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case_images: Magnetic resonance imaging (MRI) showing a right tumoral mass of the parotid. (a) T1-weighted sequence MRI frontal image showing the intracranial extension of the parotid tumor. (b) a T1-weighted sequence MRI axial image showing the infiltrating the right infra-temporal fossa by the parotid tumor.
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case_images: The apparent diffusion coefficient value measured 0.6.   The mass exhibited extension into the intracranial space through the foramen ovale and infiltration of the retrostyloid and prestyloid spaces, as well as the infra-temporal fossa (Figure 1).
case_images: Poorly defined tumor nests and sheets separated by fibrosis and infiltrating between the residual entrapped salivary ducts (HE 100x magnification).
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case_images: Histological examination showed a poorly differentiated tumor proliferation arranged in nests and sheets exhibiting a syncytial appearance (Figure 2).
case_images: Tumor cells with large atypical nuclei and poorly defined borders (syncytial appearance) intermixed with dense lymphoid stroma (HE 400x magnification).
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case_images: The stroma was heavy rich in lymphoid cells (Figure 3).
case_images: Lymphoepithelial carcinoma with lymphocytic cell infiltration in and around tumor nests; note the presence of follicles () (HE 200x magnification).
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case_images: The tumor nests were infiltrated by lymphocytes, and follicles were frequently seen (Figure 4).
case_images: (a) lymph node metastasis () of syncytial tumor sheets and accompanying lymphocytes (HE 200x magnification) (b) Epithelioid granuloma with Langerhans giant cells involving the lymph node (HE 200x magnification).
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case_images: Examination of the lymph node revealed tumor metastasis (Figure 5(a)) associated with a non-necrotizing granulomas of epithelioid cells and Langerhans giant cells (Figure 5(b)).
case_images: (a) Tumor cells stain positive for pancytokeratin (x100 magnification) (b) Immunostaining for p63 shows diffuse nuclear positivity in tumor cells (x100 magnification) (c) Positive staining for epithelial membrane antigen in the majority of tumor cells (x100 magnification) (d) Negative immunoreactivity for CK7 in tumor cells (x100 magnification).
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case_images: Immunohistochemical analysis of the parotid tumor showed a strongly positive staining of tumor cells for pancytokeratin (Figure 6(a)), p63 (Figure 6(b)) and epithelial membrane antigen (EMA) (Figure 6(c)). The tumor cells were negative for CK7 (Figure 6(d)), Alpha Smooth Muscle Actin (SMA) (Figure 7(a)) and S-100 (Figure 7(b)).
case_images: (a) Negative staining of tumor cells for SMA (x200 magnification) (b) Negative staining of tumor cells for S-100 (x100 magnification) (c) High Ki 67 proliferation index (x200 magnification) (d) lymphocytes stain positive for CD20 with presence of follicles () (x100 magnification).
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case_images: The tumor cells were negative for CK7 (Figure 6(d)), Alpha Smooth Muscle Actin (SMA) (Figure 7(a)) and S-100 (Figure 7(b)). The Ki 67 proliferation index was high (Figure 7(c)). The lymphoid stromal cells stained positive for CD20 antibody (Figure 7(d)).
case_images: Immunostaining for pancytokeratin highlighting the tumor cells in the lymph node metastasis (x100 magnification).
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case_images: Immunostaining for pancytokeratin highlighted tumor cells in the lymph node metastasis (Figure 8).