A 21-year-old woman presented to the maxillofacial surgery service with a painless tumor at the left parotid level of about 8 months of evolution.
Physical examination revealed a solid lesion at the parotid gland, not attached to deep planes.
Ultrasound aspiration puncture with needle (FNA) was requested, in which a well-defined parotid nodule of about 25mm in maximum diameter, predominantly cystic, with a solid pole was detected inside.
There was no vascularization with color Doppler; FNA was inconclusive.
These findings were complemented by neck computed tomography (CT) with intravenous contrast.
On CT, a well-defined 22mm tumor was observed, located in the superficial lobe of the left parotid gland, containing fat inside, and a rounded solid nodule of 8mm in its posterior wall.
All this was compatible by imaging with parotid cystic teratoma.
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These results were proposed to the patient, surgical intervention, who accepted.
A conservative suprafacial parotidectomy of the facial nerve was performed with en bloc resection of the lesion.
At the end of surgery, all facial nerve branches were monitored to check their integrity and function.
The surgical specimen obtained after resection showed a fragment of epidermis with hair follicles.
The anatomopathological result confirmed the definitive diagnosis of mature cystic teratoma of the left parotid gland, in which epidermal, mesenchymal, adipocytes and glands cells were found.
No atypias were observed.
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Postoperatively, the patient presented mild paresis, with complete recovery of facial mimicry 4 months after surgery.
Currently, 14 months after surgery, there is no recurrence of the lesion.
