Algorithm for the reconstruction of the parotid region: a single institution experience.

OBJECTIVE: This study aims to discuss the characteristics and treatment methods of malignant tumors in the parotid region, as well as the therapeutic effects of immediate free flap reconstruction of soft tissue for postoperative defects. MATERIALS AND METHODS: A retrospective review was conducted on 11 cases of soft tissue flap reconstruction for postoperative defects following the resection of malignant tumors in the parotid region. Statistical analysis was performed based on clinical data. RESULTS: Among the 11 cases of malignant tumors in the parotid region, there were 2 cases of secretory carcinoma (SC) of the salivary gland, 2 cases of squamous cell carcinoma (SCC), 2 cases of carcinosarcoma, 1 case of mucoepidermoid carcinoma (MEC), 1 case of epithelial-myoepithelial carcinoma (EMC), 1 case of salivary duct carcinoma (SDC), 1 case of basal cell carcinoma (BCC), and 1 case of osteosarcoma. Among these cases, 4 were initial diagnoses and 7 were recurrent tumors. The defect repairs involved: 8 cases with anterolateral thigh free flap (ALTF), 2 cases with pectoralis major muscle flaps, and 1 case with forearm flap. The size of the flaps ranged from approximately 1 cm × 3 cm to 7 cm × 15 cm. The recipient vessels included: 4 cases with the facial artery, 4 cases with the superior thyroid artery, and 1 case with the external carotid artery. The ratio of recipient vein anastomosis was: 57% for branches of the internal jugular vein, 29% for the facial vein, and 14% for the external jugular vein. Among the 8 cases that underwent neck lymph node dissection, one case showed lymph node metastasis on pathological examination. In the initial diagnosis cases, 2 cases received postoperative radiotherapy, and 1 case received 125I seed implantation therapeutic treatment after experiencing two recurrences. Postoperative follow-up revealed that 2 cases underwent reoperation due to local tumor recurrence, and there were 2 cases lost to follow-up. The survival outcomes after treatment included: one case of distant metastasis and one case of death from non-cancerous diseases. CONCLUSION: Immediate soft tissue flap reconstruction is an important and valuable option to address postoperative defects in patients afflicted with malignant tumors in the parotid region.

Huge Lipoma of Left Parotid Region with Intra-Parotid Extension.

Lipoma is a benign mesenchymal tumor originating from adipose tissue. The occurrence of this tumor in head and neck is less frequent and it rarely involves parotid gland. These are asymptomatic and occur both in the deep and the superficial lobe of the parotid. The most favored age group is from the fifth to sixth decade of life and is 10 times more common in the males. A 66-year-old male patient, with left parotid region lipoma is reported in this article. A fine-needle aspiration biopsy and ultrasonography were performed to establish the preoperative diagnosis and to plan the correct surgical approach. It was managed by surgical excision of lipoma with removal of cuff of superficial parotid tissue on superior aspect with preserving facial nerve. Follow-up examinations were planned to assess any facial nerve injury complications.

Cystic lesion in parotid region: an unexpected diagnosis.

Benign tumours of salivary glands represent 2%-3% of all tumours and parotid gland is most often affected. Keratocystoma is a rare benign tumour with multilocular cystic lesions filled with keratin materials. Histologically, it is characterised by solid epithelium islands containing keratinised lamellae with multicystic spaces. We report a case of a woman in her mid-70s with painless mass in her left parotid gland which increased in size over 1 year. Ultrasound scan revealed a 38×20 mm diameter hypoanechoic mass. Neck CT with contrast medium and fine needle aspiration were performed with diagnostic hypothesis of Warthin tumour. So, extracapsular parotid dissection with no facial nerve damage was performed. Histological examination revealed a keratocystoma. The patient had a 16-month follow-up without signs of relapse or malignancy. Despite its rarity, keratocystoma must be considered among the possible differential diagnostic hypotheses when we find parotid masses, to ensure the best treatment to the patient.

First Bite Syndrome After Parotidectomy: A Case Series and Review of Literature.

