Pathologic Quiz Case 1
Jeffrey T. Hunt, MD; Brendan C. Stack, Jr, MD; Neal D. Futran, MD, DMD; L. Frank Glass, MD; James N. Endicott, MD, Tampa, Fla
A 49-YEAR-OLD woman presented to her primary care physician with a 10-week history of a right preauricular mass. She was initially treated with a course of antibiotics, without resolution. She then began complaining of progressive right otalgia and developed right-sided facial weakness. Magnetic resonance imaging of the brain revealed no abnormalities.
The patient was referred to our institution for further evaluation. Magnetic resonance imaging of the neck and skull base revealed a 2x2-cm right parotid mass (Figure 1). Fine-needle aspiration demonstrated atypical cells, anucleated squamous cells, and necrotic debris.
A total parotidectomy was planned. Intraoperative frozen sections of tumor margins were consistent with invasive squamous cell carcinoma. The tumor tracked extensively along the facial nerve both distally and proximally. It was
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