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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery

Indexed/Abstracted in: EMBASE, Scopus




Otorinolaringologia 2003 June;53(2):75-8

language: English

Benign pleomorphic adenoma arising in the accessory parotid gland. A case report

Tamiolakis D. 1, Thomaidis V. 2, Tsamis J. 2, Cheva A. 3, Papadopoulos N. 3

1 Depart­ment of ­Cytology Regional Hos­pital, Alex­an­drou­polis, ­Greece
2 Depart­ment of Max­il­lo­fa­cial Sur­gery Regional Hos­pital, Alex­an­drou­polis, ­Greece
3 Depart­ment of His­tology-Embryo­logy Democ­ritus Uni­ver­sity of ­Thrace, Alex­an­drou­polis, ­Greece


The ­head and ­neck ­surgeon’s fas­ci­na­tion ­with ­parotid sur­gery ­arises ­from the ­gland’s spec­trum of his­to­path­o­log­ical pres­en­ta­tions, as ­well as the diver­sity of its mor­pho­log­ical fea­tures. A ­mass ­arising in the mid-­cheek ­region may ­often be over­looked as a ­rare acces­sory ­lobe ­parotid neo­plasm. ­This ­report ­serves to ­revisit the ­topic of acces­sory ­parotid ­gland neo­plasms to empha­size ­proper man­age­ment, par­tic­u­larly the sur­gical ­aspects, so ­that con­se­quences of sal­i­vary fis­tula, ­facial ­nerve par­al­ysis, and recur­rence are ­avoided. We ­report a ­case of ple­o­mor­phic ­adenoma ­which was ­assessed preoper­a­tively as ­arising ­from the acces­sory ­parotid ­gland. Com­puted tomog­raphy (CT)-sia­log­raphy pro­vided infor­ma­tion ­about the rela­tion­ship ­between the ­tumor and the ­remaining ­normal acces­sory ­parotid ­tissue, and ­fine-­needle aspi­ra­tion of the ­tumor pro­vided addi­tional infor­ma­tion as to the cyto­logic fea­tures of the ­tumor. Zygo­matic and ­buccal ­branches of the ­facial ­nerve ­extended ­over the acces­sory ­parotid ­gland ­tumor and the ­parotid ­duct was ­located ­just ­beneath the ­tumor. There­fore, preoper­a­tive assess­ment of the ­tumor’s ­nature was impor­tant for pre­ven­tion of ­facial ­nerve ­damage and sal­i­vary fis­tula. Acces­sory ­parotid ­gland neo­plasms are ­rare and may ­present as innoc­uous extrap­a­rotid mid-­cheek ­masses. A ­high ­index of sus­pi­cion, pru­dent diag­nostic ­skills (including ­fine-­needle aspi­ra­tion [FNA] ­biopsy fol­lowed by com­puted tomog­raphy [CT] ­imaging), and scru­pu­lous sur­gical ­approach (­extended parot­i­dec­tomy-­style inci­sion and lim­ited periph­eral ­nerve dis­sec­tion ­when pos­sible) are the ­keys to suc­cessful man­age­ment of ­these ­lesions.

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