PMC7384504_01
A huge swelling at right parotid region lesion measuring 13 cm x 13 cm with hyperpigmented skin.
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F1
Examination showed the presence of right parotid swelling, measuring 13 cm x 13 cm, extending from the zygomatic region superiorly to the submandibular region inferiorly and from the cheek region anteriorly to the post-auricular region posteriorly (Figure 1).
CT neck showed ill-defined large heterogenous enhancing soft tissue mass at right parotid mass measuring 7.6 cm x 5.0 cm x 8.7 cm, with multiple enlarged right cervical LN.
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F2
A computed tomography (CT) scan of the neck revealed a large, ill-defined heterogenous enhancing soft tissue mass at a right angle to the mandible, measuring 7.6 cm x 5.0 cm x 8.7 cm, involving the right parotid gland and also the presence of multiple enlarged right cervical LNs from levels I to V (Figure 2).
MRI neck T1-weighted axial view showed right parotid enlargement involving superficial and deep lobes measuring 8.4 cm x 4.4 cm x 8.9 cm with subcutaneous infiltration, and no clear demarcation with masseter and sternocleidomastoid muscles.
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F3
In view of the poor plane of the mass with surrounding structures, magnetic resonance imaging (MRI) of the neck was performed and showed enlargement of the right parotid, involving both superficial and deep lobes, measuring 8.4 cm x 4.4 cm x 8.9 cm, with subcutaneous infiltration, and lack of any clear demarcation with the masseter muscle anteriorly and the sternocleidomastoid muscle posteriorly (Figure 3).
Intra-operative view, large right parotid mass with surrounding tissue fibrosis.
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F4
The presence of a large parotid gland with surrounding tissue fibrosis was found intraoperatively (Figure 4), and the superficial part of the parotid gland could be removed with preservation of the facial nerve.
One week after operation, minimal edema edematous at right parotid region.
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F5
The wound was cleaned leaving a minimally edematous area at the right parotid region observed after one week (Figure 5).