Parotid Tail Research Articles

The Mastoid Crevasse and 3-Dimensional Considerations in Deep Plane Neck Lifting.

Advances in face and neck lifting involve release of tethering points along the superficial musculoaponeurotic system-platysma complex to freely manipulate the deep natural glide plane in the face and neck. The aim of this article was to determine a combination of deep plane techniques for addressing the face and neck and to elucidate, for the first time, a measurable endpoint for the gonial angle. Analysis of deep plane tethering and decussation zones was also undertaken. Extended deep plane surgery performed in 79 patients (158 hemifaces; age, 30-75 years; 95% female), over a 3-month period, was reviewed. Patients were followed for 1 year. Measurements were performed systematically during deep plane face and neck lifting. Before intervention, the mean [standard deviation] gonial depth was 9.4 [3.6] mm on the left and 8.3 [2.7] mm on the right. The mean depth created below the gonial angle when measuring the traditional suspension to the anterior mastoid was 15.8 [3.3] mm on the left and 13.7 [2.5] mm on the right. The distance postoperatively when measuring the gonial depth after performing the crevasse technique was 23.2 [2.2] mm on the left and 22.5 [2.5] mm on the right. This represents a mean increase in the advancement of 7.4 mm on the left and 8.8 mm on the right (average, 8.1 mm) which was demonstrated to be statistically significant bilaterally (P < .0001). The deep plane techniques described here aid manipulation of the deep plane and deep neck space, while also providing measurable endpoints and more effective modes of fixation by utilizing the mastoid crevasse. The use of techniques that release tension and allow redrape produce the most natural and well-balanced results.

Earring Lesion Of The Parotid Tail

Masses in the Parotid tail can be source of consternation to radiologist and clinicians and therefore need attention. Inaccurate localization may lead to significant iatrogenic complications. Anatomically localization lesions of Parotid tails is of relevance as it often creates radiological confusion, as was in this case also. Imaging features of Parotid tail involvement need to be reviewed for, proper understanding and discussed with radiologist for complication free management. A Clinico-radiological correlation reviewing 111 such cases was found which described pleomorphic adenoma(15) , Warthins tumor (14) , infective pathologies, Sjogren disease and also malignant lesions in 27 cases. The notable radiological findings in the cases where enhancement, multiplicity of lesions, on CT and diffusion weighted (varied) signal intensity of MR changes. Relationship of parotid tail/ lesions with surrounding structures like facial nerve or its branches , sternocleidomastoid muscle and posterior belly of digastric muscle, proximity close to the level II LN and posterior part of submandibular salivary gland all need to clearly examined and analyzed. Such a lesion has been referred to as Earring lesions in literature. Earring lesion is best appreciated and less confusing in coronal images and equally challenging in palpation. Though rare, localizing anatomical features of parotid tail lesions are reviewed in this paper along with a case report of parotid tail tumor.

Do Benign Mass Lesions in the Superficial Lobe of Parotid Gland Influence Landmark-Based Search for Facial Nerve Trunk at Surgery?

ObjectiveTo assess the influence of benign mass lesions in the superficial lobe of parotid on the known anatomic landmarks for identifying the facial nerve trunk.MethodPatients with unilateral biopsy-proven benign mass lesions in the superficial parotid were selected for this observational study. During superficial/partial superficial parotidectomy, distance of the facial nerve trunk from each landmark was assessed using spring calliper and correlated with the lesion’s volume (measured from the pre-operative imaging). At least two identifiers among tragal pointer (TP), posterior belly of digastric muscle (PBDM) and tympanomastoid suture (TMS) were considered.ResultsThe study involved 32 patients. The lesions mostly involved the parotid tail (50%) and pretragal region (34.3%), and constituted of pleomorphic adenoma (~66%) and Warthin’s tumor (~9%), the rest being various cysts and hamartomas. TP was universally uncovered, while PBDM and TMS were exposed in 26 and 25 patients, respectively. Average distances between the facial nerve trunk and TP, PBDM and TMS were 12.79 mm (SD=2.33), 9.78 mm (SD=1.21) and 7.58 mm (SD=1.33), respectively. Correlation coefficients between the lesion’s volume and the distance of facial nerve from a given landmark were -0.11, 0.04 and -0.16 for TP, PBDM and TMS, respectively.ConclusionTP was the most easily available landmark on surgical dissection, while PBDM was the most consistent and the least variable when volumetric data of the benign mass lesions in the superficial lobe of parotid were considered as a factor influencing the distance from the facial nerve trunk.

