We present the case of a 71-year-old man who, after undergoing postoperative radiotherapy for epithelial carcinoma, developed progressively enlarging erythema. Initially, the condition resembled radiation dermatitis or erysipelas, and topical steroids and antibacterial agents were administered without success. A biopsy was performed for further evaluation, revealing a cutaneous invasion of parotid carcinoma. The lesion continued to enlarge, leading to dysphagia and ultimately necessitating a tracheostomy.

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BACKGROUND: Basal cell adenoma is a rare, benign epithelial tumour of the salivary gland, comprising only 1-2 % of all salivary gland tumours. Predominantly found in the parotid gland, basal cell adenoma can also occur in minor salivary glands and are often confused with other benign and malignant salivary gland tumours. A thorough histopathological examination can provide a definitive diagnosis.
METHODS: A 65-year-old woman presented with a painless mass in the right infra-auricular region. Imaging revealed a well-defined hypodense lesion in the deep lobe of the right parotid gland, initially suspected as mucoepidermoid carcinoma. Fine needle aspiration was inconclusive, leading to the decision to perform a total conservative parotidectomy. Histopathology confirmed basal cell adenoma, characterized by cystic areas filled with mucoid material and basaloid cells arranged in trabecular and tubular patterns.
CONCLUSIONS: Basal cell adenoma was classified as a distinct entity by the WHO in 1991. Cytologically, they imitate both benign and malignant salivary as well as non-salivary gland tumours. The histological hallmark of basal cell adenoma involves basaloid cells with small round nuclei showing no atypia, scant pale cytoplasm, and distinct peripheral palisading. Treatment involves surgical removal, with a more radical approach for certain variants such as the membranous type.
CONCLUSIONS: This case highlights the clinical, radiological, and histopathological features of basal cell adenoma, emphasizing the importance of accurate diagnosis and appropriate surgical management. Early detection and appropriate treatment are crucial for optimizing patient outcomes in basal cell adenoma management.

BACKGROUND: Warthin tumor (WT) is the second most common benign tumor in salivary gland. It has a slow growth rate and most frequently occurs in the parotid gland. Most patients present with an incidental finding of a painless mass inferior/anterior to the ear. Besides the epithelial component of the tumor, WT is characteristically associated with lymphoid stroma that is considered benign. While there have been a few reports of malignant transformation of the lymphoid components in WT, cases of WT concomitant with mantle cell lymphoma (MCL) are extremely rare. To the best of our knowledge, two cases have been described in the English literature. Herein, we report a case of WT concomitant with MCL in a 70-year-old female patient, and emphasize the importance of careful examination of lymphoid stroma in WT so that concurrent lymphoma is not missed.
METHODS: A 70-year-old Chinese woman with a 40-year history of cigarette smoking presented with a one year history of a right submaxillary mass with recent enlargement.
METHODS: Cervical ultrasound (US) and computed tomography (CT) scans of the neck revealed a well-circumscribed mass in the right parotid with a maximum diameter of 3.1 cm. Surgical resection of the mass was performed. Histopathological examination revealed a characteristic double-layer of neoplastic epithelium with prominent lymphoid stroma, suggesting WT. In addition, morphology and immunohistochemistry studies confirmed the coexistence of MCL. Thereafter, the final diagnosis of this case was WT concomitant with MCL.
METHODS: The patient was staged as stage I after clinical assessment. Due to the slow growth of parotid lesions, close observation was decided with periodic clinical and radiological monitoring.
RESULTS: Currently, the patient demonstrates a stable disease by clinical evaluation.
CONCLUSIONS: To the best of our knowledge, reported cases of WT concomitant with MCL are very rare. This case highlights the importance of a comprehensive assessment of the lymphoid stroma of WT to avoid missed diagnosis of a lymphoma component in a collision tumor.

Heterotopias and choristomas are congenital lesions characterized by the presence of histologically normal tissues at non-physiological anatomic sites. The presence of gastrointestinal tissue in the oral cavity has been recognized as a heterotopic gastrointestinal cyst (HGIC) of the oral cavity. An intestinal heterotopia on the face, in relation to the parotid gland, is extremely rare. Highlighting this possibility is the case of a 42-year-old, non-habitué female with swelling in the parotid region of the face for two years. Clinical examination and radiographic investigations ruled out the possibility of a salivary gland tumor, epidermal inclusion cyst, and enlarged parotid lymph node while confirming the cystic nature of the presenting pathology. Further evaluation was carried out using an excisional biopsy. Histopathological evaluation revealed a cystic space lined by simple columnar epithelium with an abundance of goblet cells. The cystic epithelium was noted to form finger-like projections and crypts. An eosinophilic mucinous content was noted in the cystic space. Using Alcian blue-periodic acid-Schiff (PAS) staining, a distinct Alcian blue positivity of the mucinous material and the goblet cells was noted. This feature confirms the acidic nature of the mucinous content being liberated by the goblet cells. The histopathological features, along with histochemical assessment, were confirmatory for the diagnosis of an HGIC. The patient remains disease-free at the end of a 12-month follow-up. This is the first report of an HGIC at an extraoral site on the face in association with the parotid gland. It highlights the possible presentation of heterotopias in adult patients and warrants clinicopathological vigilance due to its benign nature and late presentation.

