Carcinoma Ex Pleomorphic Adenoma Presented as a Gigantic Tumor Treatment and Diagnostic Challenges

• Published in: Oman medical journal Vol. 33; no. 4; pp. 342 - 345
• Main Authors: Saniasiaya , Jeyasakthy, Abdul Rahman , Wan Faiziah Wan, Mohamad , Irfan, Nadarajah , Sanjeevan, Lazim , Norhafiza Mat, Maruthamuthu , Thevagi
• Format: Journal Article
• Language: English
• Published: Muscat - Oman Oman Medical Specialty Board 01-07-2018; OMJ
• Subjects: ADENOMA; BIOPSY; CARCINOMA; Case Report; CASE STUDIES; DIAGNOSIS; Diseases; Fine-Needle; Malignant; MALIGNANT TUMOURS; Mouth; Parotid glands; Pleomorphic; SALIVARY GLANDS; SURGERY; Surgery, Operative; Treatment; Tumors; الأورام الخبيثة; الإختزاع; التشخيص; الجراحة العامة; الغدد اللعابية; الكرسنومة; الورم الغدي; دراسات الحالة; Adenoma, Pleomorphic; Biopsy, Fine-Needle; Adenoma, Malignant
• ISSN: 1999-768X; 2070-5204
• DOI: 10.5001/omj.2018.62

Parotid gland surgery can be challenging due to intricate relationship between the gland
and facial nerve. Besides complete removal of the lesion, the main focus of surgery is
centered on the facial nerve. Surgery can be technically demanding especially when
the tumor is large or involves the deep lobe. We report a patient with a 30-year history
of gigantic parotid mass, which initial fine-needle aspiration cytology reported as
pleomorphic adenoma. The tumor, weighing 1.3 kg, was successfully resected with
facial nerve preservation. Histopathological examination of the excised mass confirmed
as carcinoma ex pleomorphic adenoma (CaExPA) of adenocarcinoma, not otherwise
specified type. We describe the specific surgical and reconstruction techniques for
successful removal of large parotid tumors with facial nerve preservation. To our
knowledge, this is the heaviest CaExPA of the parotid gland in South-East Asian region