A 9-year-old girl, previously healthy, presented a cervicofacial tumor in the parotid region, interpreted as acute parotiditis.
Six months later, he consulted again with a tumor in the same region, which was durable, painless, but caused facial aesthetic alterations.
Laboratory tests were normal and serology for EBV, CMV and toxoplasmosis was negative.
Pathological studies were performed: Ultrasound: solid lesions in the right parotid region, compatible with enlarged lymph nodes and altered architecture.
The predominant lesion measured 49x26x29 mm. Magnetic resonance imaging: lesion in the right lateral region of the neck occupying the parotid space, of 37x32x52 mm. The lesion was homogeneous and had moderate intravenous contrast administration Tce
The parotid gland superficial to the lesion had a normal appearance.
A biopsy of a cervical adenopathy adjacent to the lesion was performed to rule out lymphoproliferative disease or parotid neoplasm.
The pathology reported: lymph node with conserved general histoarchitecture, with follicular structures consolidation by conjunctive-vascular septa that divided lymphoid tissue into compartments.
Follicles with a pattern of conserved areas B and T were observed.
There was no evidence of a lymphoproliferative process.
The persistence of the lesion, two months later, a new resonance was performed to evaluate the progression of the disease.
A slight increase in lesion size was observed.
It was decided to perform the excision of the tumor due to facial manifestation that provoked the patient and the possibility of progression.
Median inframandibular incision with electrostimulation and facial nerve was completed, exeresis of the lesion displacing the parotid gland without respecting or compromising it was completed.
The sections showed a large lymph node with distortion of the follicular histoarchitecture and variable size follicle replacement (presence of follicles and small hyalinized follicles), with or without deposits of follicles.
In the mantle area and margin, linearly arranged lymphocytes were observed in " onion cathophila" structures.
There was marked vascular proliferation in the interfollicular spaces.
The histological aspect corresponded to a lymphadenopathy of Castleman's disease type.
The patient had a good postoperative recovery and was discharged without comorbidities.
After a two-year follow-up period, the child is now asymptomatic and without signs of recurrence on magnetic resonance imaging.
