PMC9536096_01
Preoperative evaluation of tumors. Enhanced neck CT (a, b) and ultrasound showed ovoid masses with slight enhancement in left parotid gland and lateral neck level II (c, d).
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Enhance neck computed tomography (CT) scan and ultrasonography showed that 25 x 15 mm sized parotid mass with variable sized multiple lymph nodes at left level II. (Figure 1) Ultrasound-guided core needle biopsy was performed on parotid and neck masses and histologic findings from each showed the admixture of epithelial and myoepithelial cells in a variable stroma, which suggested pleomorphic adenoma.
Complete excision of multiple tumors and pathologic findings. Left superficial parotidectomy with ipsilateral level II lymph node dissection was conducted. (a) Black arrow shows parotid tumor adjacent to facial nerve (a) and main mass and lymph node specimen is shown seperately (b). Pathologic finding of the parotid is compatible with benign pleomorphic adenoma showing benign epithelial cells in the myxoid stroma (H&E, x40) (c) and is also found in left level II lymph node. (H&E, x40) (d).
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Superficial parotidectomy (SP) with selective neck dissection of level II was performed under the diagnosis of initially metastasizing pleomorphic adenoma. (Figure 2(a) and (b)) Histologically, the primary parotid tumor was surrounded by a fibrous capsule and composed of the typical mixture of epithelial and myoepithelial cells with abundant mucinous material of a pleomorphic adenoma in variable chondromyxoid stroma.