Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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November 24, 2008
Pleomorphic Adenoma of the Parotid Gland
- Most common tumor of parotid gland (50-80%), usually in superficial lobes, may also be found in submandibular and sublingual glands. Most common in adult women (3:2).
- MRI: high T2 signal, circumscribed thin low T2 signal fibrous capsule, lobulated contour. May have internal calcifications and cystic degeneration; generally enhance following contrast.
- Treated with surgical excision because malignant degeneration can occur.
- Differential includes Warthin tumor, monomorphic adenoma, myoepithelioma, oncocytoma,or schwannoma. If cystic, differential includes lymphoepithelial lesions, branchial cleft cyst, simple cyst, or sialocele. In pediatric patients, includes hemangioma or lymphangioma. If bilateral, also consider underlying sarcoid, Sjögren's, or HIV.
- Malignant parotid masses typically have intermediate or low T2 signal and an indistinct margin and include mucoepidermoid carcinoma and adenoid cystic carcinoma, metastases, and lymphoma.
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