Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2019; 7(3): 366-372
Published online Feb 6, 2019. doi: 10.12998/wjcc.v7.i3.366
Papillary cystadenoma of the parotid gland: A case report
Li Wang, Shi-Kun Zhang, Ying Ma, Patrick K Ha, Zhi-Ming Wang
Li Wang, Shi-Kun Zhang, Zhi-Ming Wang, Department of Oral and Maxillofacial Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Ying Ma, Department of Pathology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Patrick K Ha, Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA 94115, United States
Author contributions: Wang L and Wang ZM contributed to the design of the article; Wang L and Zhang SK contributed to the literature review and manuscript drafting and editing; Ha PK, as an English native speaker, contributed to the critical revision and content of the manuscript; all authors approved the final draft submitted.
Supported by Natural Science Foundation of Liaoning Province, No. 20170541042.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images. The study was reviewed and approved by the Shengjing Hospital of China Medical University Institutional Review Board.
Conflict-of-interest statement: The authors state that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Ming Wang, DDS, MD, PhD, Doctor, Professor, Surgeon, Department of Oral and Maxillofacial Surgery, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. wangzm@sj-hospital.org
Telephone: +86-24-9661561515
Received: November 1, 2018
Peer-review started: November 1, 2018
First decision: November 27, 2018
Revised: December 20, 2018
Accepted: December 29, 2018
Article in press: December 30, 2018
Published online: February 6, 2019
Abstract
BACKGROUND

Papillary cystadenoma is a rare benign epithelial tumor of the salivary gland, which is characterized by papillary structures and oncocytic cells with rich eosinophilic cytoplasm. We found only one case of papillary cystadenoma in nearly 700 cases of salivary gland tumors. Our case was initially mistaken for a tumor of the right temporomandibular joint (TMJ) capsule rather than of parotid gland origin. Preoperative magnetic resonance imaging (MRI) and computed tomography (CT) should be carefully studied, which allows for appropriate preoperative counseling and operative planning.

CASE SUMMARY

Here, we report an unusual case of a 54-year-old woman with a parotid gland papillary cystadenoma (PGPC) that was misdiagnosed as a tumor of the right TMJ capsule. She was initially admitted to our hospital due to a mass anterior to her right ear inadvertently found 5 d ago. Preoperative CT and MRI revealed a well circumscribed tumor that was attached to the right TMJ capsule. The patient underwent a resection through an incision for TMJ, but evaluation of an intraoperative frozen section revealed a benign tumor of the parotid gland. Then we removed part of the parotid gland above the temporal facial trunk. The facial nerve was preserved. Postoperative histopathological findings revealed that the tumor was PGPC. No additional treatment was performed. There was no recurrence during a 20-mo follow-up period.

CONCLUSION

The integrity of the interstitial space around the condyle in MRI or CT should be carefully evaluated for parotid gland or TMJ tumors.

Keywords: Papillary cystadenoma, Parotid gland, Temporomandibular joint, Case report

Core tip: We present an unusual parotid gland papillary cystadenoma that was mistaken for a temporomandibular joint (TMJ) tumor. Surgeons should pay particular attention to the integrity of the interstitial space around the condyle in preoperative magnetic resonance imaging and computed tomography. If the space is intact, the mass may come from the parotid gland, otherwise, it is of TMJ origin. The tumor‘s origin determines operative planning and process.