A rare primary leiomyosarcoma of the parotid gland: A case report and literature review

Background

Leiomyosarcoma of the head and neck region is very rare. Primary parotid leiomyosarcoma has only been reported nine times in the medical literature.

Dermoid cyst of the parotid gland: First pediatric case

A dermoid cyst is the result of inclusion of epithelial cells along the lines of embryonic closure. Dermoid cysts of the head neck are uncommon and account for only 7% of all such cysts. They are most often reported as arising in the floor of the mouth. Dermoid cyst is rarely seen in the parotid gland. To our knowledge, there have been only six previous case reports in the English literature. Dermoid cyst of the parotid gland in pediatric patient has not been previously reported in the literature. This is the first case report concerning a dermoid cyst in a pediatric patient.     

Synchronous bilateral epithelial–myoepithelial carcinoma of the parotid gland: case report and review of the literature

Synchronous bilateral malignancy in the parotid glands is extremely rare. The English literature reveals nine case reports. The most common synchronous bilateral malignancies are acinic cell carcinoma. Epithelial–myoepithelial carcinoma is an uncommon neoplasm comprising 1% of all salivary gland tumours. In this case report, we describe, to our best of knowledge, the first case of a patient with a synchronous bilateral epithelial–myoepithelial carcinoma of the parotid gland. The clinical histopathological and immunohistochemical peculiarities are elucidated. Imaging studies like ultrasonography are mandatory for both parotid glands and upper necks in the clinical presence of a unilateral parotid gland tumour.     

Recurrent amyloid tumor of the parotid gland

A case of an organ-limited amyloid tumor of the left parotid gland is described with a history of recurrence. A slowly growing parotid mass was the only symptom. After 5.5 years following local excision, the patient was readmitted with a slowly growing recurrence in the superficial lobe of the previously treated gland. Lateral parotidectomy was performed with wide excision of the infiltrated tissue and preservation of the facial nerve. Primary amyloidosis of the AL type was confirmed with immunohistochemical studies revealing staining for lambda but not kappa light chains of immunoglobulins. There has been no clinical or laboratory evidence of systemic amyloidosis or recurrence after 2 years. To the best of our knowledge, this is the first report of a recurrent amyloid tumor of the parotid gland.     

Over-expression of c-kit in a primary leiomyosarcoma of the thyroid gland

Primary leiomyosarcoma of the thyroid gland is rare. In this paper, we report a case of high-grade leiomyosarcoma of the thyroid gland in a 43-year-old man. Lung metastasis was also noted in this patient. Despite of aggressive surgical treatment, the patient died of uncontrolled local recurrent disease 6 months after the initial operation. Immunohistochemical studies showed the tumor cells were positive for c-kit proto-oncogene product. Imatinib mesylate was used as a post-operative adjuvant treatment but the response was poor. The role of tyrosine kinase inhibitors on the treatment of thyroid leiomyosarcomas is still unclear because this is the first report of c-kit over-expression in such tumors. Nevertheless, our results show that c-kit over-expression might not be an indicator of good response to imatinib mesylate treatment in thyroid leiomyosarcomas.     

A case of primary Hodgkin's lymphoma of the parotid gland

We report an extremely rare case (sixth reported case) of primary Hodgkin's lymphoma (HL) (mixed cellularity type) of the parotid gland. A 14-year-old man was referred to our hospital for evaluation of a parotid mass. Although the initial aspiration cytology was highly suggestive of HL, the confirmatory diagnosis obtained by open biopsy was non-specific lymphadenitis. Consequently, the patient was observed without any additional treatment. Because the mass continued to increase in size, we performed a total parotidectomy which led to the diagnosis of mixed cellularity HL. This case suggests that the specimen taken during open biopsy may have been too small (about 1 cm3) to detect the presence of Reed-Sternberg giant cells, which is essential for the diagnosis of HL. Therefore, although primary HL of the parotid gland is extremely rare, adequate tissue sampling of a clinically suspicious parotid mass will be required for the diagnosis of HL.     

