The changing faces of a parotid mass

Abstract

The development of a neurofibroma in the temporal and parotid regions of the facial nerve is rare. We report a case occurring in a 32-year-old male, where the initial presentation was a parotid mass. Cytologically this was initially thought to be a pleomorphic adenoma. However, the diagnosis was then changed to a schwannoma and finally a neurofibroma after complete excision of the lesion. The case illustrates how fine needle aspiration cytology under ultrasound guidance, and even histological examination of an incision biopsy can sometimes fail to give the correct diagnosis. In this case magnetic resonance imaging was used to help plan definitive surgery.

Intraparotid Facial Nerve Schwannoma: Diagnosis and Management

“…Because preoperative diagnosis is often difficult, intraoperative identification during parotidectomy is essential. The intraoperative gross appearance of the intraparotid schwannomas of the study patients does not differ significantly from that of other benign tumors as many appear yellow and rubbery, 14 but the most diagnostic feature of intraparotid facial nerve schwannoma is intraoperative difficulty locating the facial nerve 16,17 . In addition, tumors intimately involved with or difficult to dissect from the facial nerve during superficial parotidectomy have been reported 9 .…”

US of the Major Salivary Glands: Anatomy and Spatial Relationships, Pathologic Conditions, and Pitfalls

“…Their differentiation is not possible with US. Among nonepithelial lesions, hemangiomas, lipomas (Fig 26), and neurinomas or schwannomas may be found in salivary glands (12,(87)(88)(89)(90)(91).…”

Solitary Intraparotid Facial Nerve Plexiform Neurofibroma

“…So many surgeons operate infrequently plexiform neurofibromas of the head and neck region, particularly in pediatric patients. Although facial nerve preservation during surgery is unlikely and significant morbidity can result from their excision, when the separation appears difficult nerve grafting is recommended for larger defects and end-to-end anastomosis is recommended for small defects of the facial nerve [20].…”