PMC5446876_01
(a) Hematoxylin and eosin stain illustrating a low-grade acinic cell carcinoma at the bottom juxtaposed to a high-grade carcinoma, simulating a salivary duct carcinoma with central necrosis. (b) An area of high-grade transformation demonstrating an infiltrating tumor with extensive central necrosis.
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fig1
Pathology slides were reviewed and revealed acinic cell carcinoma with areas of high-grade transformation (Figures 1(a) and 1(b)).
Coronal CT image demonstrates the residual parotid tumor (arrow), before the definitive surgery.
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fig2
Computed Tomography (CT) scan of the head and neck showed postoperative fibrotic changes in the area of the right parotid gland (Figure 2).
Cross section of the nerve showing endoneural invasion by the carcinoma.
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fig3
The final pathology results were in agreement with the preoperative diagnosis of acinic cell carcinoma with high-grade transformation and there was clear evidence of perineural invasion (Figure 3).