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Colossal Parotid Tumors: A Diagnostic and Surgical Challenge

机译:巨静脉肿瘤:诊断和外科挑战

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Tumors of the salivary glands constitute 3% of all head and neck tumors. The parotid gland (PG) is the most common site?involved in 85% of cases.?PG tumors' size varies from a few millimeters to several centimeters and is about 2-6 cm on average. However, because of insidious growth and asymptomatic nature, untreated tumors of the PG can attain large size. Pleomorphic adenoma (PA), as large as 33 cm in size or 26.5 kg in weight, has been reported in the literature. Similarly, untreated Warthin’s tumor (WT) rarely becomes giant, size up to 20 cm is reported. Giant PG tumors are commonly symptomatic and have a rare tendency to become malignant. We are reporting two giant PG tumors with different histopathological diagnoses, PA and WT of size 15x15 cm and 10x8 cm, respectively. Therefore, with a size of 10 cm, our case is the second-largest WT reported in the literature. Both the giant PG tumors were present for 15-20 years, and mild pain and discomfort were the only symptoms.?We had the differential preoperative tissue diagnosis in fine-needle aspiration cytology (FNAC) because of varying consistency. Contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) of the neck were done for these cases for preoperative planning. Compared to the former, the latter was more informative about nerve involvement preoperatively. Both the patients underwent superficial parotidectomy, and meticulous dissection was done to identify and safeguard the facial nerve and its branches. We had a challenge in closing the flaps, which was achieved with an acceptable cosmetic outcome. Both the patients were discharged in stable condition with minimal facial nerve weakness.
机译:唾液腺的肿瘤构成所有头部和颈部肿瘤的3%。腮腺(PG)是最常见的网站?涉及85%的病例。肿瘤的大小不同于几毫米到几厘米,平均约为2-6厘米。然而,由于增长明显和无症状的性质,PG的未经处理的肿瘤可以达到大尺寸。在文献中报道了含有大约33厘米或26.5公斤的含有最新的腺瘤(PA),在文献中报告。类似地,未经治疗的Warthin的肿瘤(WT)很少变得巨大,据报道尺寸高达20厘米。巨型PG肿瘤通常是对症的,并且具有罕见的倾向于恶性。我们报告了两种巨大的PG肿瘤,分别具有不同的组织病理学诊断,PA和WT的大小为15x15cm和10x8厘米。因此,大小为10厘米,我们的案例是文献中的第二大WT。巨型PG肿瘤均为15 - 20年,而轻微的疼痛和不适是唯一的症状。由于变化的一致性,唯一的症状是细针穿刺细胞学(FNAC)中的差异术前组织诊断。对于这些病例进行术前规划,对颈部的对比增强的计算断层摄影(CECT)和磁共振成像(MRI)进行了。与前者相比,后者术前对神经受累的更具信息丰富。患者均接受浅表腮腺切除术,并进行细致的解剖,以识别和保障面神经及其分支。在关闭襟翼时,我们对襟翼进行了挑战,这是通过可接受的化妆品结果实现的。患者均以稳定的条件排出,具有最小的面神经虚弱。

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