INTRODUCTION: First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain of severe facial pain in the ipsilateral parotid region with the first few bites of a meal. OBJECTIVE: The aim of this study is to shed light on the incidence and potential risk factors of FBS, including a series of cases depicting FBS observed after parotidectomy. METHODS: Retrospective review of 419 patients who underwent parotidectomy at a single tertiary care facility between December 2016 and June 2020. RESULTS: With a mean follow-up time of 16.5 months, 8 (2%) patients were documented to have symptoms of FBS after parotid gland surgery. Six of these patients underwent partial parotidectomy by dissection of the deep lobe of the parotid (DLP). CONCLUSION: Patients undergoing dissection of the DLP are particularly at risk for the development of FBS. All patients should be appropriately counseled during informed consent discussions, especially in high-risk cases.

Nevus azul celular parotídeo, una tumoración inusual / Parotid cellular blue nevi, an unusual mass

Introducción: el nevus azul celular es una tumoración melanocítica dérmica benigna. En ocasiones, puede ser falsamente diagnosticada como lesiones malignas, entre ellas, el melanoma. Caso clínico: se trata de una mujer de 37 años que presentó una masa parotídea izquierda de cuatro meses de evolución correspondiente con un nevus azul celular. Discusión: la región de la cabeza y cuello es la tercera en frecuencia, tras la sacrococcígea y las extremidades. Ante una tumoración melanocítica, es importante la confirmación diagnóstica, debido a las similitudes, tanto clínicas como anatomopatológicas, del nevus azul celular con el melanoma maligno. Conclusiones: es muy importante el diagnóstico diferencial correcto, para lo cual es de ayuda el uso de las tinciones inmunohistoquímicas. El tratamiento de esta tumoración es la exéresis quirúrgica con márgenes, esto presenta un comportamiento benigno y baja tasa de recidiva.

Introduction: Cellular blue nevi is a benign dermal melanocytic tumor. Occasionally, it can be falsely diagnosed as malignant lesions, including melanoma. Clinical case: This is a 37-year-old woman who presented with a left parotid mass of four months of evolution, corresponding with a cellular blue nevi. Discussion: The region of the head and neck is the third in frequency, after the sacrococcygeal and the extremities. During the study of a melanocytic tumor, diagnostic confirmation with a biopsy is important, due to the similarities, both clinical and pathological, of cellular blue nevi with malignant melanoma. Conclusions: the correct differential diagnosis is very important, for which immunohistochemical study is helpful. The treatment of this tumor is the surgical excision with margins, presenting benign behaviour and low recurrence rate.

[Two cases of metastasis in parotid region after surgery of scalp angiosarcoma].

Angiosarcoma of the scalp is an aggressive tumor with a high rate of local recurrence and distant metastasis. We present two cases of metastasis in parotid region at the time of one year after radical surgery of scalp angiosarcoma. It is suggested that regional lymph nodes should be treated more aggressively at the first treatment, which may achieve better results or, at least, prolong the time to local recurrence and distant metastasis.

Management of two rare cases of dermatofibrosarcoma protuberans arising in the parotid region.

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous tumour, accounting for less than 1% of malignant tumours of the head and neck region. This tumour rarely presents metastatic disease, but has a high recurrence rate. Therefore, wide surgical excision with microscopically free margins is the therapeutic gold standard. Only five cases are described in literature of this tumour arising in the parotid region, a site that presents challenges both in achieving a wide demolition and in reconstructing the resulting defect. Here we describe two cases of DFSP arising in the parotid region that were treated surgically, achieving microscopically free margins. Reconstruction of the vast skin defect was achieved by means of a supraclavicular artery island flap, with good functional and aesthetic results.

Intraparotid Osteolipoma: Treatment Option and Surgical View.

ABSTRACT: Osteolipoma is a benign neoplasm originating from the mesenchymal fat tissue cells and characterized by the presence of bone formation. In the head and neck district osteolipoma has been described as parapharyngeal, nasopharinx, submandibular gland, eyelid, floor of the mouth, and skull base lesion. Only 1 case of osteolipoma was reported as a neoplasm of the parotid region. Considering the rarity of the osteolipoma, our purpose was to describe the first case of totally intraparotid gland localization of osteolipoma and summarize and review the actual literature concerning the presence of this tumor in the region of major salivary glands. A 56-years-old male patient was treated for intraparotid osteolipoma. Surgical removal of tumor was done with a standard preauricular/cervical incision and blunt dissection. The facial nerve was identified and preserved completely. In the reviewed series, all cases were reported in adult patients with a relative long history of slow progression. According to our paper and the review of the literature, we can assess that Osteolipoma is an extremely rare lesion affecting the major salivary glands, which should be considered along with common salivary gland tumors in the differential diagnosis.

