Pleomorphic Adenoma of the Right Parotid Gland

Case Presentation:
A 51-year-old female presented with a right parotid swelling of 1-year duration. The swelling was asymptomatic with no associated pain, discharge, or functional impairment.

Past Medical History (PMH): Negative
Past Surgical History (PSH): Negative
Medication History: Negative

Investigations:
None

Ultrasound (US):

• No significant cervical lymphadenopathy.

• Normal parotid and submandibular glands, with no focal lesions.

• A small, complex nodule measuring 16 x 14 x 11 mm was identified in the superficial lobe of the right parotid gland. The nodule had increased in size compared to a previous ultrasound, raising suspicion for a neoplasm.

Fine Needle Aspiration Cytology (FNAC):

• Diagnosis: Neoplasm, benign (Milan System Category IVA).

• Cytological Suggestion: Pleomorphic adenoma (benign mixed salivary gland tumor).

Surgery:
The patient underwent a superficial parotidectomy of the right parotid gland.

Histopathological Examination (HPE):

• Final Diagnosis: Pleomorphic Adenoma

  • Composed of a mixture of epithelial and stromal elements.

  • The tumor was well-encapsulated with no evidence of malignant transformation.

  • Margins were clear of the lesion.

Postoperative Course:

• The patient recovered well with no complications, such as facial nerve injury or hematoma.

• Follow-up ultrasound and clinical examination showed no recurrence or residual disease.

Discussion:
Pleomorphic adenoma, also known as benign mixed tumor, is the most common benign salivary gland neoplasm, with a predilection for the parotid gland. Although generally benign, pleomorphic adenomas have the potential for malignant transformation into carcinoma ex pleomorphic adenoma, especially if left untreated for long periods.