Journal des rapports de cas cliniques

Surgical Resection of a Small Cell Carcinoma Primary Tumor of the Parotid Gland with Perineural and Skull Base Involvement

Abstract

Zimmerman Z, Lehman J, Hoffman-Ruddy B, Silverman E and Baekey PA

Background: One of the rarest tumors of the parotid gland is a Small Cell Carcinoma (SmCC) of neuroendocrine or ductal origin. These lesions tend to be aggressive, often invading bone and nerve and carry a grave prognosis for the patient. Presently there is no standardized treatment protocol and no consensus to tumor management. Case Report: This case report is of a 70 year-old male with a right-sided facial mass, facial pain, severe otalgia, weight loss, and right-sided facial paralysis. Subsequent imaging and Fine Needle Aspiration (FNA) revealed T4aN2bM0 SmCC of the parotid gland with facial nerve enhancement and skull base erosion. The patient underwent major extirpative surgery including radical neck dissection, total parotidectomy with facial nerve resection and cable graft, and partial temporal bone resection as the initial step in a combined modality therapy The patient has done very well post-operatively. Conclusion: This case report describes the successful, aggressive surgical management of locally and regionally advanced SmCC of the parotid gland. Although the prognosis for patients with SmCC of the parotid gland is typically grave, the absence of distant metastatic disease in the presented case provided the rationale for an aggressive surgical approach with a curative, rather than palliative, focus.