First report of parotid gland metastasis in multiple enchondromatosis with secondary CHOSA (G-III)

Chondrosarcomas constitute the second-most-frequent malignant bone tumors, representing about 10% of all malignant bone tumors. The most frequent localizations comprise the trunk, pelvis and limbs. Metastatic disease usually occurs in the lung; metastases to other localizations are seen occasionally. Manifestation in the head and neck area, either as primary tumor or metastasis, is very rare. A case of parotid gland metastasis in multiple enchondromatosis secondary chondrosarcoma (CHOSA) G-III of the left femoral bone is presented. A 79-year-old male patient reported to our clinic with a rapidly progressing mass in the left parotid gland. A superficial parotidectomy was performed and the entire tumor resected. Histopathological examination revealed nodular infiltration of the parotid by chondrosarcoma consistent with metastatic disease. Review of the literature shows that this is the first report of such a case. Received: 3 July 2001 / Accepted: 26 September 2001     

The benign lymphoepithelial cyst and a classification system for lymphocytic parotid gland enlargement in the pediatric HIV population

OBJECTIVES/HYPOTHESIS: The objectives of this study are to present a series of parotid gland benign lymphoepithelial cysts (BLEC) in HIV-positive children and to propose a three-tiered classification system for HIV-associated lymphocytic parotid gland enlargement. STUDY DESIGN: The authors conducted a retrospective case series and literature review. METHODS: The authors conducted a retrospective chart review of four pediatric patients with HIV-associated parotid gland BLEC who presented to a tertiary care university medical center. RESULTS: Four pediatric HIV-positive patients (four girls; age range, 7-17 years [mean age, 12.8 years]) were diagnosed with parotid gland BLEC. Two patients presented with acute parotitis and the others presented with asymptomatic enlargement of the parotid glands. Three patients had bilateral parotid gland BLEC. The other patient demonstrated persistent generalized lymphadenopathy (PGL) of the intraparotid and cervical lymph nodes and early BLEC limited to the left parotid gland. One patient also displayed parotid gland microcalcifications and cystic changes in the adenoids, neither of which have been described previously in the setting of HIV-associated BLEC. Computed tomography was performed on all patients, and one patient underwent fine needle aspiration to confirm the diagnosis. All patients opted for observation and antiretroviral medication therapy as long-term treatment. Based on these findings and a review of the literature, we propose a three-tiered classification system for lymphocytic parotid gland enlargement in the HIV population: 1) PGL, 2) benign lymphoepithelial lesions (BLEL), and 3) BLEC. CONCLUSIONS: This series equals the largest pediatric series of HIV-associated parotid gland BLEC in the English literature. One patient in our series also demonstrated PGL; there were no cases of BLEL. A classification system based on morphology is proposed to help resolve the confusion in terminology used to describe this entity. Most pediatric HIV-infected patients with parotid gland BLEC can be treated with observation and antiretroviral medication therapy. For others, who are symptomatic or more concerned about their cosmetic appearance, sclerotherapy may offer a reasonable option. Radiation therapy and surgery should be reserved for select cases.     

腮腺复发性肿瘤的手术方式及临床观察

目的探讨腮腺复发性肿瘤的病理类型、再次手术的方式及术后并发症。方法对2015~2018年我科腮腺复发性肿瘤14例患者的再次手术方式及并发症进行回顾性分析,追踪临床随访情况。结果14例患者术后复发时间半年到30年不等,7例为多形性腺瘤,其中1例恶变,其余病理包括血管性疾病、腺淋巴瘤、囊肿、木村病、腺癌等;12例为第2次手术,2例为第3次手术;10例患者行腮腺浅叶切除,4例患者行全腮腺切除,3例行放疗治疗;主要并发症为暂时性面瘫7例,持续性面瘫2例,涎瘘2例,Frey综合征1例。1例行3次手术患者复发肿瘤瘢痕组织与面神经分界不清,予以保留面神经,术后病理证实切缘为瘢痕纤维组织,未见肿瘤细胞。随访期间所有病例未见肿瘤复发。结论腮腺复发性肿瘤以多形性腺瘤最常见,再次手术建议采用浅叶或全腮腺切除,避免区域性切除,减少复发。多次手术解剖困难,神经损伤几率增加,术中可使用神经监护仪,利于神经保护。     

