PMC5854657_01
(A) T1-weighted coronal MRI image and (B) axial CT image showing large mass in left parotid gland.
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F1
MRI soft tissue neck with and without contrast showed a 3.8 cm x 5.0 cm x 4.0 cm fatty lesion involving the superficial and deep lobes of the left parotid gland and masticator space with widening of the stylo-mandibular tunnel, with the tumor abutting the medial surface of ramus of the mandible (Figure 1A). The patient underwent a preoperative CT soft tissue neck with contrast, showing a dumbbell-shaped hypodense lesion in the deep lobe of the parotid gland, with anterior displacement of the pterygoids and medial displacement of the parapharyngeal space, as well as mild bony remodeling of the mandibular ramus and thinning of the mandibular condyle (Figure 1B).
Intraoperative and postoperative photos: (A) lipoblastoma in relation to the deep lobe of the parotid gland and the upper and lower divisions of the facial nerve, (B) lipoblastoma prior to excision from parotid gland, (C) excised parotid gland lipoblastoma (5.2 cm x 4.3 cm x 3.5 cm), (D) No evidence of tumor recurrence at 20 months of follow up.
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F2
The superficial aspect of the parotid bed was spared, and upper and lower divisions of the facial nerve were identified and preserved (Figure 2A). The tumor, which primarily involved the deep lobe of the parotid gland, was entirely excised (Figures 2B,C). He has full function of the facial nerve, with intact upper and lower divisions, and 20 months of follow-up without evidence of recurrence (Figure 2D).
Pathology images: (A) well-defined nodule with fibrous septae (2x), (B) intervening white fibrous trabeculae (4x), (C) myxoid stroma at the periphery of the nodule (4x), (D) mature adipose tissue with myxoid material in the background (10x).
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F3
The lipoblastoma was described as a well-defined mass composed predominantly of lobules of mature adipose tissue with fibrous septae (Figures 3A,B). Areas of myxoid stroma were noted at the periphery of the mass with nodules and strands of fibrous tissue within the center of the mass (Figures 3C,D).