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.
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。