PMC8821948_01
A giant mass in the left anterior neck.
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F1
Physical examination showed that there was a 32 x 28 x 25 cm irregular solid mass in the left anterior neck, with a small portion crossing the midline (Figure 1).
Computed tomography showed a large mixed-density lesion in the left anterior neck, with the trachea and thyroid gland being squeezed to the right side. The internal density of the mass was uneven, with patchy high-density shadows (A). No obvious enhancement was found in the arterial phase (B).
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F2
The CT value of the solid area was ~55 Hounsfield units (HU) and that of the cystic area was ~20 HU (Figure 2A). After contrast infusion, there was no obvious enhancement of the mass (Figure 2B).
Histological and immunohistochemical features. (A,B) Haematoxylin-eosin (HE) staining showing ductal cells, myoepithelial cells and prominent chondromyxoid matrix background. The cuboidal ductal epithelium forms a glandular tubular structure, with red secretion in the lumen; the myoepithelial cells surround the glandular tubular structure or are scattered across the chondromyxoid matrix; the cellular atypia is not obvious (magnification, A x 50, B x 200). By immunohistochemistry, the ductal cells are strongly positive for CK7 (C) and positive for CD117 (D), while myoepithelial cells are positive for p63 (E) and S-100 (F). Less than 1 % cells were positive for Ki-67 (G). The final diagnosis was pleomorphic adenoma [magnification, (C-F) x 200, G x 100].
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F3
Haematoxylin-eosin (HE) staining showed ductal cells, myoepithelial cells and prominent chondromyxoid matrix background (Figures 3A,B). Immunohistochemically, ductal cells were strongly positive for CK7 and positive for CD117, while myoepithelial cells are positive for p63 and S-100 (Figures 3C-F). The proliferative index, assessed by Ki-67, was <1% positive (Figure 3G).
Gross view of the resected specimen (A) and appearance of the incision on the neck (B).
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F4
It weighed 5.2 kg, and the dimensions were 32 x 28 x 25 cm (Figure 4A). The patient recovered well after surgery (Figure 4B).