A Rare Case of a Metastatic Basal Cell Carcinoma

Background: Basal cell carcinomas are malignant slow-growing neoplasms of the epidermal layer of the skin. They are the most common form of skin cancer, accounting for 80% of non-melanoma skin cancers. Metastasis is rare with an incidence rate of 0.0028 to 0.55%. We report a case of an 83 year old male presenting with basal cell carcinoma (BCC) of the right cheek. The tumour was completely excised with close margins. The patient was closely monitored clinically and on follow-up, a mass in the region of the right parotid was identified. Excision of the tail of the right parotid identified a tumour with similar subtype to the primary tumour excised from the cheek confirming diagnosis of metastatic BCC.&#x0D; Methods: A literature search was carried out inclusive of the terms identify existing data and guidelines to determine best evidence based practice.&#x0D; Discussion: Literature search identified aetiology of BCCs and methods of diagnosis and treatment. The search also highlighted an incidence rate of 0.0028 to 0.55% and complications associated with metastasis. The patient underwent a course of radiotherapy as surgery in this case was contraindicated due to history of excision of the parotid tail.&#x0D; Risk factors for developing BCCs include intermittent sun exposure, ionising radiation, genetic predisposition and immunosuppression. Metastases occurs via the lymphatic system or haematogenously. Surgery is the main form of treatment and aims to be curative.

An Unusual Presentation of Pleomorphic Lipoma

Abstract Introduction/Objective Pleomorphic lipomas are benign tumors that typically occur in the shoulder, posterior neck, and back. Here, we present a case of a pleomorphic lipoma arising in an unusual location. Methods A 63-year-old male presented with a 1.3 x 1.3 x 0.9 cm enhancing slightly heterogeneous mass in the subcutaneous tissue superficial to the right parotid tail. The mass was biopsied and then excised. Results Histopathologic examination of the biopsy and resection specimens revealed an adipocytic neoplasm composed of mature adipose tissue with admixed spindle cells within a myxoid stroma. Lipoblasts, cellular atypia or increased mitotic figures were absent. Numerous floret-like cells were identified. These floret cells are characteristic of pleomorphic lipoma. The tumor cells were diffusely positive for CD34 and negative for desmin, smooth muscle actin, MyoD1, keratin, SOX10, and Melan-A by immunohistochemistry, consistent with pleomorphic lipoma. Conclusion Pleomorphic lipomas arising from the periparotid adipose tissue are rare. They tend to have a favorable prognosis with low incidence of recurrence if excised with clear margins. Following complete excision, the patient is doing well.

Metastasis of oral squamous cell carcinoma to the parotid lymph nodes

Parotid lymph node (PLN) metastasis greatly worsens the prognosis of patients with oral squamous cell carcinoma (OSCC) and poses a great challenge for further treatment of OSCC. The clinicopathological characteristics and treatment strategies for PLN metastasis from OSCC need to be comprehensively elucidated. A retrospective review of OSCC patients who experienced postoperative PLN metastasis in our department between 2000 and 2018 was performed in this study. A total of 47 OSCC patients with postoperative PLN metastasis were identified. PLN with metastasis were divided into three groups based on the location: parotid tail (PLN-t), superficial lobe (PLN-sl), and deep lobe (PLN-dl). Most of the patients experienced PLN metastasis within less than 12 months after the primary surgery for OSCC. Comparatively, patients with PLN-sl metastasis were more prone to have infiltration of the facial nerve. The tongue and buccal mucosa were the most frequent primary sites associated with PLN metastasis from OSCC. PLNs in the parotid tail were most commonly affected by the metastasized OSCC. Consequently, we recommend a series of strategies for the prevention and treatment of PLN metastasis for OSCC patients. In conclusion, PLNs should not be overlooked during preoperative evaluation and postoperative follow-up examinations for OSCC patients.

Parotidectomy via Individualized Mini-Blair Incision

Background: The modified Blair incision is the standard facial incision for the vast majority of parotid gland lesions. We utilize three types of incisions: “classic mini-Blair” for parotid body tumors, “cervical mini-Blair” for parotid tail tumors, and “vertical mini-Blair” for anterior parotid tumors. In this study, we describe the surgical and esthetic outcomes of these individually tailored incisions. Methods: Patients undergoing parotidectomy between 2011 and 2013 were included. The surgical outcomes and patients’ satisfaction were assessed. Results: Of 122 patients, 89 were included. All patients completed a questionnaire assessing the postoperative course and patients’ satisfaction regarding the surgery in general and the scar in particular. Among these patients, 78 (87%) had a benign pathology and 11 (13%) had malignant tumors. The tumors were located at the parotid body in 57 patients (64%), at the parotid tail in 19 (21%), at the deep lobe in 8 (9%), and at the anterior parotid gland in 5 (6%). All tumors were removed successfully with negative margins on pathology. No inadvertent permanent facial nerve paralysis occurred. The median operation time was 72 min (23–211). The average patient scores of satisfaction with the surgical scar and with the surgery were 9.54 and 9.72, respectively. Conclusions: Individualized mini-Blair incision is feasible for benign as well as selected malignant parotid tumors.

