PDF(Pubmed)
Abstract：
BACKGROUND: Parotid gland agenesis is a rare, congenital, usually asymptomatic disorder. Until now, only 24 cases with unilateral, incidentally found, parotid gland agenesis have been described. Here, we present the first reported case of an ipsilateral preauricular neoplasm in a patient with unilateral parotid gland agenesis. During surgery, the position of the greater auricular- and facial nerves was documented. Furthermore, we performed the first sialendoscopy for this rare disorder to assess the number of duct branches, which might be indicative of the abundance of parotid tissue. Moreover, we looked for sialendoscopic characteristic features that could aid in identifying these patients in the ambulatory setting.
METHODS: A 50-year-old Greek man presented with a painless, slowly enlarging mass in the right parotid space. Magnetic resonance imaging revealed a complete absence of the right parotid gland without accessory parotid tissue. The right parotid gland was replaced by fatty tissue and the radiologist suggested a benign parotid tumor. Fine needle aspiration was indicative of a reactive lymph node. Sialendoscopy revealed only two branches within the right parotid duct. Surgical resection was performed through a conventional lateral parotidectomy. This revealed typical anatomic position of the greater auricular- and facial nerves despite the parotid tissue agenesis. Histopathology revealed a small lymphocytic lymphoma.
CONCLUSIONS: Surgeons should feel confident to resect tumors of the parotid space in patients with parotid gland agenesis. Reduced branching observed during sialendoscopy might indicate parotid gland agenesis. Physicians should be even more cautious than usual with the watch and wait strategy in patients with tumors of parotid gland agenesis, since the probability of a tumor being a benign salivary gland tumor might be lower than usual.
METHODS: A 50-year-old Greek man presented with a painless, slowly enlarging mass in the right parotid space. Magnetic resonance imaging revealed a complete absence of the right parotid gland without accessory parotid tissue. The right parotid gland was replaced by fatty tissue and the radiologist suggested a benign parotid tumor. Fine needle aspiration was indicative of a reactive lymph node. Sialendoscopy revealed only two branches within the right parotid duct. Surgical resection was performed through a conventional lateral parotidectomy. This revealed typical anatomic position of the greater auricular- and facial nerves despite the parotid tissue agenesis. Histopathology revealed a small lymphocytic lymphoma.
CONCLUSIONS: Surgeons should feel confident to resect tumors of the parotid space in patients with parotid gland agenesis. Reduced branching observed during sialendoscopy might indicate parotid gland agenesis. Physicians should be even more cautious than usual with the watch and wait strategy in patients with tumors of parotid gland agenesis, since the probability of a tumor being a benign salivary gland tumor might be lower than usual.
摘要：
背景：腮腺发育不全很少见，先天性,通常无症状的疾病。直到现在,只有24例单方面的，偶然发现,腮腺发育不全已被描述。这里,我们报道了首例单侧腮腺发育不全患者的同侧耳前肿瘤。手术期间,记录了大耳和面神经的位置。此外，我们对这种罕见的疾病进行了首次鼻内镜检查，以评估导管分支的数量，这可能表明腮腺组织的丰度。此外，我们寻找可以帮助在门诊环境中识别这些患者的鼻内镜特征性特征.
方法：一名50岁的希腊男子无痛，右侧腮腺间隙的肿块逐渐扩大。磁共振成像显示右腮腺完全缺失，没有副腮腺组织。右腮腺被脂肪组织取代，放射科医生建议腮腺良性肿瘤。细针抽吸指示反应性淋巴结。内窥镜检查显示右腮腺导管内仅有两个分支。手术切除是通过常规的腮腺外侧切除术进行的。尽管腮腺组织发育不全，但这揭示了大耳和面神经的典型解剖位置。组织病理学显示为小淋巴细胞淋巴瘤。
结论：对于腮腺发育不全患者，外科医生应该有信心切除腮腺间隙肿瘤。在鼻内镜检查期间观察到的分支减少可能表明腮腺发育不全。对于腮腺发育不全的肿瘤患者，医生应该比平时更加谨慎地观察和等待策略，因为肿瘤是良性唾液腺肿瘤的可能性可能比平常低。
方法：一名50岁的希腊男子无痛，右侧腮腺间隙的肿块逐渐扩大。磁共振成像显示右腮腺完全缺失，没有副腮腺组织。右腮腺被脂肪组织取代，放射科医生建议腮腺良性肿瘤。细针抽吸指示反应性淋巴结。内窥镜检查显示右腮腺导管内仅有两个分支。手术切除是通过常规的腮腺外侧切除术进行的。尽管腮腺组织发育不全，但这揭示了大耳和面神经的典型解剖位置。组织病理学显示为小淋巴细胞淋巴瘤。
结论：对于腮腺发育不全患者，外科医生应该有信心切除腮腺间隙肿瘤。在鼻内镜检查期间观察到的分支减少可能表明腮腺发育不全。对于腮腺发育不全的肿瘤患者，医生应该比平时更加谨慎地观察和等待策略，因为肿瘤是良性唾液腺肿瘤的可能性可能比平常低。
