J Korean Assoc Oral Maxillofac Surg.  2022 Aug;48(4):237-241. 10.5125/jkaoms.2022.48.4.237.

Sclerosing polycystic adenosis arising in the parotid gland with trismus: a case report and literature review

• Yee YJ
• Han D
• Lee C
• Kim JY

• KMID: 2532830
• DOI: http://doi.org/10.5125/jkaoms.2022.48.4.237

Abstract

Sclerosing polycystic adenosis (SPA) is a rare, asymptomatic disease that occurs mainly in the salivary glands. We report the case of a 51-year-old man who presented with trismus and pain upon mouth opening. Magnetic resonance imaging revealed a 2-cm mass located in the anterior portion of the left parotid gland. SPA was diagnosed based on histopathological examination of the surgical specimen. In pathologic findings, there was a well-circumscribed multicystic nodule in the parenchyma. Dense fibrosis and chronic non-specific inflammatory cells were observed in the stroma. In 13 previous reports on SPA, the most preferred treatment was superficial or total parotidectomy. This report suggests that simple excision of SPA preserves facial nerve function and facial volume.

Keyword

Neoplasm; Benign neoplasm; Tumor; Parotid gland; Trismus

Figure

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  Fig. 1 Magnetic resonance imaging revealed a 2-cm-sized mass in the anterior portion of the left parotid gland, compressing the masseter muscle anteriorly (A). The lesion is mainly T2-hyperintense; it is a rim-enhancing lesion with a small localized enhancing area (A, C). The lesion in T1-hypointense (B, D). (Asterisks: cystic area, Hollow arrow: masseter muscle, Arrowhead: solid area of the tumor)

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  Fig. 2 Histopathological examination of the surgical specimen through H&E staining. (A). A multicystic nodular mass within the parotid parenchyma was observed under low magnification. Original magnification, ×12.5. (B). The cysts lining the epithelium show simple or stratified cuboidal cells with oncocytic cytoplasm. Ductal hyperplasia, chronic non-specific inflammation, and dense fibrosis are present. Original magnification, ×100. (C). A characteristic hyalinized nodule surrounding the degenerative duct is observed (yellow arrow). Some acini and ducts show eosinophilic cytoplasmic changes (green arrows). Original magnification, ×200. (D). Some glandular ducts show sebaceous metaplasia (yellow arrow). Prominent lymphocytic infiltration and ductal hyperplasia are also observed (green arrow). Original magnification, ×200.

Reference

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