Evaluation of Outcomes following Radiofrequency Ablation for Treatment of Parotid Tail Warthin Tumors.

To evaluate efficacy and safety of radiofrequency (RF) ablation for parotid Warthin tumor. From September 2016 to August 2017, 7 consecutive patients with biopsy-proven parotid Warthin tumors who did not undergo surgery presented with symptoms or cosmetic concerns and underwent US-guided percutaneous RF ablation treatment. RF ablation procedures were performed using the moving shot technique. US, contrast-enhanced CT, or MR imaging was performed 6-12 months after each procedure. Complications and cosmetic scale improvement after RF ablation were also evaluated. There was a significant reduction in mean tumor volume from 14.6 cm3 ± 13.1 (range, 1.9-35.5 cm3) to 0.8 cm3 ± 0.5 (range, 0.2-1.54 cm3) and a mean cosmetic scale improvement (from 4 to 1) on imaging studies 6-12 months after RF ablation compared with before RF ablation (P < .05). Volume reduction ratios at 1-2 months, 5-6 months, and 10-12 months after RF ablation were 51.2% ± 18.1%, 87.8% ± 10.6%, and 94.3% ± 2.0%. There was no facial nerve injury. One patient with parotitis and hematoma recovered in 1 week. RF ablation using the moving shot technique could be an effective and safe alternative treatment for parotid tail Warthin tumors in patients unsuitable for or unwilling to undergo surgical resection.

Extracapsular dissection via sternocleidomastoid muscle-parotid space approach-a new operative technique for treating clinically benign tumor in the parotid tail.

The aim of this study was to introduce extracapsular dissection via the sternocleidomastoid muscle-parotid space approach (ECD-SMPSA) as a modified operative technique for removal of clinically benign tumors from the parotid tail. The study included 52 patients with clinically benign tumors in the parotid tail, and the patients were divided into 2 groups: one group was treated with ECD-SMPSA and the other with extracapsular dissection (ECD). All of the patients were followed up for at least 2 years. The ECD-SMPSA group had lower incidence of subjective Frey syndrome (P = .03) and higher satisfaction with the cosmetic result after the surgery (P = .023) compared with the ECD group. All of the patients were free of salivary fistulae. Facial palsy (P = .234) and earlobe numbness (P = .291) were not significantly different between the groups (P < .05). With careful preoperative assessment, ECD-SMPSA may be a more suitable approach for the treatment of clinically benign tumors in the parotid tail.

Spontaneously infarcted parotid tumours: MRI findings.

To report MRI findings of spontaneous infarction in parotid tumours. 14 patients (13 male, 1 female; mean age 73 years) with spontaneously infarcted parotid tumours were reviewed retrospectively. MR images were assessed for the location, the presence of synchronous parotid masses, margin characteristics, signal intensity on T 1 and T 2 weighted images, and internal architecture according to the distribution of T 2 signal hyperintensity. 12 tumours were located in the parotid tail and 2 in the superficial lobe. Synchronous parotid masses were seen in four tumours, three of which were located in the ipsilateral parotid tail and one in the contralateral parotid tail. Seven tumours had well-defined margins and seven had ill-defined margins. The signal intensities on T 1 weighted images were a mixture of high and intermediate in all cases; in 11 tumours, hyperintense areas were dominant. On T 2 weighted images, all tumours also showed a mixture of high and intermediate signal intensities. Internal architectures on T 2 weighted images were mosaic hyperintensity in three tumours, central hyperintensity in five, and multiseparated hyperintensity in six. Spontaneously infarcted parotid tumours were mostly located in the parotid tail and showed mixed signal intensities with predominant hyperintensity on T 1 weighted images. Half of the tumours had ill-defined margins, and the internal architectures varied.

Oral Squamous Cell Carcinoma with Metastasis to the Parotid Lymph Node.

