Parotid gland tumors are usually solitary tumors, and multiple tumors of the parotid gland are extremely rare. We present a highly unusual case of bilateral and simultaneous pleomorphic adenoma and basal cell adenoma of the parotid gland. We review the literature and discuss the clinical manifestations, diagnosis, and treatment of these two rare tumors.
Adenoma, Pleomorphic ; Humans ; Parotid Gland ; Parotid Neoplasms/diagnosis*

BACKGROUND: Recent findings in molecular pathology suggest that genetic translocation and/or overexpression of oncoproteins is important in salivary gland tumorigenesis and diagnosis. We investigated PLAG1, SOX10, and Myb protein expression in various salivary gland neoplasm tissues. METHODS: A total of 113 cases of surgically resected salivary gland neoplasms at the National Cancer Center from January 2007 to March 2017 were identified. Immunohistochemical staining of PLAG1, SOX10, and Myb in tissue samples was performed using tissue microarrays. RESULTS: Among the 113 cases, 82 (72.6%) were benign and 31 (27.4%) were malignant. PLAG1 showed nuclear staining and normal parotid gland was not stained. Among 48 cases of pleomorphic adenoma, 29 (60.4%) were positive for PLAG1. All other benign and malignant salivary gland neoplasms were PLAG1-negative. SOX10 showed nuclear staining. In normal salivary gland tissues SOX10 was expressed in cells of acinus and intercalated ducts. In benign tumors, SOX10 expression was observed in all pleomorphic adenoma (48/48), and basal cell adenoma (3/3), but not in other benign tumors. SOX10 positivity was observed in nine of 31 (29.0%) malignant tumors. Myb showed nuclear staining but was not detected in normal parotid glands. Four of 31 (12.9%) malignant tumors showed Myb positivity: three adenoid cystic carcinomas (AdCC) and one myoepithelial carcinoma with focal AdCC-like histology. CONCLUSIONS: PLAG1 expression is specific to pleomorphic adenoma. SOX10 expression is helpful to rule out excretory duct origin tumor, but its diagnostic value is relatively low. Myb is useful for diagnosing AdCC when histology is unclear in the surgical specimen.
Adenoma ; Adenoma, Pleomorphic ; Antibody-Dependent Cell Cytotoxicity ; Carcinogenesis ; Carcinoma, Adenoid Cystic ; Diagnosis ; Immunohistochemistry ; Oncogene Proteins ; Oncogene Proteins v-myb ; Parotid Gland ; Pathology, Molecular ; Salivary Gland Neoplasms ; Salivary Glands ; SOX Transcription Factors ; Translocation, Genetic

Myxomas can be divided into two groups: those derived from the facial skeleton, and those derived from external skeletal soft tissue. Soft tissue myxomas of the head and neck are uncommon, with fewer than 50 cases reported. In any form and location, myxoma of parotid gland is rare. We report a case of myxoma arising from the left superficial lobe of the parotid gland with good long-term follow-up after superficial parotidectomy with tumor excision. A 49-year-old man was referred to our department of plastic and reconstructive surgery with a painless palpable mass that had persisted in the left mandible angle region for 2 years. Excision of the facial mass and superficial parotidectomy with facial nerve preservation were performed. The biopsy result was myxoma. Long-term follow-up for 22 months showed favorable results without evidence of recurrence but with temporary facial nerve weakness right after the surgery. Myxoma should be considered as a differential diagnosis when benign tumor of the parotid gland is being considered.
Biopsy ; Diagnosis, Differential ; Facial Nerve ; Follow-Up Studies ; Head ; Humans ; Mandible ; Middle Aged ; Myxoma ; Neck ; Parotid Gland ; Plastics ; Recurrence ; Skeleton ; Soft Tissue Neoplasms

Kimura disease is a rare idiopathic chronic inflammatory disorder. It typically presents in the head and neck area, whereas bilateral involvement is unusual. Its diagnosis requires it to be differentiated from other inflammatory diseases and from head and neck tumors. Treatment methods include conservative management, steroid administration, radiotherapy, and surgery; however, no single treatment of choice has been established. Herein, we report an unusual presentation of Kimura disease with bilateral parotid involvement. This case was treated by surgical excision.
Angiolymphoid Hyperplasia with Eosinophilia* ; Diagnosis ; Head ; Head and Neck Neoplasms ; Neck ; Parotid Neoplasms ; Radiotherapy

