A 30-year-old female patient, with a personal history of basal cell carcinoma of the skin in the left paranasal region, came to our consultation for presenting a tumor of progressive growth in the region of the right mandibular angle of three years.
It provided a cytological report from two aspiration punctures performed in another center, with the result of smears suggestive of epithelial proliferation of low cytological aggressiveness.
The observed findings were compatible with a pleomorphic adenoma of the salivary gland, however the amount of stroma was minimal, and the pattern was diverted from the usual in these cases, so other tumors could not be ruled out.
Examination revealed a 2 cm diameter nodule in the right jugular-digastric region, displaceable over deep planes and not attached to the skin.
No other adenopathies or tumors were observed at the cervicofacial level.
With the diagnostic suspicion of a tumor in the superficial lobe and right parotid tail, a cervicofacial computerized tomography (CT) was performed with contrast, performing a window of soft parts and bone window.
At the level of the superficial lobe of the right parotid gland, in the tail of the parotid gland, a nodular image was observed, such as a benign pleomorphic gland, salivary gland due to well-defined margins approximately 1.5 cm in diameter adenoma.
Adenopathies of non-significant size were observed in submandibular, jugular-digastric and posterior triangle pathways.
With the clinical suspicion of orotracheal closure of superficial tumor resection and right parotid gland was surgically intervened under general anesthesia and intubation, performing suprafacial parotidectomy through a lobule x flap approach.
The pathological study of the specimen revealed a well-defined 18 mm diameter, whitish-colored tumour with homogeneous surface, at one end of the specimen.
At the cut, a well-defined tumor of homogeneous texture and macroscopic characteristics of normality for the rest of the gland was observed.
Likewise, a 2.5 x 1 cm diameter excision of the disease was performed in the proximity of the parotid gland, which in the section presented homogeneous white color, adenosis and elastic consistency.
Microscopic examination revealed an encapsulated lesion consisting of nests or trabeculae separated by an eosinophilic basement membrane consisting of peripherally arranged basaloid cells.
Cellularity in the immunohistochemical study was positive for high molecular weight cytokeratin and focally positive for S-100.
The anatomopathological diagnosis was basal cell adenoma of the parotid gland and lymph nodes with follicular hyperplasia.
1.
The immediate postoperative period did not present significant complications, except slightia at the level of the frontal and oral branches of the facial nerve, which experienced progressive improvement in the days subsequent to the intervention pairs.
