Malignant Peripheral Nerve Sheath Tumor Presenting as a Chronic Parotid Gland Mass: A Case Report
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Malignant peripheral nerve sheath tumors (MPNSTs) affecting the parotid gland representonly about 2.8% of all head and neck MPNSTs. We present this rare parotid tumor to contribute to published data, raise awareness of its clinical presentation and to improve surgical management. A 22-year-old male presented with a 10-year history of gradual right-sided hemifacial weakness, later developing a mass at the right preauricular area. Preoperative ultrasoundshowed a right parotid hypovascular mass exhibiting heterogenous echopattern and microcalcifications. A multidisciplinary team of surgeons from surgical oncology and plastic surgeryperformed total parotidectomy followed by a minimal access cranial suspension lift and suprabrow lift to address the right sided facial drooping. Histopathology revealed a solid cluster ofpleomorphic spindle cells which stained positive for S-100 and vimentin consistent withMPNST. There was improvement of the facial asymmetry and he did not undergo radiotherapy.
Abstract
Malignant peripheral nerve sheath tumors (MPNSTs) affecting the parotid gland representonly about 2.8% of all head and neck MPNSTs. We present this rare parotid tumor to contribute to published data, raise awareness of its clinical presentation and to improve surgical management. A 22-year-old male presented with a 10-year history of gradual right-sided hemifacial weakness, later developing a mass at the right preauricular area. Preoperative ultrasoundshowed a right parotid hypovascular mass exhibiting heterogenous echopattern and microcalcifications. A multidisciplinary team of surgeons from surgical oncology and plastic surgeryperformed total parotidectomy followed by a minimal access cranial suspension lift and suprabrow lift to address the right sided facial drooping. Histopathology revealed a solid cluster ofpleomorphic spindle cells which stained positive for S-100 and vimentin consistent withMPNST. There was improvement of the facial asymmetry and he did not undergo radiotherapy.