To increase the awareness of oral squamous cell carcinoma (OSCC) metastasis to the parotid region and the characteristics of these cases, and to evaluate the outcomes and provide treatment suggestions. A retrospective study was conducted among the OSCC patients with metastasis to the parotid gland at the Peking University School and Hospital of Stomatology from 2000 to 2015. The demographic data and the medical records including primary tumour, treatment protocol, follow-up information and outcomes were collected and analysed. A total of 10 patients with parotid metastasis (out of 1358 OSCC patients) were included in the study. The incidence of parotid metastasis was relatively low (0.74%). All the cases were poorly differentiated (Grade II/III) and the primary sites were in an advanced stage (T3/4). Parotid metastasis occurred frequently following neck dissection and radiotherapy, and the inferior parotid lymph nodes were most commonly involved. Surgery and radiotherapy were mainly salvage protocols for parotid metastasis. The 5-year survival rate of these patients was 38.9% by the Kaplan-Meier method. OSCC has the potential to metastasise into the parotid lymph nodes. The salvage rate and prognosis were relatively poor. Removing of the parotid tail along with the neck dissection is recommended for OSCC patients.

Treatment of intractable parotid sialocele occurred after open reduction-fixation of mandibular subcondylar fracture.

A sialocele is a subcutaneous cavity containing saliva, most often caused by facial trauma or iatrogenic complications. In subcondylar fractures, most surgeons are conscious of facial nerve injury; however, they usually pay little attention to the parotid duct injury. We report the case of a 41-year-old man with a sialocele, approximately 5×3 cm in size, which developed 1 week after subcondylar fracture reduction. The sialocele became progressively enlarged despite conservative management. Computed tomography showed a thin-walled cyst between the body and tail of the parotid gland. Fluid leakage outside the cyst was noted where the skin was thin. Sialography showed a cutting edge of the inferior interlobular major duct before forming the common major duct that seemed to be injured during the subcondylar fracture reduction process. We decided on prompt surgical treatment, and the sialocele was completely excised. A duct from the parotid tail, secreting salivary secretion into the cyst, was ligated. Botulinum toxin was administrated to block the salivary secretion and preventing recurrence. Treatment was successful. In addition, we found that parotid major ducts are enveloped by the deep lobe and extensive dissection during the subcondylar fracture reduction may cause parotid major duct injury.

Surgical treatment strategy in Warthin tumor of the parotid gland

IntroductionWarthin tumors are the second most common benign tumors of the parotid gland. We examined the clinical features of Warthin tumors in our hospital, and analyzed the consistency within the literatures. ObjectiveThe aim of this study is to analyze the clinical features of Warthin tumors in our 10-year experience of 118 Warthin tumors undergoing surgery at a single institute. MethodsFrom December 2006 to December 2016, 110 patients who underwent surgical treatment for Warthin tumors were identified based on their medical records. ResultsA total of 118 parotid gland operations were performed in 110 patients. Almost 90% of Warthin tumors were found in males, and average patient age was 66.1±6.1 years. The prevalence of smoking history was 89.1% (98/110). Eight patients (7.3%) had bilateral Warthin tumors. Seventy-seven lesions (65.3%) were located in the parotid tail portion, followed by 34 lesions in the superficial lobe (28.8%) and 7 lesions in the deep lobe (5.9%). ConclusionWe determined the appropriate extent of surgery depending on the fine needle aspiration cytology and tumor location by computed tomography scans. Partial facial dysfunction after the operation was detected in 12 cases, and facial nerve function recovered within 3 months. Only one patient experienced a recurrence, and was disease free after the re-operation. We suggest that our treatment algorithm, depending on the location of tumors and the result of fine needle aspiration cytology, can be useful to determine the appropriate extent of surgery for Warthin tumors.

Preservation of Salivary Function Following Extracapsular Dissection for Tumors of the Parotid Gland

