J Korean Assoc Oral Maxillofac Surg.  2012 Oct;38(5):314-317. 10.5125/jkaoms.2012.38.5.314.

Basal cell adenoma misdiagnosed as an adenoid cystic carcinoma in the parotid gland

• Kim CW
• Kim SG

• KMID: 1434335
• DOI: http://doi.org/10.5125/jkaoms.2012.38.5.314

Abstract

Basal cell adenoma (BCA) of the parotid gland is a rare benign tumor. In the parotid gland, BCA is occasionally difficult distinguish from adenoid cystic carcinoma in terms of clinical and pathological perspectives. An adenoid cystic carcinoma of the parotid gland grows slowly but spreads persistently to the surrounding tissues, particularly along the perineural spaces. In the present case, BCA of the parotid gland was misdiagnosed as an adenoid cystic carcinoma. We discuss the reason for such a misdiagnosis, and present a method for making a correct diagnosis.

Keyword

Adenoma; Parotid gland

MeSH Terms

Adenoids
Adenoma
Carcinoma, Adenoid Cystic
Diagnostic Errors
Parotid Gland

Figure

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  Fig. 1 Left preauricular area swelling and painless movable mass.

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  Fig. 2 A. In T1W1 magnetic resonance imaging, there is a well-defined and non-homogeneously enhanced mass on the deep portion of left parotid gland. B. There is higher signal intensity portion in middle and medial site of lesion.

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  Fig. 3 A. Pre-auricular incision was done. B. Superficial parotid gland was removed and the mass was excised. C. Facial nerve trunk was conserved.

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  Fig. 4 The tumor cells rarely showed keratinization and almost consisted of intermediate cell type. There were small and cuboidal, exhibiting deeply basophilic nuclei and little cytoplasm and mitotic activity was rarely seen (H&E staining, ×100).

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  Fig. 5 PCNA was frequently positive in tumor cells, but the immunostain of p53 was rarely stained. Cytokeratin-7 was frequently positive in glandular structure, but the cytokeratin-14 was rarely stained. Snail was frequently positive in tumor cells, but the beta-catenine was rarely stained. Pan-K and S-100 was positively stained, but wnt-1 was negative (×100). (PCNA: proliferating cell nuclear antigen, Pan-K: pancytokeratin)

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