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Dear Sir/Madam, I Had Low Grade Mucoepidermoid Carcinoma Of Right

Posted on Wed, 6 Mar 2019

Question: Dear Sir/Madam,
I had low grade mucoepidermoid carcinoma of right parotid 7 years ago with perineural invasion. My upper 3 (three) branches of facial nerve was inside the tumor but I had no nerve palsy or weakness. Only thing I had formication( tingling and ant crawling on right face). My surgeon preserved the facial nerve by piecemeal excision of tumor and followed by radio therapy of 64 Gy. As there were microscopic particles inside the nerve and he told it will be cleared by radio therapy.
1) CBC is normal
2) ESR- 5
3)Calcium Serum 6.8
4) TSH-5.8

1) The risk due to piecemeal excision by nerve sparing technique has adverse effect on outcome. Can it be taken care by radio therapy?
2) What is the chance of cure in my case? How long I have to follow up?

3) I have not done chest x-ray for last 4 years. Is there any chance of distance metastasis to lungs? Even if it metastasize to lungs , will it symptoms less for 4 years? do not have any lung related symptoms.
4) Will there any chance of recurrence after so many years?

Only problem I have is my gum bleeds easily. Is it due to side effect of Radiation Therapy? if yes is it normal for those having Radio therapy?
Please reply.
Thanks

Follow up: Dr. Monish De (0 minute later)

Dear Sir/Madam,
I had low grade mucoepidermoid carcinoma of right parotid 7 years ago with perineural invasion. My upper 3 (three) branches of facial nerve was inside the tumor but I had no nerve palsy or weakness. Only thing I had formication( tingling and ant crawling on right face). My surgeon preserved the facial nerve by piecemeal excision of tumor and followed by radio therapy of 64 Gy. As there were microscopic particles inside the nerve and he told it will be cleared by radio therapy.
1) CBC is normal
2) ESR- 5
3)Calcium Serum 6.8
4) TSH-5.8

1) The risk due to piecemeal excision by nerve sparing technique has adverse effect on outcome. Can it be taken care by radio therapy?
2) What is the chance of cure in my case? How long I have to follow up?

3) I have not done chest x-ray for last 4 years. Is there any chance of distance metastasis to lungs? Even if it metastasize to lungs , will it symptoms less for 4 years? do not have any lung related symptoms.
4) Will there any chance of recurrence after so many years?

Only problem I have is my gum bleeds easily. Is it due to side effect of Radiation Therapy? if yes is it normal for those having Radio therapy?
Please reply.
Thanks

Answered by Dr. Monish De (14 hours later)

Brief Answer:

Chances of cure is 50 percent

Detailed Answer:

Hi

Since you are suffering from low grade mucoepidermoid carcinoma of right parotid external beam radiation along with intraoperative brachytherapy plus postoperative external beam radiation is required in your case

The risk due to piecemeal excision by nerve sparing technique yes can be taken care by radio therapy

Chances of cure is 50 percent

You have to follow up for 5 years

Yes possibility of distant metastasis to lungs is there

Would advise you to do 6 monthly CT scan chest.

Symptoms if it has spread to lung start after 1 year such as dry cough and bleeding sputum.

Chance of recurrence after many years is only 25 percent.

Gums bleeding easily to to side effects of radiation

You can take tranexamic acid tablets for it with your doctor advise
and also do blood test for PT, INR, bleeding time and clotting time

It is normal for those who have radiotherapy

Regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Monish De (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Monish De (2 hours later)

Please read question carefully.

It happened 7 years back. Now I am fine. My chest x-ray also normal.

In my case what is the chance of cure?
I have already followed up for last 7 years. So how long I have to follow up?

Is there any chance of distant metastasis after 7 years?

Only my problem is Gum bleeding. Is it side effect of radiation therapy after 7 years?
Thanks.

Follow up: Dr. Monish De (0 minute later)

Answered by Dr. Monish De (1 hour later)

Brief Answer:

Follow up for 10 years

Detailed Answer:

Hi

Since 7 years have passed the chance of cure is 100 percent

Follow up for 10 years

No chance of distant metastasis after 7 years

Gum bleeding is not a side effect of radiation therapy as 7 years have already passed

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Answered by Dr. Monish De (0 minute later)

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Monish De (1 hour later)

Sir,

My right side salivary gland is completely removed. So I am facing little dryness in my mouth. Will it be reason for Gum bleeding?
Is it normal for patients those have undergone Parotid surgery and followed by radiation therapy?

Thanks

Follow up: Dr. Monish De (0 minute later)

Answered by Dr. Monish De (2 hours later)

Brief Answer:

Take tranexamic acid and ciprofloxacin tablet

Detailed Answer:

Hi

Since your salivary gland was completely removed and you had undergone radiation therapy it is common to cause dry mouth and damage to the lining of the mouth from radiation therapy which can cause infection to develop which causes bleeding

You can take tranexamic acid and ciprofloxacin tablet for it with your doctors advise

Regards

Above answer was peer-reviewed by : Dr. Yogesh D