This study evaluated salivary function after extracapsular dissection (ECD) compared with partial superficial parotidectomy (PSP) and classic superficial parotidectomy (CSP) of benign parotid gland tumors. The authors hypothesized that ECD would be superior to PSP and CSP in preserving postoperative salivary function. Retrospective analyses were performed for 43 consecutive patients who underwent parotidectomies of benign parotid tumors performed by a single experienced surgeon. Clinical data and pre- and postoperative whole salivary flow rates were compared among the operative procedures. Pearson χ2 and Fisher exact tests were used to compare categorical variables. Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed rank tests were used to compare means. A P value less than .05 was considered significant throughout the study. Tumor sizes did not differ among groups. Operative times, amounts of drainage, and hospital days for ECD were markedly decreased compared with CSP and tended to be decreased compared with PSP. Resection margins were exposed in 0, 12.5, and 6.7% of patients who underwent ECD, PSP, and CSP, respectively. Postoperative complications occurred less often (but not meaningfully) after ECD. Postoperative basal salivary flow rates in the ECD, PSP, and CSP groups were 0.39, 0.32, and 0.14mL/minute, respectively (P=.05). Stimulated salivary flow rates remained stable for the ECD and PSP groups but decreased in the CSP group. ECD is a safe and time-efficient surgical approach, offering early recovery from parotid tumors and better preservation of salivary function. ECD should be considered a surgical approach for parotid tumors, especially those in the parotid tail region, such as Warthin tumors.

Vascularized Fascia Lata for Prevention of Postoperative Parotid Fistula Arising From Partial Parotidectomy During Neck Dissection

Postoperative parotid fistula can occur after partial parotidectomy, which is a routine surgical procedure during neck dissection of oral cancers arising from or close to the oropharyngeal area. The aim of this study was to evaluate the reliability of vascularized fascia lata for the prevention of postoperative parotid fistula after neck dissection. A retrospective review was conducted of patients with oral cancer who underwent ablative resection involving the parotid tail and reconstruction using the anterolateral thigh (ALT) flap with a vascularized fascia lata paddle. The vascularized fascia lata paddle was used to seal off the parotid stump by tightly suturing the edges of the fascia lata and parotid wound together. Twenty-three patients (18 men and 5 women) with primary oral cancer arising from or close to the oropharyngeal area were enrolled. The mean area of parotid defect was 16.7cm2 and the mean area of fascia lata harvested was 21.8cm2. All flaps survived. Pressure dressing or anticholinergic drugs were not used in any case. During the follow-up period, there was no clinical evidence of the development of parotid fistula. The vascularized fascia lata paddle is a reliable option for the prevention of postoperative parotid fistula after neck dissection of oral cancer.

Metastases to the parotid nodes: CT and MR imaging findings.

To present and characterize CT and MR imaging findings of metastases to the parotid nodes. CT (n = 10) and MR (n = 11) images from 14 patients with metastases to the parotid nodes were reviewed. The primary tumour sites were the ocular adnexa in five patients, facial skin in four patients, upper aerodigestive tract in four patients and thyroid gland in one patient. CT and MR images were evaluated with emphasis on the size and number of parotid tumours, their location in the parotid gland, the presence of associated clinically pathological cervical nodes or previous history of cervical node metastasis, margin characteristics and the presence of central necrosis. A total of 18 tumours were identified in 14 patients, with an average maximal cross-sectional diameter of 19 mm (7-44 mm). 12 patients had a single parotid tumour and 2 patients had unilateral multiple tumours; 12 tumours in 10 patients were located in the parotid tail, 6 tumours in 4 patients were located in the superficial lobe and no tumour was noted in the deep lobe. In the superficial lobe, four of six tumours were located in the pretragal area. Three of nine patients whose primary sites were the ocular adnexa or skin had associated clinically pathological cervical nodes. None of these patients had a previous history of cervical node metastasis. All five patients with other primary sites had associated pathological cervical nodes or a history of such. 11 tumours had well-defined margins and 7 tumours had ill-defined margins. Post-contrast images showed central necrosis in 2 of 11 tumours. Metastases to the parotid nodes tend to present as solitary parotid masses with two preferential sites.

A radiation oncologist’s guide to contour the parotid gland

The parotid gland is the largest of the salivary glands and is primarily responsible for salivation and prevention of dry mouth as well as oral health. Routinely, the parotid gland is near target in head and neck cancer cases. It is critical that attention be given to avoid unnecessary dose to the parotid glands to preserve saliva, taste, and oral health. The facial nerve (CN VII) passes through the gland and divides it into the superficial and deep lobes. Anteriorly, it overlies the lateral surface of the masseter muscle; laterally, it is surrounded by subcutaneous fat planes of the cheek; and posterosuperiorly, it is bounded by the external auditory canal. The deep lobe is medial to CN VII and is bound by the parapharyngeal space medially, the mastoid process of the temporal bone posteriorly, and the ramus of the mandible anteriorly. Superiorly, the deep lobe extends to the level of the stylomastoid foramen.1,2 It should be noted that, inferiorly, below the angle of the mandible, the parotid tail inserts between platysma and sternocleidomastoid muscle in the area of the posterior submandibular space. Although the gland is divided into the 2 lobes, this anatomical distinction does not aid in the contouring process. However, the retromandibular vein, which is seen coursing through the deep lobe just along the medial margin of CN VII, may be useful for the radiation oncologist. There may be circumstances in which it would