Sialolipoma is a rare tumor found within both major and minor saliva. Benign fatty tumors of parotid gland (lipomas) are very unusual, accounting for less than 0.5% of all parotid tumors. Sialolipoma, a distinct variant, is characterized by proliferation of mature adipocytes with secondary entrapment of normal salivary gland elements. Sialolipoma is well circumscribed and contains mature adipose tissue admixed with benign salivary gland component. We report a case of 51 years old female who presented with the complaint of swelling in the right parotid region for 12 years duration. Ultrasonography suggested adenoma and FNAC suggested a cystic lesion. Histopathological examination after superficial parotidectomy reported sialolipoma. The aim of this article is to report a case of sialolipoma, discuss the features and contribute to differential diagnosis. There are very few reported cases of sialolipoma in the existing English literature.

Parotid gland is the largest salivary gland of the body. Pleomorphic adenomas are the most prevalent benign parotid gland tumors. They can eventually grow to a size where they weigh several kilograms if not timely addressed. The \'pleomorphic\' characteristics are attributed to the origin of the tumor from the connective tissue and epithelium. Pleomorphic adenomas often arise from the superficial lobe, further extending into the parapharyngeal space and gland\'s other deeper tissues. Common incidence is noted in females between 30 and 50 years. Tumors typically present as asymptomatic swelling and progress slowly. The cornerstone of treatment is surgical removal of the tumor mass, with great care being given to protect the facial nerve. Most of these tumors are observed with the involvement of the superficial lobe; only a few are observed involving the deep lobe. This case report presents an intriguing case of a pleomorphic adenoma of superficial and deep parotid gland in a 65-year-old male. The left side of the patient\'s face had a steadily increasing, asymptomatic swelling on admission. Magnetic resonance imaging of the neck revealed a pleomorphic adenoma of the superficial and deep parotid gland. The patient underwent surgical excision of the parotid gland, which was uneventful.

Mucoepidermoid carcinoma (MEC) is a salivary gland tumor commonly arising from the parotid gland. MEC has various presenting symptoms, including a painless, slow-growing mass below or anterior to the ear lobule. However, an unusual presentation can also be in the form of post-auricular swelling. Other more common benign differentials for post-auricular swelling include lymphadenopathy, epidermoid cysts, and lipomas. Thus, diagnosing a postauricular swelling as MEC solely based on clinical presentation is challenging, and a high suspicion, as well as a multidisciplinary approach with various radiological investigations such as computed tomography (CT) and magnetic resonance imaging (MRI), are required in collaboration with histopathological assessment for an accurate diagnosis of this malignancy. Prognosis depends on various factors, including the grade of the tumor, the patient\'s age, and comorbidities, as well as the stage at the time of diagnosis. Early diagnosis and surgical intervention are the mainstays of treatment, which can be followed by adjuvant radiotherapy based on the stage of the malignancy. This is a report of a patient who presented with post-auricular swelling, which was initially misdiagnosed as a benign necrotic lymph node. After further evaluation, it was found to be a mucoepidermoid carcinoma of the parotid gland, which was managed by surgical excision and radiotherapy.

Intraparotid gland neurofibroma is a rare benign tumor that arises from Schwann cells of the facial nerve within the parotid gland. This case report discusses a 41-year-old woman who experienced a painless preauricular swelling on her right side for over 5 years. Clinical examination and ultrasound revealed a well-defined mass in the parotid gland. The patient underwent total mass excision, resulting in transient facial nerve dysfunction but complete recovery. These tumors often manifest as solitary masses in the parotid region and may compress nearby structures, causing facial paralysis or numbness. Their diagnosis can be challenging due to similarities with other parotid gland tumors and possible associations with neurofibromatosis. Managing intraparotid tumors, including neurofibromas, involves a multidisciplinary approach with input from cytopathologists, radiologists, and surgeons.

Malignant melanoma of the parotid gland is an unusual tumor in the head and neck region, and most parotid melanoma is reported as a metastatic lesion of cutaneous malignant melanoma. We report a case of primary malignant melanoma arising in the parotid gland duct with diagnostic challenge. The patient was a 68-year-old man who complained of repeated right facial swelling that presented 3 months prior. Swelling was detected along the Stensen\'s duct of the cheek, and brown-colored saliva-like fluid was aspirated. On MR and CT images, a fluid-filled duct with small nodule and heterogeneously enhancing mass in the parotid parenchyma was detected. The nodular mass on the ductal wall grew rapidly, and the hyperintense T1 signal became significant on follow-up images. The final diagnosis via histopathologic examination using biopsy and parotidectomy specimen revealed the lesion as malignant melanoma of the duct and pleomorphic adenoma of the parenchyma. Even if the incidence of primary malignant melanoma is very low among tumors occurring in the parotid gland, efforts supporting an early diagnosis using imaging characteristics are important.