Atypical Cystic Parotid Gland Acinic Cell Carcinoma in a Child

Abstract

Purpose: To describe the extremely rare occurrence of acinic cell carcinoma of the parotid in a young child. Materials & Methods: A 14-year-old boy presented with a left sided facial mass. It was initially thought to be a bug bite or perhaps a wrestling injury. However, it progressed rapidly overall several weeks. CT revealed a well-circumscribed, cystic, 3.9 × 2.8 × 3.2 cmmass centered in the deep lobe of the left parotid gland, also involving the superficial lobe and extending medially through the stylomandibular tunnel with a component extending to the stylomastoid foramen. There was no solid enhancing portion. There were several enlarged level II lymph nodes suspicious for nodal metastases. Results: The mass was biopsied and pathology was consistent with acinic cell carcinoma. Complete left parotidectomy and left selective neck dissection was performed, confirming the diagnosis. Conclusions: Salivary gland neoplasms are rare in children. Less than 5% of salivary gland tumors occur in children. Salivary gland neoplasms account for less than 8% of pediatric head and neck tumors. Approximately 1/3 of salivary gland tumors arising in childhood are malignant; most being mucoepidermoid. Acinic cell carcinoma of the parotid gland in children is extremely rare, especially in those under age 16, with only a few available case reports. This case was also unusual in that the lesion was predominantly cystic.