Parotid mucoepidermoid carcinoma
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Left cheek mass.
Within the left parotid tail is a hypoechoic mass with minimal peripheral vascularity.
Within the parotid tail at the level of the mandible angular is a relative hyperdense mass, abutting the anterior aspect sternocleidomastoid muscle. No suspicious lymph nodes.
The patient underwent a partial parotidectomy.
MACROSCOPIC DESCRIPTION: "Left parotidectomy": An unorientated piece of tissue, 43x32x26mm. The external surface is inked blue. The specimen is serially sliced to show a nodular lesion measuring 28x24x15mm which focally abuts the resection margin. Several small satellite nodules up to 5mm are noted. The cut surface of the nodule is mostly white and glistening with some yellow tinged areas.
MICROSCOPIC DESCRIPTION: 1. The sections show one benign lymph node. 2. Sections show a predominantly cystic tumor lined by a mixture of mucinous cells, epidermoid cells and intermediate cells. There is no tumor necrosis or anaplasia and mitoses are inconspicuous. No neural invasion or lymphovascular invasion is identified. Three intraparotid lymph nodes show no evidence of malignancy. The tumor is separated from adjacent skeletal muscle by fibrous tissue. The background salivary gland is normal. The tumor is 1mm clear of the closest resection margin.
DIAGNOSIS: Mucoepidermoid carcinoma. - Low grade (AFIP). - Size 28mm. - 1mm clear of resection margin. - Three benign lymph nodes (0/3). - pT2 N0
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