MANAGEMENT AND RECONSTRUCTION OF RECURRENT SIALOBLASTOMA AND ITS COMPLICATIONS IN A PEDIATRIC PATIENT: A MULTIDISCIPLINARY APPROACH

Abstract

Background: Sialoblastoma is an exceedingly rare congenital epithelial tumor of salivary gland origin, predominantly affecting infants. It exhibits aggressive behavior with potential for recurrence and requires a multidisciplinary approach for management. This case report highlights the challenges of diagnosing and treating recurrent sialoblastoma in a pediatric patient, emphasizing innovative reconstructive techniques.

Case Presentation: A 2-year-old South Asian boy presented with a progressively enlarging left cheek swelling since infancy. Initial imaging and cytology suggested a salivary gland neoplasm, leading to total parotidectomy. Histopathological analysis confirmed sialoblastoma. Despite adjuvant chemotherapy, local recurrence occurred, requiring further surgical intervention, including hemimandibulectomy. Postoperative radiotherapy was administered; however, complications such as wound dehiscence and tumor recurrence necessitated additional surgical and reconstructive measures.

Intervention and Outcomes: The patient underwent a multidisciplinary surgical approach involving lesion excision, removal of the exposed mandibular plate, and mandibular reconstruction using a pedicled osseomyocutaneous pectoralis major flap with the sixth rib. Six-month follow-up showed no recurrence, with satisfactory functional and cosmetic outcomes.

Conclusion: This case underscores the aggressive nature of sialoblastoma, the importance of complete tumor excision, and the utility of innovative surgical reconstruction techniques. Multidisciplinary management and vigilant long-term follow-up are crucial for improving outcomes in pediatric sialoblastoma.