Recurrent Eccrine Acrospiroma of the Parotid Region: A Case Report.

Eccrine acrospiroma is a benign tumor of skin and adnexa arising from eccrine sweat gland epithelium. It is usually solitary, slow growing tumor commonly affecting extremities. Rarely it affects head and neck region, and extremely rare in parotid region. Females are affected more often. Treatment of choice is wide local excision with adequate skin margins. Although benign this tumor is very notorious for recurrence after inadequate resection. We describe here a case of young male patient with recurrent eccrine acrospiroma over parotid region which was managed by wide local excision with primary repair with excellent results.

Feather foreign body caused periparotid and peritonsillar abscess in a 9-month-old girl.

Migratory foreign body appeared to be bird feather, caused peritonsillar and periparotid abscess in a nine-month-old infant. Patient presented painful, tender and fluctuating red neck mass on the left neck region II, and refusal of oral intake, with no fever. Azithromycin was introduced four days before presentation for suspected urinary tract infection. ENT examination revealed left peritonsillar abscess; ultrasound confirmed periparotid abscess, MSCT verified both diagnoses. Under general anaesthesia, we performed abscess incision, after pus drainage, small foreign body spontaneously came through the wound. After washing it with saline, it appeared like a bird feather. Subsequently, peritonsillar abscess was incised and drained. After 24-hour postoperative care on pediatric intensive care unit, the patient continued three-day parenteral antibiotic treatment on the otolaryngology department; it was discharged with a recommendation to continue seven days of oral antibiotic therapy. Suggested mechanism was ingestion of bird feather from stuffed bedding, that got trapped in the tonsillar crypt. Afterwards, it started to migrate through the neck tissue. Households with children younger than three years should not have feather stuffed clothes or beddings.

Reconstruction of Extensive Composite Parotid Region Oncologic Defects with Immediate Facial Nerve Reconstruction Using a Chimeric Scapulodorsal Vascularized Nerve Free Flap.

BACKGROUND: Cancer involving the parotid gland region may originates from parotid parenchyma itself or from locoregional organs and in rare cases, the facial nerve (FN) has to be sacrificed during tumor resection. In these cases, cancer extension often goes beyond the parotid compartment and requires extensive local resection responsible for complex multitissular defects. The goals of reconstruction may be summarized in the following two components: (1) restoration of the volumetric tissue defect and (2) FN reconstruction. The aim of this study is to describe our surgical technique and our cosmetic results using the chimeric scapulodorsal vascularized nerve (SDVN) flap to reconstruct extensive maxillofacial defects associated with FN sacrifice. METHODS: All patients undergone an extensive maxillofacial resection with FN sacrifice and primarily reconstructed with a SDVN flap were included. We classified the maxillofacial defects into six groups based on the type of resection. Intraoperative data including flap composition, topography of FN injury, length of nerve gap, and number of nervous anastomosis were recorded. RESULTS: Twenty-nine patients were included. Mean follow-up was 38.7 months. The harvested flaps included the SDVN combined with different components according to the defect group. A satisfactory volumetric restoration was obtained in 93% of cases. The mean number of distal nervous anastomosis was 4.5. The length of the vascularized grafted nerve ranged from 7 to 10 cm. CONCLUSION: This is largest series presented in literature on primary FN reconstruction utilizing a vascularized nerve graft. We believe that the chimeric SDVN flap should be highly considered for these cases due to its versatility. The surgeon is able to use single donor site available soft and hard tissues components along with a vascular motor nerve graft, which offers a great length and number of distal branches, and easily matches with the extracranial FN trunk and its peripheral ramifications.

