Parotid

Atypical lipomatous tumor/well-differentiated liposarcoma of the parotid gland: Case report and literature review

September 30, 2009     Usama Mahmood, MD, John D. Nguyen, MD, John Chang, MD, Mai Gu, MD, PhD, and Brian J.F. Wong, MD, PhD
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Abstract

Although liposarcoma is the second most common soft-tissue sarcoma in adults, it is exceedingly rare in the head and neck. According to our MEDLINE search, only 11 cases of liposarcoma of the parotid gland have been reported since 1968. We report a new case of primary atypical lipomatous tumor/well-differentiated liposarcoma of the parotid gland in a 77-year-old man. Because only a very limited number of case reports and small series have been published on liposarcoma in the head and neck, we also provide a review of the literature on this uncommon disease entity.

Intraparotid facial nerve schwannoma: Clinician beware

July 31, 2009     Neil Tanna, MD, MBA, Philip E. Zapanta, MD, Leela Lavasani, MD, and Nader Sadeghi, MD
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Abstract

Intraparotid facial nerve schwannomas are rare neoplasms that are challenging to diagnose and manage. Many patients present with a painless, palpable facial mass. The presence of facial paralysis is variable. Imaging studies and fine-needle aspiration cytology are not always helpful in preoperative diagnosis. With early diagnosis of facial nerve schwannoma, management of the patient can be planned and, ultimately, facial nerve function optimized. By reviewing the literature and 2 cases from a series of patients seen in our practice, we provide insight into the current diagnosis and treatment of a rare pathology.

Distal parotid duct pseudocyst as a result of blunt facial trauma

July 31, 2009     Ashkan Monfared, MD, Justin Ortiz, MD, and Carrie Roller, MD
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Abstract

The sequelae of sharp trauma to the parotid duct, such as sialocele and salivary fistula, are well known. In contrast, complications of blunt trauma to the parotid duct are not as common. A search of the English-language literature revealed 2 cases of parotid pseudocysts caused by blunt trauma. Although no well-known management protocol exists for complications of blunt trauma to the parotid duct, the treatment modalities for sharp trauma complications potentially could be applied. We describe a case of a blunt-trauma-induced distal parotid duct pseudocyst that remained refractory to conservative management, including repeated aspiration and cannulation of the duct. After characterizing and localizing the pseudocyst with sialography and cross-sectional imaging, we performed a surgical repair. This repair involved marsupialization of the parotid duct to the level of the pseudocyst. The edges of the opening of the proximal duct and the pseudocyst were sutured to the oral mucosa, and a small intraoral drain was left in the pseudocyst to prevent collapse and abscess formation. The drain was removed after 5 days, and the patient experienced no further problems during 14 months of follow-up.

Oncocytoma of the parotid gland

April 30, 2009     Deba P. Sarma, MD and Eric E. Santos, MD
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Epidermoid carcinoma involving the parotid gland and orbital region: Case report of a rare entity

June 30, 2008     Sundus Aslan, MD, Haluk Yavuz, MD, Rana Altan-Yaycioglu, MD, Filiz Bolat, MD, and Nuri Ozgirgin, MD
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Abstract

Epidermoid carcinoma (also known as squamous cell carcinoma) of the parotid gland is more prevalent among the elderly, as are other head and neck tumors. In most cases it is observed either as a nodal metastasis of a primary tumor that drains into the parotid area or as a direct extension of a tumor that has originated in the upper dermis. Primary epidermoid carcinomas arising directly from the parotid gland are extremely rare. Similarly, secondary invasion of the orbital region by a neighboring tumor is more common than primary epidermoid carcinoma of the orbit, which is also rare. In this article, we discuss the diagnosis and treatment of a rare case of epidermoid carcinoma simultaneously invading the parotid gland and the orbit.

