PMC6920309_01
Preoperative antero-posterior view.
gr1.jpg
PMC6920309_01_gr1.jpg
fig0005
The mass itself was not tender, with nodular bosselated outer surface and the surrounding skin was congested in some areas (Fig. 1, Fig. 2).
CT angiography (antero-posterior view).
gr3.jpg
PMC6920309_01_gr3.jpg
fig0015
CT angiography was also done and showed that the main arterial supply was from the facial branch of the left external carotid artery, common, external and internal carotid arteries on both sided which were patent and of normal shape (Fig. 3, Fig. 4).
Inferolateral incision.
gr5.jpg
PMC6920309_01_gr5.jpg
fig0025
After securing them, we continued the dissection both superiorly and inferiorly in the medial direction to the right side (Fig. 5, Fig. 6).
Postoperative specimen.
gr7.jpg
PMC6920309_01_gr7.jpg
fig0035
We were able to remove the tumor completely which weighed 8.1 kg (Fig. 7).
Covering with Thiersch graft.
gr8.jpg
PMC6920309_01_gr8.jpg
fig0040
The tumor had a very wide base therefore the defect couldn't be closed primarily and we used a thiersch graft (Fig. 8).
Pleomorphic adenoma shows alternating.
gr9.jpg
PMC6920309_01_gr9.jpg
fig0045
These were associated with clear plumpy, rounded epitheloid and plasmacytoid, as well as spindle shaped myoepithelial cells admixed with cartilaginous foci against myxoid background (Fig. 9, Fig. 10, Fig. 11).
Acinar structures lined by epithelial cells admixed with myo-epithelial cells and myxoid matrix. (H&E. x100).
gr11.jpg
PMC6920309_01_gr11.jpg
fig0055
These were associated with clear plumpy, rounded epitheloid and plasmacytoid, as well as spindle shaped myoepithelial cells admixed with cartilaginous foci against myxoid background (Fig. 9, Fig. 10, Fig. 11).
Dystrophic calcification (Hx&E, x400).
gr12.jpg
PMC6920309_01_gr12.jpg
fig0060
Multiple areas of infarction necrosis were seen with ghosts of cells appearing, admixed with areas of dystrophic calcification (Fig. 12, Fig. 13).
Nuclear positivity of ki67 in 2% of tumor cells (x40).
gr14.jpg
PMC6920309_01_gr14.jpg
fig0070
It exhibited nuclear positivity in only about 2% of tumor cells (Fig. 14).