | Follow-up (mo) | Final outcome |
|---|---|---|---|---|---|---|---|---|---|
| Diagnostic delay (mo)* | HB grade at referral | Reason for suspicion | Definitive treatment | ||||||
| 1 | F/69 | Skin SCC | 13 | 2 | Yes | Facial nerve biopsy (parotidectomy approach) | No | 46 | NED |
| 24 | 6 | Progressive, irreversible | Chemoradiation treatment | ||||||
| 2 | M/33 | Parotid ACC | 8 | 5 | No | Facial nerve biopsy (Incidental finding at facial reanimation surgery) | Regional recurrence, POD 40 mo- > Palliative treatment | 68 | AWD until last follow-up |
| 15 | 5 | Irreversible | Radical parotidectomy with neck dissection, temporal bone resection Postoperative radiation | ||||||
| 3 | M/58 | Skin SCC | 20 | 4 | Yes | Transoral biopsy of inferior alveolar nerve (multiple cranial nerve invasion) | Stable disease | 22 | AWD |
| 21 | 5 | Progressive, irreversible | RT | ||||||
| 4 | M/50 | Parotid ACC | 15 | 2 | Yes | Facial nerve biopsy | Lung metastasis, POD 32 mo-> salvage surgery | 72 | NED |
| 19 | 6 | Progressive, irreversible | Radical parotidectomy with neck dissection, temporal bone resection postoperative radiation | ||||||
| 5 | M/54 | Skin SCC | 12 | 2 | Yes | Infraorbital nerve biopsy | Stable disease | 30 | AWD |
| 21 | 6 | Progressive, irreversible | CCRT | ||||||
| 6 | M/81 | Skin SCC | 28 | 5 | Yes | Transmastoid biopsy | Progressive disease | 36 | AWD until last follow-up |
| 34 | 6 | irreversible | Clinical trial† | ||||||
| 7 | M/79 | Facial nerve schwannoma | 17 | 2 | Yes | No biopsy‡ | Stable disease | 28 | AWD |
| 28 | 6 | Progressive, irreversible | Regular follow-up | ||||||
| 8 | F/56 | Facial nerve schwannoma | 180 | 3 | Yes | No biopsy‡ | Stable Disease | 24 | AWD |
| 180 | 6 | Progressive, irreversible | Regular follow-up | ||||||
| 9 | F/59 | Parotid malignant tumor | 23 | 3 | Yes | Contralateral neck node biopsy | 4 | AWD until last follow-up | |
| 34 | 6 | Progressive, irreversible | Recommend surgery and postoperative radiation therapy |
HB House-Brackmann; SCC squamous cell carcinoma; ACC adenoid cystic carcinoma; NED no evidence of disease; AWD alive with disease
*Diagnosis delay was defined as the time between initial symptoms of facial weakness and identification of malignancy
†Extensive tumor with widespread perineural and dural invasion at the time of pathologic diagnosis
‡No surgery for tumor resection of infratemporal facial nerve schwannoma