Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery
Parotid lymphoepithelial carcinoma is extremely rare, and makes up only 0.4% of cases among the anaplastic variant of salivary gland carcinoma. We present a 63-year-old man who had progressive enlarging right neck swelling for one year. He sought treatment in another centre and underwent superficial...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Istanbul University Press
2022-09-01
|
| Series: | The Turkish Journal of Ear Nose and Throat |
| Subjects: | |
| Online Access: | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/DC9FDAE611A04107949EAD81152FCE34 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850146809181110272 |
|---|---|
| author | Thilaga Rajendran Lum Sai Guan Arman Zaharil Mat Saad Suria Hayati Md Pauzi Mohd Razif Mohamad Yunus |
| author_facet | Thilaga Rajendran Lum Sai Guan Arman Zaharil Mat Saad Suria Hayati Md Pauzi Mohd Razif Mohamad Yunus |
| author_sort | Thilaga Rajendran |
| collection | DOAJ |
| description | Parotid lymphoepithelial carcinoma is extremely rare, and makes up only 0.4% of cases among the anaplastic variant of salivary gland carcinoma. We present a 63-year-old man who had progressive enlarging right neck swelling for one year. He sought treatment in another centre and underwent superficial parotidectomy, following an ultrasound assessment of the mass that was suggestive of a benign parotid tumour. There was no fine needle aspiration cytology or other radiological imaging performed prior to the surgery. However, the surgeon encountered difficulty intraoperatively and abandoned the surgery. The incisional biopsy of the tumour was reported as lymphoepithelial carcinoma. He then presented to us with the progression of the residual parotid malignant tumour. CT and MRI showed a locally aggressive parotid tumour that had infiltrated the subcutaneous tissue, external auditory canal, facial nerve, and multiple ipsilateral metastatic cervical lymph nodes. Subsequently, the patient underwent total parotidectomy with facial nerve resection, lateral temporal bone resection and ipsilateral modified radical neck dissection. The surgical site defect was reconstructed with anterolateral thigh myocutaneous free flap. Concurrent static facial reanimation with fascia lata sling was performed. The patient received adjuvant chemoradiation following the surgery. The extent of the local infiltration by the tumour and the resulting surgery could have been reduced if the tumour had been properly assessed and excised at the initial stage. A complete preoperative assessment of a parotid mass is essential to avoid misdiagnosis, unexpected intraoperative finding and delay in definitive treatment. |
| format | Article |
| id | doaj-art-df29ed2ed8784e4e87b4d73d87fd14c8 |
| institution | OA Journals |
| issn | 2602-4837 |
| language | English |
| publishDate | 2022-09-01 |
| publisher | Istanbul University Press |
| record_format | Article |
| series | The Turkish Journal of Ear Nose and Throat |
| spelling | doaj-art-df29ed2ed8784e4e87b4d73d87fd14c82025-08-20T02:27:45ZengIstanbul University PressThe Turkish Journal of Ear Nose and Throat2602-48372022-09-01323626710.26650/Tr-ENT.2022.1119617123456Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive SurgeryThilaga Rajendran0https://orcid.org/0000-0002-1772-3358Lum Sai Guan1https://orcid.org/0000-0002-7397-9315Arman Zaharil Mat Saad2https://orcid.org/0000-0002-4003-6783Suria Hayati Md Pauzi3https://orcid.org/0000-0001-5845-0061Mohd Razif Mohamad Yunus4https://orcid.org/0000-0002-8563-9000University Kebangsaan, Kuala-Lumpur, MalaysiaUniversity Kebangsaan, Kuala-Lumpur, MalaysiaManagement and Science University, Selangor, MalaysiaUniversity Kebangsaan, Kuala-Lumpur, MalaysiaUniversity Kebangsaan, Kuala-Lumpur, MalaysiaParotid lymphoepithelial carcinoma is extremely rare, and makes up only 0.4% of cases among the anaplastic variant of salivary gland carcinoma. We present a 63-year-old man who had progressive enlarging right neck swelling for one year. He sought treatment in another centre and underwent superficial parotidectomy, following an ultrasound assessment of the mass that was suggestive of a benign parotid tumour. There was no fine needle aspiration cytology or other radiological imaging performed prior to the surgery. However, the surgeon encountered difficulty intraoperatively and abandoned the surgery. The incisional biopsy of the tumour was reported as lymphoepithelial carcinoma. He then presented to us with the progression of the residual parotid malignant tumour. CT and MRI showed a locally aggressive parotid tumour that had infiltrated the subcutaneous tissue, external auditory canal, facial nerve, and multiple ipsilateral metastatic cervical lymph nodes. Subsequently, the patient underwent total parotidectomy with facial nerve resection, lateral temporal bone resection and ipsilateral modified radical neck dissection. The surgical site defect was reconstructed with anterolateral thigh myocutaneous free flap. Concurrent static facial reanimation with fascia lata sling was performed. The patient received adjuvant chemoradiation following the surgery. The extent of the local infiltration by the tumour and the resulting surgery could have been reduced if the tumour had been properly assessed and excised at the initial stage. A complete preoperative assessment of a parotid mass is essential to avoid misdiagnosis, unexpected intraoperative finding and delay in definitive treatment.https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/DC9FDAE611A04107949EAD81152FCE34fine needle aspirationparotid carcinomasalivary gland carcinomalymphoepithelial carcinomamyocutaneous free flapfacial reanimation |
| spellingShingle | Thilaga Rajendran Lum Sai Guan Arman Zaharil Mat Saad Suria Hayati Md Pauzi Mohd Razif Mohamad Yunus Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery The Turkish Journal of Ear Nose and Throat fine needle aspiration parotid carcinoma salivary gland carcinoma lymphoepithelial carcinoma myocutaneous free flap facial reanimation |
| title | Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery |
| title_full | Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery |
| title_fullStr | Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery |
| title_full_unstemmed | Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery |
| title_short | Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery |
| title_sort | primary lymphoepithelial carcinoma of parotid gland inadequate preoperative assessment resulting in extensive surgery |
| topic | fine needle aspiration parotid carcinoma salivary gland carcinoma lymphoepithelial carcinoma myocutaneous free flap facial reanimation |
| url | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/DC9FDAE611A04107949EAD81152FCE34 |
| work_keys_str_mv | AT thilagarajendran primarylymphoepithelialcarcinomaofparotidglandinadequatepreoperativeassessmentresultinginextensivesurgery AT lumsaiguan primarylymphoepithelialcarcinomaofparotidglandinadequatepreoperativeassessmentresultinginextensivesurgery AT armanzaharilmatsaad primarylymphoepithelialcarcinomaofparotidglandinadequatepreoperativeassessmentresultinginextensivesurgery AT suriahayatimdpauzi primarylymphoepithelialcarcinomaofparotidglandinadequatepreoperativeassessmentresultinginextensivesurgery AT mohdrazifmohamadyunus primarylymphoepithelialcarcinomaofparotidglandinadequatepreoperativeassessmentresultinginextensivesurgery |