Parotid salivary mucocele in a companion rabbit (Oryctolagus cuniculus): a report on the clinical and laboratory characteristics and surgical treatment - case report / [Mucocele salivar parotídea em coelho doméstico (Oryctolagus cuniculus): relato de características clínico-laboratoriais e tratamento cirúrgico - relato de caso]

The present report aimed to describe the main characteristics of the parotid salivary mucocele in an adult male rabbit, which presented with a painless fluctuating mass with fluid content. Owing to the need for repeated fluid drainage, surgical excision was the chosen mode of treatment. Preoperative evaluation included radiography and blood analysis. The patient underwent surgical excision of the affected gland. Inhalation anesthesia was maintained by means of isoflurane and the cardio-respiratory parameters were monitored throughout the surgery. A bipolar electrocautery was used to assist in the incision and polyglactin 910 and nylon were the suture materials used in the wound closure technique. Post-operative medications included analgesics, anti-inflammatory agents and antibiotics. Histopathology of the excised glandular tissue revealed a mixed inflammatory infiltrate, fibroblasts, hemorrhage and hyperemia. The observations in this case suggest that surgical excision of the affected gland is the treatment of choice for the management of mucocele in companion rabbits, which has already been identified for other animals. Periodic acid-reactive Schiff staining confirmed the diagnosis of salivary mucocele. The complementary investigations helped to rule out the differential diagnosis and indicated a favorable prognosis, in view of the fact that the case was successfully resolved without complications or recurrence.(AU)

O presente relato teve como objetivo descrever as principais características da mucocele salivar parotídea em um coelho macho adulto, que apresentou uma massa flutuante indolor e com um conteúdo líquido em seu interior. Devido à necessidade de repetidas punções deste fluido, optou-se pela excisão cirúrgica como forma de tratamento. A avaliação pré-operatória incluiu radiografias e análises sanguíneas. O paciente foi submetido ao tratamento cirúrgico com excisão da glândula afetada. A anestesia inalatória foi mantida com isoflurano e os parâmetros cardio-respiratórios foram monitorados durante a cirurgia. Um eletrocautério bipolar foi utilizado para auxiliar na incisão e os fios poliglactina 910 e nylon foram utilizados na técnica de sutura. As medicações pós-operatórias incluíram agentes analgésicos, anti-inflamatórios e antibióticos. A histopatologia do tecido glandular removido revelou infiltrado inflamatório misto, fibroblastos, hemorragia e hiperemia. As observações neste caso sugerem que a remoção cirúrgica da glândula afetada seja o tratamento de escolha no manejo da mucocele em coelhos de companhia, o que já vem sendo identificado para outros animais. A coloração do ácido periódico reativo de Schiff confirmou o diagnóstico da mucocele salivar. Os exames complementares ajudaram a excluir as doenças que fazem parte do diagnóstico diferencial e indicaram um prognóstico favorável, tendo em vista o fato que este caso foi resolvido com sucesso, sem complicações ou recorrência.(AU)

[Diagnosis and characteristics of parotid region lesions in children].

Objective:To observe the disease spectrum of the parotid region lesions in children, and clarify the outcome and prognosis of the disease by analyzing of clinical data. Method:The basic information, clinical symptoms, diagnosis results, treatment, prognosis and follow-up of 170 cases with parotid region lesions were analyzed. Result:Among 170 cases of the parotid region lesions, 83 cases（48.82%） were congenital disease, 62 cases（36.47%） were vascular mass, 17 cases（10.00%） were benign or malignant tumor, and 8 cases（4.71%） were infectious disease; 108 cases of the patients were treated with surgery, 34 of them were treated with local bleomycin injection while 28 cases were treated with both surgery and local bleomycin injection. Two cases was cured by reoperation after recurrence and 1 case had facial paralysis but recovered after 3 months of follow-up. Conclusion:The most common diseases of parotid region lesions in children were congenital disease and vascular mass. Surgery combined with bleomycin local treatment is the main therapy in parotid area and has achieved remarkable results. Oral propranolol has certain therapeutic value for parotid region hemangioma.

A Facelift Procedure for Resection of Benign Parapharyngeal Tumors.

<b>Objective:</b> The feasibility, surgical outcomes and possible risks and complications encountered during a facelift procedure for patients with parapharyngeal space (PPS) tumor were analyzed. <br><b>Method:</b> This retrospective analysis examined 10 patients who underwent surgery for PPS tumor using a facelift incision at our institutes between April 2015 and August 2019. <br><b>Results:</b> This study included four retro-styloid (benign nerve sheath tumor) and six pre-styloid tumors (pleomorphic adenoma). Mean tumor dimensions were 4.1 x 4.2 x 3.8 cm respectively. None of the patients needed conversion to conventional open resection. Transient sensory changes in the auricle occurred in 30% of the patients; however, all recovered within four months. In all the patients, postoperative scars were fully concealed by the auricle and hair. No recurrences were detected during a mean follow-up period of 16.6 months. <br><b>Conclusion: </b>The facelift procedure provides adequate visualization, workspace and excellent cosmetic results in properly selected cases.

