Lipoma in the deep lobe of the parotid gland: a case report

Department of Otolaryngology and Head and Neck Surgery, Tokyo Medical and Dental University School of Medicine, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Auris Nasus Larynx (Impact Factor: 1). 11/2002; 29(4):391-3. DOI: 10.1016/S0385-8146(02)00018-4
Source: PubMed

ABSTRACT We report here on a rare case of lipoma in the deep lobe of the parotid gland. MRI revealed that the tumour was situated mainly in the deep lobe and it extended posteriorly and medially into the space between the sternocleidomastoid muscle and the posterior belly of the digastric muscle, with slight extension into the parapharyngeal space. This tumour produced strong signals on T1- and T2-weighted MR images and weak signals on fat suppression images. In addition, MRI clearly showed the margin of the tumour, which enabled us to readily distinguish the tumour from the surrounding adipose tissue. The images suggested a diagnosis of deep lobe parotid lipoma with posteromedial extension to the sternocleidomastoid muscle, which proved true at surgery. We thus believe that MRI is highly useful, perhaps even necessary, in diagnosing tumours of the head and neck.

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    • "However, this incidence is as high as 80% (four in five reported deep parotid lipoma cases) after the surgery for deep lobe parotid lipoma. As the lipoma resembles the appearance of the surrounding normal tissue, it is probably to increase the facial nerve dysfunction [2] [3] [4] [5]. "
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    ABSTRACT: We would like to present our experience in management of lipomas arising in the deep lobe of the parotid gland, which were diagnosed and operated in our clinic from the point of complication/morbidity, and recurrence, in line with the literature. Five patients with lipoma found in the deep lobe of the parotid gland, diagnosed and treated at our clinic in the 12-year period between March 1992 and March 2004, were included in this study. Limits of the tumors were determined by computed tomography (CT), and/or magnetic resonance imaging (MRI). Preoperative fine needle aspiration biopsy (FNAB) was also performed. Through a classic parotidectomy incision, the parotid gland was exposed. Full exposure of the facial nerve and its branches was performed. The removal of deep lobe parotid lipomas was achieved by enucleation in all cases. Postoperative complication/morbidity and recurrence were evaluated. The most common symptom was an otherwise asymptomatic mass on the parotid region and/or upper lateral neck. One of five patients was presented with medial displacement of the lateral pharyngeal wall, and tonsil as the additional physical finding. Preoperative radiologic evaluation results revealed that CT and/or MRI scans accurately localized 100% of the tumors in relation to the deep lobe of the parotid gland. FNAB did not enable us to make a diagnosis of lipoma in four of the cases. Total resection was achieved in all cases. Temporary facial nerve paralysis, due to the dissection of the facial nerve, did not occur in any cases. There was no recurrence of the tumors after a mean follow-up of 60 months. Assessment of the exact location of the tumor is an important consideration for selection of the appropriate surgical approach. Different from lipomas found in other locations, those observed in the parotid gland cannot be easily resected by simple dissection. Resection of these tumors requires full exposure of the facial nerve.
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    ABSTRACT: Lipomas of the parotid are interesting lesions because they rarely occur and are not considered in the preoperative diffential diagnosis. We present a case of a lipoma in the left parotid of a 67-year-old male. This mass developed slowly over 10years. Limited superficial parotidectomy was done. Neither tumor recurrence nor Frey's syndrome was observed 2years after the surgery. The essential factor in the differential diagnosis of a mass in the parotid glands is whether it is benign or malignant. Although lipomas of the parotid rarely occur, they should be taken into consideration in the preoperative diffential diagnosis. KeywordsLipoma-Parotid gland-Superficial lobe
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    ABSTRACT: The purpose of the present study is to evaluate the background fat intensity suppression instability of each area in the head and neck region, and in the post-reconstruction with metal plate and myocutaneous flap, of patients with oral cancer using fat-saturated (FS) images. STIR and FS T2-weighted images at pre- and post-surgery in 59 patients with oral cancer were scored for uniformity of fat suppression and tissue conspicuity in each region of the head and neck. The scores of FS on uniformity of fat suppression pre-operatively were worse than those of STIR in the mandibular level, but not lesion and tissue conspicuity. However, the deterioration both of scores between pre- and post-surgery using FS was worse than that using STIR using metal plate and/or myocutaneous flap. At diagnosis, we should recognize on MR images using FS that instability of the status of fat suppression might be brought about by respective area and reconstruction with metal plate and myocutaneous flap of patients with oral cancer.
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