Synchronous unilateral parotid gland neoplasms of three different histological types

A 67-year-old male with three synchronous tumors in the unilateral parotid gland is reported. Postoperative histological examinations confirmed the presence of three synchronous primary tumors, specifically pleomorphic adenoma, Warthin's tumor and salivary duct carcinoma, in the right parotid gland. To our knowledge, this is the first case report describing three different histological types in the unilateral parotid gland.     

Uncommon situation and presentation of chronic sclerosing sialadenitis

Chronic sclerosing sialadenitis of the parotid gland is a very uncommon chronic inflammatory salivary gland disease. Clinically, it presents as a slow-growing painful. Histologically, it showed a chronic inflammation and fibrosis. This case report highlights the clinical, radiological and histological aspects of this disease.We report unusual case of chronic sclerosing sialadenitis of the parotid in a 12-year-old man. CT detected a mass of tissue density in the right parotid. The evolution was marked by spontaneous fistula allowing a surgical biopsy. The mass regressed after corticosteroids. The follow-up was normal.The location, age and presentation make our case very interesting.     

Solitary fibrous tumor of the parotid gland extending to the parapharyngeal space

Solitary fibrous tumors (SFT) arise in the pleura and less commonly in extrapleural sites. Head and neck regions have included the nose and paranasal sinuses, soft palate, epiglottis, thyroid, parotid and submandibular glands, as well as the infratemporal fossa and parapharyngeal space. We report a case of SFT arising from the parotid gland and extending to the parapharyngeal space. To our knowledge, this is the fourth case of SFT originating from the parotid gland and is the largest of its kind among the extrapleural lesions described. The characteristics revealed by computed tomography and magnetic resonance imaging are presented. Received: 28 May 1997 / Accepted: 25 August 1997     

Recurrent attacks of facial nerve palsy as the presenting sign of leukemic relapse

OBJECTIVE: To present an unusual case of recurrent facial palsy resulting from acute leukemic infiltration of the parotid gland. STUDY DESIGN: Case report. METHODS: An 11-year-old boy who had been treated for acute lymphoblastic leukemia (ALL) from 3 to 6 years of age presented with intermittent left facial nerve palsy with concurrent ipsilateral parotid fullness. The initial findings at diagnosis and workup are presented, and the disease progression and resolution with therapy are documented. RESULTS: The patient had been off therapy when this finding developed. A workup for central and viral etiologies for the facial palsy was unrevealing. Biopsy of the parotid gland demonstrated a lymphoblastic leukemic infiltrate. The patient was placed on a chemotherapy protocol for relapsed leukemia, resulting in complete resolution of the facial palsy. CONCLUSION: Isolated facial nerve dysfunction, albeit rare, has been documented as a sign of central nervous system involvement in leukemia, but until now this presentation has not been described in the setting of leukemic relapse presenting with acute infiltration of the parotid gland.     

Accessory parotid gland lesions: case report and review of literature

There are numerous causes for chronic cheek swelling, including masseteric hypertrophy, lymphadenopathy, diffuse inflammatory changes and neoplasia. We report an unusual case of a recurrent swelling as the result of sialolithiasis of an accessory parotid gland, which lay isolated from the main parotid gland along the Stensen's duct. The calculi developed in the accessory salivary tissue whereas all major salivary glands presented without sialolithiasis. Clinical findings as well as imaging results are shown and surgical management and histopathology are discussed. Hereby, for the first time we report a case with multiple calculi in an accessory parotid gland removed via a standard parotid incision. Further to this, we give a comprehensive review of literature on accessory parotid gland lesions.     

