PMC10368098_01
Biopsy from the latero-cervical mass. a (H&E). Tumour presenting a microcystic and follicular pattern, with large cells with indistinct cell borders, vacuolated eosinophilic/amphophilic cytoplasm, and round to oval nuclei. Mitosis, necrosis, or relevant pleomorphism were not seen. b (DOG1 immunohistochemistry). The neoplastic cells are positive for DOG1, characteristic of ACC. The diagnosis of metastatic ACC was rendered.
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F1
DOG1, and SOX10, p40 negative), as shown in Figure 1. Discussion in multidisciplinary team agreed on parotidectomy and cervical lymph node dissection.
Cervical computed tomography scan of the parotid mass. a Tumour at diagnosis, with a necrotic mass of 39 x 38 mm (arrow). b Tumour after completion of RT treatment. c Tumour after six cycles of chemotherapy.
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F2
Imagological response was favourable by the end of the treatment, as shown in Figure 2; however, clinical deterioration and progressive immunosuppression occurred, resulting in multiple hospital admissions.