case_images: PMC6815534_01
case_images: Cervico-thoraco-abdominal CT scan exposed a 16 x 1 x 17 mm nodular image on the right parotid gland (a); Parotid ultrasound documented a non specific 18 mm hypoechogenic nodule in the right parotid gland, with no signs of vascular invasion and no cervical adenomegalies (b).
case_images: CRIE2019-3196283.001.jpg
case_images: PMC6815534_01_CRIE2019-3196283.001.jpg
case_images: fig1
case_images: Cervico-thoraco-abdominal computed tomography (CT) scan exposed a 16 x 1 x 17 mm nodular image on the right parotid gland (Figure 1(a)). Parotid ultrasound, subsequently performed, documented a non specific 18 mm hypoechogenic nodule in the right parotid gland, with no signs of vascular invasion or cervical adenomegalies (Figure 1(b)).
case_images: Octreoscan revealed increased uptake in the parotid gland (a) and mild expression in liver metastases (b).
case_images: CRIE2019-3196283.002.jpg
case_images: PMC6815534_01_CRIE2019-3196283.002.jpg
case_images: fig2
case_images: Somatostatin receptor scintigraphy (Octreoscan) demonstrated an increased uptake in the parotid gland (Figure 2(a)), whereas liver metastases exhibited mild expression (Figure 2(b)).
case_images: Histology-ACC: solid pattern and necrosis (H&E staining) (a); typical acinar cells with diastase-resistant PAS-positive granules (PAS-D staining) (b). The tumour cells showed strong immunoreactivity for DOG1 (c), being negative for ACTH immunostaining (d). ACC: acinic cell carcinoma; H&E: hematoxylin and eosin; PAS: periodic acid-schiff; PAS-D: PAS-diastase; DOG1: discovered on GIST-1; ACTH: adrenocorticotropic hormone.
case_images: CRIE2019-3196283.003.jpg
case_images: PMC6815534_01_CRIE2019-3196283.003.jpg
case_images: fig3
case_images: Immunoexpression of ACTH was not detected (Figure 3).