Kimura disease is a rare idiopathic chronic inflammatory disorder. It typically presents in the head and neck area, whereas bilateral involvement is unusual. Its diagnosis requires it to be differentiated from other inflammatory diseases and from head and neck tumors. Treatment methods include conservative management, steroid administration, radiotherapy, and surgery; however, no single treatment of choice has been established. Herein, we report an unusual presentation of Kimura disease with bilateral parotid involvement. This case was treated by surgical excision.
Angiolymphoid Hyperplasia with Eosinophilia* ; Diagnosis ; Head ; Head and Neck Neoplasms ; Neck ; Parotid Neoplasms ; Radiotherapy

Carcinoma ; complications ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; complications ; Parotid Gland ; pathology ; Parotid Neoplasms ; diagnosis ; secondary

No abstract available.
Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Neck/diagnostic imaging ; Parotid Gland/*pathology ; Parotid Neoplasms/diagnosis/diagnostic imaging/pathology ; Sarcoidosis/*diagnosis/diagnostic imaging ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVE: To investigate the imaging manifestations of 16-slice enhanced CT of parotid adenolymphoma in the parotid gland and the corresponding pathology,in order to improve the understanding of the CT imaging manifestations of parotid adenolymphoma in the parotid gland. METHOD: The enhanced CT characteristics of 34 cases of parotid adenolymphoma in the parotid gland confirmed by histological pathology were retrospectively analyzed. RESULT: There were totally 86 lesions in 34 cases, of which 12 cases with lesions in bilateral sides and 22 cases with lesions in unilateral side. Sixty-six lesions located behind and below the superficial lobe of the parotid gland. The lesions showed moderate to obvious enhancement at arterial phase, and the cystic region within the lesions showed no enhancement. CONCLUSION The relatively specific enhanced MSCT manifestations of parotid adenolymphoma in parotid gland include lesions located behind and below the superficial lobe of parotid gland unilaterally or bilaterally, sometimes exhibited as multiple masses, with clear edge, obvious enhancement and cystic degeneration inside.
Adenolymphoma ; diagnosis ; pathology ; Humans ; Parotid Gland ; pathology ; Parotid Neoplasms ; diagnosis ; pathology ; Tomography, X-Ray Computed

OBJECTIVE: To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal. METHOD: Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed. RESULT: There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later. CONCLUSION Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
Carcinoma, Adenoid Cystic ; diagnosis ; surgery ; Carcinoma, Basal Cell ; diagnosis ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; Ear Canal ; pathology ; Ear Neoplasms ; diagnosis ; surgery ; Humans ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Parotid Gland ; pathology ; Prognosis ; Retrospective Studies ; Temporal Bone ; surgery

Nodular fasciitis (NF) is a benign tumor-like fibroblastic proliferation, and there have only been few reports about NF involving the parotid gland. Here, we report our experience of three cases of NF in the parotid gland, as well as our evaluation of the diagnostic tools for NF in the parotid gland, such as fine-needle aspiration cytology (FNAC), CT, and clinicopathologic investigations. In the three cases observed, all had growing masses in the parotid gland, and the lesions showed heterogeneous or peripheral rim enhancement on the contrast-enhanced CT, which could have been misdiagnosed as parotid malignancy. On FNAC, the cells had an elongated spindle shape and contained variable amounts of stromal matrix, which could have caused misinterpreted as pleomorphic adenoma. We observed dense cellularity and varying amounts of collagenous stroma, and immunohistochemical staining revealed positive reactivity to CD10, CD34, and smooth muscle actin. NF should be considered in the differential diagnosis of benign and malignant parotid tumors.
Actins ; Adenoma, Pleomorphic ; Biopsy, Fine-Needle ; Collagen ; Diagnosis, Differential ; Fasciitis* ; Fibroblasts ; Muscle, Smooth ; Parotid Gland* ; Parotid Neoplasms ; Pathology ; Spiral Cone-Beam Computed Tomography ; Tomography, X-Ray Computed