Primary salivary gland carcinoma with neuroendocrine differentiation is of rare occurrence, especially so in the parotid gland. Amongst the various reported primary tumors with neuroendocrine differentiation, acinic cell carcinoma (ACC) one such tumor. A 48 year old lady presented with a gradually increasing right infra-auricular swelling for a period of 1 year which enlarged suddenly in a short period. Contrast Enhanced Computed Tomography (CECT) suggested diagnosis of Pleomorphic Adenoma. Fine Needle Aspiration Cytology (FANC) yielded a cystic fluid suggesting a possibility of Warthin’s tumor or Oncocytic lesion. Intraoperative findings were suggestive of a Warthin’s tumor. Initial histopathological examination of the tumor was suggestive of neuroendocrine carcinoma. However, extensive sectioning revealed peripheral islands of ACC. Immunoexpression of S-100, Neuron specific Enolase (NSE), Chromogranin A and Synaptophysin confirmed the diagnosis. The possibility of neuroendocrine differentiation in a primary salivary gland tumor should be kept in mind whenever a salivary gland tumor shows only neuroendocrine histology.
Abstract:Lipomas are common soft tissue neoplasms. They are rarely seen in parotid gland, often not considered in the initial differential diagnosis of parotid gland tumors. Lipomas account for 0.6% to 4.4% of all parotid tumors. Superficial lobe is common site of origin in parotid gland with only rare reports from deep lobe. When there is any suspicion, imaging studies are of high diagnostic value. We present a case of parotid lipoma involving the deep and superficial lobes of the parotid gland. Computed tomography (CT) and ultrasound were performed in radiological diagnosis. Findings were confirmed by fine needle aspiration cytology.
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