Accessory Parotid Malignancy Requiring Ductal Transection

Abstract

Figure I. MRI shows a hyperdense massin the leftcheek, overl ying the masticatormuscle(arrow). Continuedon page 66 The patient is a 41-year-old woman who presented with a 1 year history of a painful left cheek mass. She denied weight loss, fevers, chills, or difficulty tolerating a normal diet. However, she presented for removal because of persistent pain. On exam, a 1.0 x 1.0-cm mass was palpated in the left cheek, overlying the masticator muscle. Magnetic resonance imaging (MRI) confirmed the presence of a lesion distinct from the main parotid gland. It measured 1 x 0.6 x 0.7 em, was located in the cheek fat pad , and was associated with a possible accessory parotid gland (figure 1). A fine-needle aspiration (FNA) was ordered but was nondiagnostic (consistent with a fibrotic mass). Based on these findings and the patient's persistent pain, surgery was recommended. Intraoperatively, the accessory parotid gland tumor From Osborne Head and Neck Institute. Los Angeles.