PMC7787848_01
Computed tomography showing a buccal space mass with irregular margins and invasion of the neighboring masseter muscle.
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Computed and magnetic tomography, with 1.25 mm thickness cuts in the transverse plane and with image reconstruction cuts of 1.25 and 2.5 mm in coronal and sagittal planes, respectively, revealed a lesion of 1.64 cm x 4.8 cm in dimensions which occupied the right buccal space, originating from the right major zygomaticus muscle, and extending to the right anterior part of the parotid gland (Figures 1 and 2).
MR T2 sequence showing a buccal space mass.
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fig2
Computed and magnetic tomography, with 1.25 mm thickness cuts in the transverse plane and with image reconstruction cuts of 1.25 and 2.5 mm in coronal and sagittal planes, respectively, revealed a lesion of 1.64 cm x 4.8 cm in dimensions which occupied the right buccal space, originating from the right major zygomaticus muscle, and extending to the right anterior part of the parotid gland (Figures 1 and 2).
Lymphocytic proliferation of the parotid gland (hematoxylin and eosin).
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fig3
FNA biopsy was performed, retrieving numerous lymphocytes and nonspecific atypical cells, and was characterized as nondiagnostic (Figure 3). Permanent histology described a solid white/brown ulcerated neoplastic mass with a maximum diameter of 5.3 cm (Figure 3).
Extended parotidectomy incision for the surgical excision of the buccal space mass.
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The patient underwent resection through a modified parotidectomy incision (Figures 4-8).
Preparation of a subplatysmal flap for good exposure of the mass. Neighboring branches of the facial nerve are identified and preserved.
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The patient underwent resection through a modified parotidectomy incision (Figures 4-8).
Careful dissection is performed, and the mass is followed anteriorly into the buccal fat pad.
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The patient underwent resection through a modified parotidectomy incision (Figures 4-8).
Surgical field following excision of the mass. A large portion of the masseter muscle has been removed en block with the tumor.
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fig7
The patient underwent resection through a modified parotidectomy incision (Figures 4-8).
Surgical specimen following excision.
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fig8
The patient underwent resection through a modified parotidectomy incision (Figures 4-8).