Presentation
Left neck pain and swelling and left pharyngeal mass with uvula deviation.
Patient Data
Age: 60 years
Gender: Female
From the case:
Pleomorphic adenoma - deep parotid gland
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- Large 4.6 x 2.9 x 4.4 cm (AP x ML x SI) left neck mass, continguous with/arising from the most medial aspect of the deep lobe of the parotid gland
- Lobulated contour and well circumscribed
- Prominent T2 signal hyperintensity with near homogeneous contrast enhancement along the inferior aspect of the lesion with more heterogeneous enhancement superiorly.
- The lesion extends medially, along the posterior surface of the pterygoid muscles, displacing the oropharynx anterolaterally to the right.
- Effacement of the left parapharyngeal fat.
- No infiltration / invasion
- No cervical lymphadenopathy
Case Discussion
The patient underwent parotidectomy and excision of this mass.
Histology: pleomorphic adenoma
MRI allows precise topographical localization of the mass and diagnosis in the majority of cases.
This case had classic MRI characteristics of pleomorphic adenomas which are:
- well-circumscribed borders
- complete capsule
- lobulated contour
- high T2 signal intensity
- inhomogeneous contrast enhancement
- no lymphadenopathy
- no invasion/infiltration into surrounding structures
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