Oncocytoma of the Parotid Gland: A Case Report and Review of the Literature
A 67-year-old male presented to the ENT service with left facial swelling of 5 months duration. His medical history was unremarkable, he had no pain or cutaneous inflammatory reaction. An intraoral exam revealed swelling of the soft tissue palate, and CT and MRI imaging studies were performed to identify the nature of the swelling.\nCT revealed an isodense expansive mass of 7.3 cm in diameter, partially confined to the inside of the left deep parotid lobule with moderate enhancement observed after intravenous contrast media injection. Hypodense areas were present.\nThe mass encompassed the anterior lateral and retromandibular vein, the anterior and medial pterygoid muscle, the pharyngeal mucous space, the posterior carotid space and obliteration of ipsilateral parapharyngeal fat resulting in a decrease of airway volume. The morphology of the right parotid gland and bilateral submaxillary glands was intact. The bilateral submaxillary, jugulodigastric, and left periparotid nonspecific lymph nodes were also intact (fig. , fig. ).\nMRI showed a large solid expansive process in the deep lobule of the left parotid gland. An isodense area was seen on T1 sequence and a mildly hyperintense on T2 (fig. , fig. ). After intravenous injection of paramegnetic contrast, a moderate enhancement was observed. The mass crosses the stylomandibular space, the parapharyngeal space involving the oropharyngeal posterior wall decreasing the airway. Furthermore, it involves the anterior base of the tongue and reaches the prevertebral space (fig. ).\nA biopsy was performed on oropharyngeal submucous samples resulting in the following diagnosis: ‘fragment of benign epithelial tumor consistent with oncocytoma’ (fig. ).\nFollowing the results of the tests, it was decided that surgical excision was the best treatment with total parotidectomy, complete tumor resection and facial nerve preservation (fig. ). At present, the patient has remained disease free with no signs of recurrence.