Multiple pilomatrixomas: Case report and literature review

March 31, 2008     Shashidhar Sadda Reddy, MD, MPH, Swarupa A. Gadre, MD, Patrick Adegboyega, MD, and Arun K. Gadre, MD
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Abstract

Pilomatrixoma is a rare, benign, circumscribed, calcifying epithelial neoplasm that is derived from hair matrix cells. Multiple pilomatrixomas are uncommon. We describe a case of multiple pilomatrixomas in a 23-year-old black woman who presented with lesions on her face and back. Based on the results of the clinical examination, she was provisionally diagnosed with either calcified sebaceous cysts or calcified lymph nodes. She underwent surgical excision of the masses. On histopathology, the lesions were identified as pilomatrixomas. We attribute our original failure to diagnose this condition to our lack of familiarity with it. We discuss the presentation, differential diagnosis, and other characteristics of pilomatrixomas.

Bilateral multinodular oncocytomas of the parotid arising in a background of bilateral oncocytic nodular hyperplasia

January 1, 2008     Jason Hyde, MD, Masayoshi Takashima, MD, Brennan Dodson, MD, and Sherif Said, MD, PhD
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Abstract

Oncocytic tumors of the major salivary glands are rare, accounting for less than 1% of all salivary gland tumors. When they do occur, these neoplasms typically present as solitary nodules that affect only one major salivary gland, usually the parotid. Multiple bilateral multinodular tumors are rare. We report the case of a 53-year-old woman with a case of synchronous multiple bilateral multinodular oncocytomas that arose in a background of bilateral oncocytic nodular hyperplasia in the parotid glands. The patient underwent superficial parotid resections, and at the 4-year follow-up, she exhibited no evidence of recurrence.

Deep-lobe parotid tumor presenting in the parapharyngeal space

December 1, 2007     Sofia Avitia, MD, Jason S. Hamilton, MD, and Ryan F. Osborne, MD, FACS
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Squamous cell carcinoma of the accessory parotid gland

September 30, 2007     Ryan F. Osborne, MD, FACS
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An 85-year-old man presented with a persistent right accessory parotid gland carcinoma after surgical resection and radiotherapy (figure 1). The patient had been initially diagnosed by fine-needle aspiration as having a moderately to well-differentiated keratinizing squamous cell carcinoma of the right accessory parotid gland.

Osteoclast-like giant-cell tumor of the parotid with salivary duct carcinoma: Case report and cytologic, histologic, and immunohistochemical findings

September 30, 2007    
article

Maryam Kadivar, MD, APCP;
Yalda Nilipour, MD;
Alireza Sadeghipour, MD, APCP

Abstract


Primary giant-cell tumor of the salivary gland is a rare lesion with an incompletely characterized histogenesis. To the best of our knowledge, only 16 cases have been previously documented in the English-language literature. We report a new case, which occurred in a 75-year-old man who presented with a parotid mass and cervical lymphadenopathy. The patient underwent a left total parotidectomy and cervical lymph node dissection. As far as we know, ours is the only reported case of a primary giant-cell tumor of the salivary gland in which the patient presented with lymph node metastasis. Because so little is known about giant-cell tumor of the salivary gland, we use the occasion of this case report to describe the cytologic, histologic, and immunohistochemical characteristics that we observed.

Use of AlloDerm implant to improve cosmesis after parotidectomy

July 31, 2007     Suzanne M. Sachsman, MS; Dale H. Rice, MD
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Abstract
We evaluated the effectiveness and practicality of using AlloDerm, an acellular human dermal matrix graft, as an interpositional barrier in an attempt to improve the appearance of the surgical defect created by parotidectomy. We performed AlloDerm reconstruction in a series of 10 patients, and we found that normal contour was satisfactorily restored in all 10. We conclude that the use of an AlloDerm implant is a low-risk, practical option for repairing the surgical defect in postparotidectomy patients.

Parotid sialocele in a 10-year-old girl

January 1, 2007     Kevin D. Pereira, MD; Stacey L. Smith, MD; Ron B. Mitchell, MD
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