Inflammatory myofibroblastic tumor of the parotid gland: case report and review of the literature

An inflammatory myofibroblastic tumor, previously known as an inflammatory pseudotumor, is an uncommon neoplasm. This tumor, which has characteristic morphological and immunohistochemical features, is mostly seen in the lung. Herein we present a rare case of an inflammatory myofibroblastic pseudotumor of the parotid gland as well as a review of the literature. The patient was a 66-year-old man with recurrent painful swelling of the parotid gland. A total parotidectomy with preservation of the facial nerve branches was performed. The patient showed no signs of recurrence>3 years after surgery. The presence of clonal cytogenic abnormalities supported the neoplastic origin of this process. The treatment consisted of complete resection. Clinicians should however be aware that an inflammatory myofibroblastic tumor may mimic a reactive process.     

Severe compression injury of the soft tissue of the parotid

Introduction: Parotid gland injuries occur infrequently following blunt trauma, which typically involves significant force resulting in complicated gland injury. Case report: We present a case of uncomplicated parotid gland injury that resolved with conservative management. Discussion: Injury to the parotid gland can result in complicated gland injury involving facial nerve neuropathy, hematoma or pseudocyst formation. Patients with blunt trauma to the parotid gland should be evaluated for any associated injury and be managed conservatively for uncomplicated injury.     

Warthin's tumor associated with IgG4-related disease

Immunoglobulin G4-related disease (IgG4-RD) is an inflammatory condition associated with elevated serum IgG4 levels and tissue infiltration by IgG4-expressing plasma cells. Several inflammatory conditions associated with IgG4-RD have been reported. Warthin's tumor is a benign parotid gland tumor consisting of oncocytic epithelial cells and lymphoid stroma containing lymphoid follicles with reactive germinal centers. This is the first report describing a case of Warthin's tumor with possible involvement of IgG4-RD. The patient was a 71-year-old man presenting with swollen right parotid and bilateral submandibular glands. He had a history of a Warthin's tumor of the left parotid gland, autoimmune pancreatitis, and an inflammatory abdominal aortic aneurysm. Laboratory tests revealed a high serum IgG4 level. Histological examination of the resected parotid gland showed a Warthin's tumor and a nodule showing severe lymphocytic infiltration containing many IgG4-positive plasma cells. This case shows the possible involvement of Warthin's tumor with IgG4-RD.     

Extraskeletal osteosarcoma in the parotid gland: A case report

Extraskeletal osteosarcoma is a very rare tumor and accounts for 4–5% of all osteosarcomas. We describe a 47-year-old Japanese man who presented with a right parotid tumor. The patient underwent total resection with postoperative radiotherapy; however, the tumor recurred in the lung, whereupon he underwent chemotherapy and partial lung resection. After surgery, a hemorrhagic brain metastasis appeared; this tumor was extirpated to prevent bleeding into the brain, after which additional chemotherapy was administered. Nevertheless, the patient developed additional metastases and died 17 months after the total parotidectomy. This tumor was unique in that it arose in the parotid gland; this case provides an instructional example of an extremely rare manifestation of this type of tumor.     

Agenesis of the unilateral parotid gland associated with pleomorphic adenoma of the contralateral parotid gland

Congenital absence of the parotid gland is extremely infrequent. We present here a case of unilateral parotid gland agenesis with pleomorphic adenoma of the contralateral parotid gland. Even though pleomorphic adenoma is the most common tumour of the parotid gland, to our knowledge this is the first case of these two conditions being seen together.     

Actinomycosis of the parotid gland

Abstract - Actinomycosis is a slowly progressive infection caused by anaerobic bacteria with relatively decreasing incidence now-a-days. The Parotid gland is a quite rere site to be involved in cervico-facial actinomycosis as compared to the other sites in the face & neck region. We report a successfully managed case of Actinomycosis involving the parotid gland.