Cases reported "Parotid Neoplasms"

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11/180. lipomatosis of the parotid gland in a child.

    lipomatosis of the parotid gland is a very rare tumour and its discovery in a child is exceptional. These tumours are not generally considered in the preoperative differential diagnosis of parotid region neoplasms because of their rarity. The treatment of choice is surgical excision, with a superficial or total parotidectomy, preserving the facial nerve. Long-term follow-up is advised due to possible microscopic infiltration. A case of lipomatosis of the parotid gland in a 4-month-old child is reported.
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12/180. Salivary gland involvement as an initial presentation of Wegener's disease. A case report.

    The case is presented of a 47-year-old woman with an 8-week history of persistent right ear discomfort and a 2-week history of unilateral parotid swelling, as well as peripheral paresis of the facial nerve. The case points to the difficulties encountered when Wegener's granulomatosis presents in an unusual and varied way which mimics a malignant tumour of the parotid gland. To our knowledge, the association of parotid gland involvement and facial palsy in Wegener's granulomatosis has not previously been described in the literature.
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13/180. Spindle cell lipoma of the parapharyngeal space: first report of a case.

    Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.
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14/180. Unusual causes of hemifacial spasm.

    hemifacial spasm (HFS) has been defined as consisting of brief clonic jerking movements of the facial musculature, beginning in the orbicularis oculi with downward spreading to other facial muscles. HFS, perhaps the most common of the abnormal involuntary facial movements, has been classically ascribed to vascular loop compression at the root exit zone of the facial nerve. Causes other than such vascular loops are rare in the medical literature. Here we present three case studies in which the phenomenology of the HFS was atypical in onset and evolution. Using these three patients as introduction to the topic, we reviewed the literature of all cases of HFS with causes other than the vascular loop. In these three cases, HFS was caused by (1) a parotid gland tumor, (2) a cerebellopontine angle meningioma, and (3) an acoustic schwannoma. We also discuss the radiological findings as well as possible differences in the genesis of HFS and phenomenology in such cases and present recommendations on how to evaluate these patients.
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15/180. Acute facial-nerve paralysis with parotid adenolymphoma.

    An 82-year-old woman presented with acute facial paralysis in association with parotid swelling following fine-needle aspiration cytology of a parotid adenolymphoma. Evacuation of a tense haematoma decompressed the nerve and led to complete recovery within 6 months. Additionally, the tumour is no longer evident, either clinically or radiologically, and fine-needle aspiration cytology appears to have been both diagnostic and, inadvertently, therapeutic in this case.
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16/180. Extensive metastatic renal cell carcinoma presenting as facial nerve palsy.

    Metastatic lesions of the parotid gland are well described in the literature. Metastatic spread to the parotid from renal cell carcinoma is rare. We present the only reported case of facial nerve palsy caused by a metastasis to the parotid from a renal cell carcinoma.
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17/180. A very rare benign tumour in the parotid region: calcium pyrophosphate dihydrate crystal deposition disease.

    calcium pyrophosphate dihydrate crystal deposition disease, exhibits several clinical manifestations, from absence of symptoms to severely destructive arthropathy or conditions simulating neoplasm, which is frequently related to the temporomandibular joint. Fifteen of the 31 reported cases of tophaceous pseudogout were found in the head and neck region. A patient presented with a parotid swelling, which initially was suspected to be malignant because of the following findings: radiodensity, progression into the joint, osseous destruction of the major ala of the sphenoid and a fine needle aspirate with crystals, osteoblasts, megakaryocytes and irregular cells of varying size. At surgery there was found a tumour consisting of a white, firm gritty material. It progressed to the skull base where material had to be left, because of the presence of the nerves and vessels. A frozen specimen was reported to be benign. Histological examination showed inflammatory cells, macrophages, a chondroid material with embedded metaplastic chondroid cells and giant cells of foreign body type. Crystal examination of x-ray diffraction revealed calcium pyrophosphate dihydrate.
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18/180. Combined transcervical transmastoid approach to giant parotid pleomorphic adenoma: a case report.

    Although rare, giant major salivary gland pleomorphic adenomas are among the most astonishing patient presentations. patients may ignore these slow-growing, benign lesions until significant functional impairment occurs. Complete tumor excision and facial nerve preservation in these cases are challenging requirements and are greatly aided by combined transcervical and transmastoid approaches to these lesions. In the presented case, facial nerve monitoring accurately identified the collateralization between the upper and lower divisions of the facial nerve and allowed the required sacrifice of the lower division without the need for facial nerve grafting or reconstruction. The patient recovered full function of all branches.
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19/180. A neurilemmoma of the parotid gland: report of a case.

    Benign primary tumors of the facial nerve are frequently misdiagnosed because of the variety of their clinical manifestations. Much attention has been paid to neurilemmomas in the recent otolaryngologic literature, but far less has been focused on intraparotid facial nerve neurilemmomas. In this article, we describe a new case of this truly rare tumor, and we review its diagnosis, pathology, and treatment.
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20/180. Treatment of postparotidectomy salivary fistula with botulinum toxin.

    We report on the successful treatment with botulinum toxin type A local injections of a salivary fistula that occurred after superficial parotidectomy. In a 58-year-old woman, transcutaneous discharge of saliva in the preauricular region had persisted in spite of 2 surgical revisions. Moreover, facial weakness and synkinesis had developed as a result of an iatrogenic lesion that had occurred at the time of primary surgery and required immediate reanastomosis of the main nerve trunk. Botulinum toxin A was injected into the deep lobe of the remaining parotid gland under ultrasonographic guidance. Additionally, botulinum toxin A was injected into the left orbicularis oculi muscle in order to improve the synkinesis. No adverse effects were observed. The sialorrhea was stopped for 11 months, and the synkinesis of the facial muscles was reduced significantly for 4 months. We conclude that botulinum toxin A injection is a successful alternative for the treatment of chronic salivary fistula.
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