We report the case of a 77-year-old man who consulted for a non-painful, palpable, preauricular tumor of 3 cm in maximum diameter.
An ultrasound of the lesion identified in the left parotid gland a hypoechogenic space-occupying lesion of 23 x 12 x 19 mm and incidentally, a hypoechogenic nodular lesion of the left gland 12 x 12 mm posterior reinforcement.
With these data PAAF of both nodules is performed, observing in the largest one abundant cellularity of large size, with central and occasionally peripheral nuclei, rounded, poorly patent and fine granular chromatin.
The cytoplasm is very characteristic, being abundant, pale and foamy edges unisolated, vacuolized and containing abundant violet granules.
Cells are arranged in more or less compact groups of large two-dimensional laminae, sometimes adopting an acinar architectural pattern.
Along with this cellularity, smaller size cells with low cytoplasm and small rounded or oval central nucleus are observed.
The cytological image was consistent with acinar cell tumor, probably carcinoma for which excision was proposed.
FNAC of the second lesion obtained less material, given its small size, however, abundant homogeneous cellularity was observed, rounded with slightly basophilic and granular cytoplasm, with large central nucleus, without atypia.
She was diagnosed as suggestive of onychocytoma, also recommending its exeresis.
The patient has no known allergies, is left-sided carrier of second degree AVB, and without other data of interest for the current process, is admitted in a scheduled way for surgical intervention of parotid tumor.
The definitive histological study confirms the lineage of both diagnoses, ensuring the complete exeresis of both tumors as well as the absence of unusual surgical margins.
Unfortunately, the macroscopic image of these pieces is not preserved.
