PMC6815534_01
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).
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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)).
Octreoscan revealed increased uptake in the parotid gland (a) and mild expression in liver metastases (b).
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Somatostatin receptor scintigraphy (Octreoscan) demonstrated an increased uptake in the parotid gland (Figure 2(a)), whereas liver metastases exhibited mild expression (Figure 2(b)).
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.
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Immunoexpression of ACTH was not detected (Figure 3).