Outcomes and prognosticators in regionally recurrent cutaneous squamous cell carcinoma of the head and neck.

INTRODUCTION: Data regarding regionally metastatic cutaneous squamous cell carcinoma of the head and neck (cSCCHN) is limited and derived almost exclusively from Australian and United States (US) institutions. We report the first United Kingdom perspective, with the aims of benchmarking survival outcomes and identifying clinically relevant prognosticators. MATERIALS AND METHODS: Ninety-one patients with regionally recurrent cSCCHN treated with curative intent over a ten-year period (2009-2018) were studied retrospectively. Time-to-event analyses were used to estimate oncological outcomes, and log-rank statistics and Cox proportional hazards models used to examine potential prognosticators. Receiver operating characteristics were also used to analyse the influence of nodal disease burden. RESULTS: Parotid involvement (with or without neck involvement) was most common (79.2%), and time to recurrence in those with parotid disease alone significantly shorter than for any other disease distribution (p = 0.034). Respective five-year overall, disease-specific, and disease-free survival estimates were 43.8%, 63.8%, and 36.2%. Extracapsular spread (ECS) portended reduced DFS and DSS (p = 0.012 and p = 0.005 respectively). Increasing nodal burden (≥4 involved nodes) also reduced DSS (p = 0.020), while parotid disease alone predicted more favourable DSS (p = 0.008). ECS and isolated parotid involvement remained significant on multi-variate analysis (p = 0.014 and p = 0.028 respectively). CONCLUSIONS: Oncological outcomes were unfavourable but broadly consistent with previous reports, notionally lending support to a more proactive approach in managing the clinically node negative neck/parotid in selected high-risk cases. Our data also support distinct parotid classification and consideration of involved lymph node number in future staging systems.

Gross Anatomical, Radiographic and Doppler Sonographic Approach to the Infra-auricular Parotid Region in Donkey (Equus asinus).

The present study was performed on 12 heads of donkey's cadavers of both sexes for different anatomic techniques and on 20 live adult donkeys for ultrasonographic approaches of local anesthetic techniques. The aim was to achieve safe desensitization of the ear canal and tympanic membrane in addition to measuring different parameters of the structures occupying the infra-auricular parotid region. The internal auricular nerve was divided into two fine branches and constituting, at its origin, a characteristic V-shape with the caudal auricular nerve. The styloid process of auricular cartilage was an adequate landmark for ultrasonographic needle-guided anesthesia for internal auricular and auriculopalpebral nerves, whereas the great auricular nerve was easily palpated subcutaneously that showed safety and success in all cases. The auricular branch of mandibular nerve joined the auriculopalpebral branch of facial nerve. The maxillary vein was descending, partially embedded within the texture of the parotid glandular tissue. The parotid gland divided into five segments was clearly demarcated by maxillary vein tributaries with three main collecting radicles pouring into the parotid duct. The mandibular duct received about 12-15 fine radicles and supplied with a separate branch from the external carotid artery. Using the Doppler sonographic technique in donkeys for diagnosis of ear affections, evaluation of retrograde sialography to salivary glands with their blood vasculature and their indices might be helpful for the detection of different critical abnormalities, such as stenosis, thrombosis, and other vasopathological affections through measuring their resistivity and pulsatility indices.

Reconstrucción de defectos parotídeos con injertos de tejido graso libre abdominal. Estudio clínico de una sencilla técnica quirúrgica / Reconstruction of parotid defects with abdominal free fat grafts. Clinical study of a simple surgi-cal technique