Demographics of benign parotid tumours: Warthin’s tumour versus other benign salivary tumours

Conclusion: Some variation from the ‘classical’ clinical picture for Warthin’s tumours is evident in these patients. A predilection for the parotid tail and a propensity for multiplicity has been confirmed. Objectives: This study sought to analyse demographic and clinical features of a Warthin’s patient population. Methods: Retrospective review of patients presenting with a benign parotid tumour. The group of Warthin’s tumours was compared with the group of patients with other benign parotid tumours. Results: Of 170 primary parotid tumours, 41 (24%) were Warthin’s tumour. Mean age of Warthins patients was significantly older (60 years vs 48 years, p = 0.001) and male gender more prevalent (61% vs 33%, p = 0.015) than in other benign tumours. Most (86%) Warthin’s tumours were found in the parotid tail, compared with 61% of other benign tumours (p = 0.002). There was no significant ethnic predilection for Warthin’s tumours. Bilaterality (30%) and multiplicity (27%) were common. Significance of gender differences disappeared with logistic regression analysis.

Comparative Study of Ultrasound Guided FNAC and Conventional FNAC in the Diagnosis of Parotid Tumour

Objective: To evaluate role of ultrasound guided FNAC for the diagnosis of parotid tumor.Methods: This cross sectional study was conducted in 39 patients with parotid tumor admitted in the ENT department of out door of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital, and Sir Salimullah Medical College and Mitford Hospital Dhaka, during July 2013 to June 2014 were enrolled for surgical management. Conventional FNAC and ultrasound guided FNAC were done in all these patients and they were followed up from the admission upto the post operative tissue diagnosis of parotid tumor in respective pathology departments for histopathological correlation.Results: The highest incidence of parotid tumor was in 4th decade and male to female ratio was almost 1:1. The main clinical feature were 27(69.2%) had firm, 6(15.4%) soft, 1(2.6%) hard and 5(12.8%) over the parotid tail. The validity of histopathology evaluation for pleomorphic in USG FNAC sensitivity 95.7%, specificity 100.0%, accuracy 97.4%, positive predictive values 100.0%, negative predictive values 94.1%. Evaluation for Meucoepidermoid sensitivity 80.0%, specificity 97.1%, accuracy 94.9%, positive predictive values 80.0%, negative predictive values 97.1% in USG FNAC. In USG FNAC for identification Warthin sensitivity 100.0%, specificity 100.0%, accuracy 100.0%, positive predictive values 100.0%, negative predictive values 100.0%. Evaluation for Adenocystic in USG FNAC sensitivity 100.0%, specificity 100.0%, accuracy 100.0%, positive predictive values 100.0%, negative predictive values 100.0%.Conclusion: It can be concluded that Ultrasound guided FNAC has definite value in the diagnosis of tumours and can be regarded as a sensitive and specific imaging modality for pre-operative discrimination of the benign and malignant parotid tumours.Bangladesh J Otorhinolaryngol; April 2015; 21(1): 5-16

A Rare Case of Chondroma of the Parotid Gland

Patient: A 39-year-old Hispanic woman. History of Present Illness: The patient had swelling of the left side of her neck, which she had first noticed 3 to 4 months before consultation and which did not subside after 2 courses of antibiotics. She reported no tenderness, dysphagia, odynophagia, dysphonia, otalgia, fevers, chills, or weight changes. Past medical history: The patient had a past history of gastroesophageal reflux disease, arthritis (knee and cervical disease), and a prior abnormal Pap smear result (high grade squamous intraepithelial lesion). The cervical lesion was treated with a loop electrosurgical excision procedure (LEEP). Her past surgical history is remarkable for cholecystectomy and a left breast biopsy with benign results. Social history: Noncontributory. Family history: Noncontributory. Physical exam: The patient harbored a firm, nontender, fully mobile 2- to 3-cm left parotid tail mass without other abnormalities; her facial nerve function was intact in all branches. Principle Laboratory Findings: See [Image 1][1], [Image 2][2], [Image 3][3], [Image 4][4], [Image 5][5], and [Image 6][6]. * FNA : fine needle aspiration LEEP : loop electrosurgical excision procedure CT : computed tomography [1]: #F1 [2]: #F2 [3]: #F3 [4]: #F4 [5]: #F5 [6]: #F6