OBJECTIVES

To report a case of a giant pleomorphic adenoma in a 64-year-old Filipino woman, its management and surgical outcome.

METHODS

Design:Case Report

Setting:Tertiary Government Training Hospital

Patient: One

RESULTS

A 64-year-old woman presented with a 50-year history of a slow growing, painless, left infra-auricular mass, not associated with facial weakness, xerostomia, or hearing loss. Computed tomography revealed a 14 x 15 x 19 cm large lobulated complex enhancing mass with calcifications and septations, with no enlarged lymph nodes identified in the neck. Fine needle aspiration cytomorphology was consistent with pleomorphic adenoma. The patient underwent superficial parotidectomy with facial nerve preservation. The facial nerve was identified using standard landmarks. Final histopathological findings were consistent with pleomorphic adenoma measuring 23.5 cm x 11.5 cm x 15 cm and weighing 2177 grams

CONCLUSION

Pleomorphic adenoma can grow to a gigantic size if left untreated. It often presents as a chronic, slow growing and painless swelling. The approach to its diagnosis is mainly clinical and can be confirmed by fine needle aspiration biopsy and computed tomography scan. In our case, the standard landmarks for facial nerve identification were still reliable despite the size of the mass, producing good post-surgical outcomes.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Adenoma ; Lymph ; Needles ; Diagnosis ; Xerostomia ; Hearing Loss ; Neck ; Research Report ; Tomography ; Facial Nerve

Objective: To report a case of multifocal pediatric tuberculosis presenting with mandibular swelling and discuss its etiology, clinical findings, diagnosis, management, and outcome after treatment.

Methods:

Design: Case Report

Setting: Tertiary Government Training Hospital

Patient: One

Results: A 3-year-old boy presented with progressive non-tender, right mandibular swelling for 11 months. Panoramic X-ray exhibited extensive multiple loculations with lytic changes on the mandible. CT Scans revealed a peripherally enhancing hypodense mass with lytic expansion of the right mandibular angle extending across the left mandibular body with an incidental finding of right lung mass. Other extrapulmonary lesions were also detected involving the scapula, pleura with lysis of the adjacent ribs at the level of T7 and T8. Biopsy of the mandibular and lung mass confirmed the presence of caseating and non-caseating granulomas consistent with Koch's infection. The patient showed significant improvement by the 7th month of a 12-month course of anti-tuberculous therapy.

Conclusion: Multifocal TB can present as simple mandibular swelling, and a thorough workup should look for other involved sites. Early diagnosis in children may prevent debilitating sequelae and improve long-term treatment outcomes.

Human ; Male ; Child Preschool (a Child Between The Ages Of 2 And 5) ; Mandible ; Child