Abstract
Objective: Objective of this study is to highlight the importance of considering clinical and radiological findings in parotid tumors before operating tumors with high suspicion of malignancy though reported as benign on histopathology. Material and Methods: 20 years old female patient underwent radical parotidectomy for epithelial-myoepithelial carcinoma of the left parotid gland which was diagnosed on FNAC. Contrast CT and contrast MRI also showed a tumor involving left parotid gland with destruction of ramus of mandible and loss of tissue planes medially & laterally. Facial nerve was infiltrated by tumor, thus sacrificed. Post operatively, patient had left facial palsy and was discharged after 7 days without any other sequelae. Postoperative histopathology showed pleomorphic adenoma with positive resection margins medially, superiorly & posteriorly. No further treatment was given in view of the benign nature of the tumor. Results: Patient was kept on monthly follow up and was disease free at one year follow up. Conclusion: Aggressive surgical treatment should be planned for malignant parotid tumors to give a better tumor free survival. Misdiagnosis can occur on FNAC as it can hit only one part of the tumor thus missing a malignant tumor or can interpret pleomorphic adenoma as epithelial-myoepithelial carcinoma.
Highlights
Pleomorphic adenoma is the most common neoplasm of both the major and minor salivary glands
Material and Methods: 20 years old female patient underwent radical parotidectomy for epithelial-myoepithelial carcinoma of the left parotid gland which was diagnosed on FNAC
Misdiagnosis can occur on FNAC as it can hit only one part of the tumor missing a malignant tumor or can interpret pleomorphic adenoma as epithelial-myoepithelial carcinoma
Summary
Pleomorphic adenoma is the most common neoplasm of both the major and minor salivary glands. Epithelial-myoepithelial carcinoma (EMC) is a rare biphasic tumor of the salivary glands typically arising in the parotid. Epithelial-myoepithelial carcinoma (EMC) is a rare type of malignant tumor, accounting for about 1% of all salivary gland tumors [1,2] and recognizes a typical biphasic pattern: a central ductular structure, often containing eosinophilic material surrounded by clear cells of myoepithelial origin. It was firstly described as a glycogenrich or clear cell adenoma because of the clear cell component.
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