Background: The spindle cell lipoma is a rare benign tumor that originated from subcutaneous adipose tissue. It is a slow growing lesion and may become voluminous causing the patient an aesthetic disfigure. The diagnosis is made by the histological examination combined with immunohistochemical analysis. Radiological features present a variety of description because of the proportions difference of spindle cell lipoma components, but imaging is useful to determine the mass extents. The treatment of this kind of benign tumors is surgery which must be completed without need for other therapy. Aim: This case report highlights the exceptional location of spindle cell lipoma in the soft tissues of the parotid-masseter lodge, which may raise differential diagnosis problems with a primary parotid gland tumor. Case Presentation: A 58-year-old man, with no medical history, was presenting a swelling of the parotid region, growing progressively for 6 years, without other associated sign. The patient benefited from a careful physical examination. A computed tomography and magnetic resonance imaging were carried out. Clinical and radiological findings were suggesting a benign tumor occupying the left parotid-masseter lodge. The patient went through a surgical excision of the tumor. Histological and immunohistochemical features revealed a classic shape of spindle cell lipoma. After one year of follow-up, we notice a good recovery without local recurrence. Conclusion: Surgeons and pathologists have to keep in mind the possible development of spindle cell lipoma in any subcutaneous site even if unusual one.
The salivary gland tumor pathology remains relatively rare, representing 3 to 4% of all tumors of the head and neck.Parotid localization is predominant. It is characterized by a great morphological and histological diversity, but it is the benign forms which predominate especially the pleomorphic adenoma [1]. The most frequent mode of revelation is a cervical swelling of the parotid space. Complementary examinations, in this case imagery, have become real diagnostic tools, on the one hand, to specify the exact location of the lesion, its extension to adjacent tissues and, on the other hand, to predict the malignant or benign nature of the lesion. Ultrasound, whether or not combined with fine needle aspiration, CT and MRI are the most frequently used methods. The objective of this work is to study the MRI characteristics of parotid tumors correlated with surgical histopathology (parotidectomy) and describe the typical imaging aspects of the main parotid tumors.
Materials and MethodsThis is a retrospective study of 46 patients who were followed up and treated for a parotid tumor. The cases were collected over a period of 4 years, from January 2016 to July 2019, at the ENT surgery department at the Hassan II FES University Hospital. We only retained the files containing a computed tomography (CT) and / or magnetic resonance imaging (MRI) and whose nature of the tumor was confirmed by a histological study after parotid surgery. The parameters studied were the patient's age and sex, the motif of consultation. All of the clinical features of the swelling were studied and correlated with histology data. As for the imaging data, for each diagnostic method, we correlated the report of the radiologists concerning the nature of the tumor, to the results of the final histology, and we calculated the sensitivity, the specificity and the diagnostic efficiency of each diagnostic method. All our patients underwent surgical treatment on the tumor with or without associated lymph node surgery. MRI diagnostic values, sensitivity and specificity were calculated for three types of parotid lesions: pleomorphic adenoma, Warthin's cystadenolymphoma, and malignant tumors.
ResultsThe gender distribution was almost equivalent, with 25 women (54%) and 21 men (46%). The average age was around 39 years with extremes of 7 years and 87 years. All our patients presented a common symptomatology which is the parotid swelling with a size variation between 2 and 4 cm (2
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