INTRODUCCIÓN: La cirugía parotídea es una técnica muy habitual y presenta múltiples tipos de abordajes y métodos de reconstrucción. Las distintas opciones de reconstrucción primarias empleadas son el colgajo del sistema músculo aponeurótico superficial (SMAS), la rotación del músculo esternocleidomastoideo (ECM), injertos libres/microvascularizados o la utilización de biomateriales tipo Alloderm, entre otros. Se presenta nuestra experiencia en la utilización de injerto de grasa libre abdominal periumbilical para la reconstrucción primaria del defecto parotídeo. MATERIAL Y MÉTODOS: Se realiza un estudio observacional de las reconstrucciones con injerto de tejido graso libre abdominal en pacientes que precisaron la realización de una parotidectomía (superficial, total o radical) debida a una neoplasia parotídea primaria o a una recidiva tumoral. Los pacientes fueron intervenidos por el mismo cirujano entre mayo de 2013 y enero de 2019. El estudio analiza aspectos epidemiológicos y clínicos de los pacientes, los abordajes y el tiempo quirúrgico, la estancia hospitalaria, las complicaciones postquirúrgicas, las secuelas, el seguimiento clínico y el resultado estético de los pacientes. RESULTADOS: Un total de 22 pacientes fueron intervenidos con utilización de injertos de grasa abdominal tras una parotidectomía superficial conservadora, total o radical. Fueron trece hombres y nueve mujeres de edades entre 13 y 79 años (46 años de media), con el diagnóstico inicial realizado mediante punción aspiración por aguja fina (PAAF) y tomografía computerizada (TC) o resonancia magnética (RM). El resultado estético en todos los pacientes fue muy bueno o excelente. No secuelas a largo plazo ni síndrome de Frey. No complicaciones de interés, salvo leves hematomas y seromas postquirúrgicos. CONCLUSIÓN: Se presenta una técnica muy sencilla y con muy pocas complicaciones para la reconstrucción primaria de defectos postparotidectomía a través de mínimas incisiones con unos excelentes resultados estéticos

INTRODUCTION: Parotid surgery is a common technique with multiple approaches and reconstruction options. Primary reconstruction options are the superficial musculoaponeurotic system (SMAS) flap, the sternocleidomastoid muscle flap, free or microvascular grafts and biomaterials (Alloderm), among others. We present our experience in periumbilical abdominal free fat graft for primary reconstruction of the parotid defect. MATERIAL AND METHODS: A observational study was performed in patients requiring a parotidectomy (superficial, total or radical) due to a primary parotid neoplasm or tumor recurrence. In all cases were used a free abdominal fat graft. The patients were operated by the same surgeon between May 2013 and January 2019. The study analyzes epidemiological and clinical aspects, approach, surgical time, hospital stay, post-surgical complications, sequelae, clinical follow-up and aesthetic results. RESULTS: A total of 22 patients were incluyed after a conservative, total or radical superficial parotidectomy. Thirteen men and nine women aged between 13 and 79 years (46 years on average), with the initial diagnosis made by fine water aspiration puncture (FNA) and Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI). Aesthetic result in all patients was excellent or very good. No long-term sequelae or syndromes Frey. No complications interest except minor postsurgical hematomas and seroma. CONCLUSIONS: A very simple technique with few complications is presented for the primary reconstruction of postparotidectomy defects with excellent aesthetic results

A rare case of a recently described entity: mammary analogue secretory carcinoma (MASC) of the parotid gland / Un caso raro de una entidad descrita recientemente: carcinoma secretorio análogo mamario (CSAM) de la glándula parótida

MASC is a salivary gland tumour which shares histological, immunologic and genetic characteristics with mammary secretory carcinoma including an ETV6 translocation and immunocytochemical positivity for S-100 protein, CK7, and mammaglobin as well as negativity for DOG1. This is a rare tumour with uncommon characteristics when compared to other salivary gland tumours. The case reported here is of a 28-year-old female patient who presented in the ER due to a palpable mass in the left parotid region. She underwent a superficial parotidectomy with using a mini-lifting approach, with tumour resection, followed by radiotherapy. The identified tumour shared most of the clinical characteristics with other cases of MASC described in the literature

CSAM es un tumor de glándula salival que comparte características histológicas, inmunológicas y genéticas con el carcinoma secretor mamario, que incluye una translocación ETV6 y positividad inmunocitoquímica para la proteína S-100, CK7 y mamaglobina, así como negatividad para DOG1. Este es un tumor raro con características poco comunes en comparación con otros tumores de glándulas salivales. El caso referido aquí es el de una paciente de 28 años de edad que se presentó en la sala de emergencias debido a una masa palpable en la región parotídea izquierda. Se sometió a una parotidectomía superficial con un abordaje de mini-lifting, con resección tumoral, seguida de radioterapia. El tumor identificado compartía la mayoría de las características clínicas con otros casos de CSAM descritos en la literatura