Tumors of the Accessory Lobe of the Parotid Gland: A 10-Year Experience

Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, TN, USA.
The Laryngoscope (Impact Factor: 2.14). 10/2004; 114(9):1652-5. DOI: 10.1097/00005537-200409000-00028
Source: PubMed


The differential diagnosis of midcheek masses include pathology arising from normal anatomic structures or from variations of normal accessory parotid gland tissue. Accessory parotid gland tissue has been described as salivary tissue adjacent to Stenson's duct that is separate from the main body of the parotid gland. We report our 10-year experience with the diagnosis and treatment of eight accessory parotid gland neoplasms that have been followed by the senior authors.
This is a retrospective review of our experience with eight accessory parotid gland neoplasms.
A literature review and retrospective chart review of our experience with accessory parotid gland tumors over the past 10 years. The presentation, evaluation, management, treatment, and outcome were recorded.
Eight cases of accessory lobe parotid tumors were identified, which have been followed since the date of initial treatment. All of the patients presented with a slowly growing cheek mass. There was one case of carcinoma expleomorphic adenoma, one case of undifferentiated carcinoma (small cell carcinoma), one case of basal cell adenocarcinoma, one case of benign salivary cyst, two cases of pleomorphic adenoma, and two cases of monomorphic adenoma. A standard facelift approach or modified Blair incision was used to excise these tumors.
Neoplasms of the accessory parotid gland are rare. Management of these tumors include a high index of suspicion, good understanding of the anatomy, and meticulous surgical approach.

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    • "A retrospective review of her MRI study 3 years before her current presentation revealed that a small APG tumor was present at the time she underwent a resection of her MPG tumor. There are many pathological entities that can involve the central cheek region, including metastatic tumors, Kimura's disease, and vascular lesions such as hemangioma and vascular malformations [5] "

    Preview · Article · Jan 2013
    • "Histologically, Pleomorphic adenoma is the most common benign tumor, and mucoepidermoid carcinoma is the most common malignant tumor.[11–13] A clinicopathological study by Lin et al.[14] on Tumors of the accessory lobe of the parotid gland identified eight cases of accessory lobe parotid tumors. All of the patients presented with a slowly growing cheek mass. "
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    ABSTRACT: Tumors of accessory parotid gland are considered in the differential diagnosis of a mid cheek mass. Parotidectomy is the procedure of choice. All pathological types of parotid main gland tumors occur in the accessory parotid gland also. Presenting as a mid cheek or infrazygomatic mass, the tumors of this accessory parotid gland are notorious for recurrences, if adequate margins are not achieved. We describe two such cases of such a tumor. 40-year-old male with a slowly progressive mid cheek mass was operated by a mid cheek incision. Histopathology of the tumor was pleomorphic adenoma. Facial nerve paresis recovered complelety in 6 months. A 52-year-old female with progressive mid cheek mass who underwent parotidectomy and neck dissection by a modified Blair's incision was diagnosed with extranodal marginal zone lymphoma with focal transformation to a diffuse large B-cell lymphoma. Chemotherapy with CHOP regime was initiated. There was no recurrence at 6 months of follow-up. Lymphoma of accessory parotid gland is a very rare tumor. Standard parotidectomy incision is advocated to prevent damage to facial nerve branches.
    No preview · Article · Apr 2012
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    • "An accessory salivary gland is occasionally observed on the masseter muscle along with Stensen's duct. Neoplasms arising from an accessory parotid gland are relatively rare, and variable types of malignant tumor have been reported in the literature: carcinoma ex pleomorphic adenoma [12], squamous cell carcinoma [13], mucoepidermoid carcinoma [14], acinic cell carcinoma [15], oncocytic carcinoma [16], basal cell carcinoma [14], and small cell carcinoma [14]. "
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    ABSTRACT: Low-grade cribriform cystadenocarcinoma (LGCCA) is a rare tumor of the salivary gland that exhibits clinically indolent behavior. In this paper, we present a case of invasive adenocarcinoma of the accessory parotid gland in a young male that exhibited histology suggestive of an association of LGCCA. A 27-year-old man presented with a subcutaneous tumor in his left cheek. The tumor was separated from the parotid gland and located on the masseter muscle. The tumor was resected, and the postoperative histological diagnosis was adenocarcinoma, not otherwise specified (ANOS). The tumor exhibited papillary-cystic and cribriform proliferation of the duct epithelium and obvious stromal infiltration. Some tumor nests were rimmed by myoepithelium positive for smooth muscle actin, p63, and cytokeratin 14, indicating the presence of intraductal components of the tumor. Tumor cells exhibited mild nuclear atypia, and some of them presented an apocrine-like appearance and had cytoplasmic PAS-positive/diastase-resistant granules and hemosiderin. Other cells had foamy cytoplasm with microvacuoles. Immunohistochemistry revealed that the almost all of the tumor cells were strongly positive for S-100. These histological findings suggest the possibility that ANOS might arise secondarily from LGCCA. This is an interesting case regarding the association between ANOS and LGCCA in oncogenesis. Virtual Slides The virtual slide(s) for this article can be found here:
    Full-text · Article · Dec 2011 · Diagnostic Pathology
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