Parotid pleomorphic adenoma: myxoid type

Case contributed by Dr Ian Bickle

Presentation

Young male with a three month history of a right parotid lump. No facial weakness. No palpable cervical nodes.

Patient Data

Age: 30 years
Gender: Male
Modality: MRI

A well defined low T1, T2 hyperintense homogeneously enhancing mass in the superficial lobe of the right parotid gland is present.  The medial aspect of the mass abuts the retromandibular vein, with no extension into the deep lobe or extra-capsular extension. No intra-parotid lymphadenopathy.

Borderline right submandibular space lymph node.  

Case Discussion

The patient went on to have a FNAC.

Cytology

Multiple smears prepared from the FNA of the right parotid gland show ductal epithelial and myoepithelial cells situated in a fibromyxoid stroma. Some of the cells show plasmacytoid pattern. The appearances are those of a pleomorphic adenoma

Discussion

Pleomorphic adenomas account for 70-80% of benign salivary gland tumours and are especially common in the parotid gland, and are most often located in the superficial lobe.

Three histological types have been described:

  1. myxoid (hypocellular) - which is the most frequently observed.
  2. cellular
  3. classic

The myxoid type has a very hyperintense appearances as in this case.

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Case Information

rID: 48254
Case created: 27th Sep 2016
Last edited: 13th Oct 2016
System: Head & Neck
Inclusion in quiz mode: Included

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