METHODS: We present a young lady of HGT-AdCC of right parotid gland with temporal bone involvement in the form of isolated perineural invasion (PNI) of facial nerve till the tympanic segment. She underwent right radical parotidectomy with modified radical neck dissection with modified lateral temporal bone resection and pectoralis major myocutaneous flap reconstruction. Histopathological examination revealed both low- and high-grade areas. Sections from facial nerve showed tumor invasion.
CONCLUSIONS: The radiological features of isolated perineural spread in intratympanic part of facial nerve can be easily missed if not specifically looked for. Every attempt should be made preoperatively and intraoperatively to determine the complete extent of the tumor for adequate disease clearance. A combined clinico-radiological approach aided by histopathology examination helps in early detection of this carcinoma and in better patient management.
方法:我们介绍了一名右腮腺HGT-AdCC的年轻女士,颞骨受累,其形式是面神经孤立性侵犯(PNI),直至鼓段。她接受了右腮腺根治性切除术,改良根治性颈清扫术,改良颞骨外侧切除术和胸大肌肌皮瓣重建。组织病理学检查显示了低级和高级区域。面神经切片显示肿瘤浸润。
结论:如果不明确查找,很容易错过孤立的神经周扩散在面神经鼓室部分的放射学特征。应在术前和术中进行一切尝试,以确定肿瘤的完整范围,以清除足够的疾病。由组织病理学检查辅助的联合临床放射学方法有助于早期发现这种癌并更好地管理患者。