Medicine · 2025
Mucoepidermoid carcinoma of the parotid gland with invasion of the jugular foramen region: A case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Li Yongtuan, Wang Ying, Zhao Hai
Аннотация
RATIONALE: Mucoepidermoid carcinoma of the parotid gland, being the most prevalent malignant neoplasm among salivary gland tumors, represents the leading incidence rate among primary parotid malignancies. This pathological entity predominantly affects young and middle-aged females, typically presenting as a painless parotid mass. Due to its variable disease progression and nonspecific clinical manifestations, preoperative misdiagnosis as a benign tumor is frequently encountered. However, when parotid mucoepidermoid carcinoma progresses to involve the jugular foramen region, a complex anatomical structure, the diagnostic and therapeutic challenges are significantly amplified.
PATIENT CONCERNS: This case report presents a 56-year-old male patient with difficulties in closing his right eye and deviation of the mouth corner for 1 year, along with coughing while drinking water and hoarseness for 2 months. After multiple misdiagnoses and ineffective treatments, the patient was admitted to our hospital with a suspected diagnosis of jugular foramen syndrome.
DIAGNOSES: Radiological examinations revealed abnormal enhancement in the right parotid gland, cavernous sinus, and petrous bone of the right temporal bone, with surrounding bone destruction. Surgical pathology confirmed the diagnosis of mucoepidermoid carcinoma of the parotid gland, with intermediate grade and nerve invasion. The tumor had also invaded the jugular foramen region.
INTERVENTIONS: The patient underwent skull base lesion resection via the infratemporal fossa approach, parotidectomy, cervical lymph node dissection, abdominal fat filling, and external auditory canal closure. And he was treated with postoperative radiotherapy and chemotherapy.
OUTCOMES: After 1 year and 4 months of follow-up, there was no recurrence of the tumor. The patient presented with significant deglutition-related aspiration, prompting surgical intervention to enhance quality of life. Following vocal cord augmentation performed in our department, the patient demonstrated marked improvement in both aspiration symptoms and vocal quality.
LESSONS: This case highlights the importance of detailed differential diagnosis and a comprehensive understanding of the jugular foramen region in avoiding misdiagnosis and ensuring timely treatment.
PATIENT CONCERNS: This case report presents a 56-year-old male patient with difficulties in closing his right eye and deviation of the mouth corner for 1 year, along with coughing while drinking water and hoarseness for 2 months. After multiple misdiagnoses and ineffective treatments, the patient was admitted to our hospital with a suspected diagnosis of jugular foramen syndrome.
DIAGNOSES: Radiological examinations revealed abnormal enhancement in the right parotid gland, cavernous sinus, and petrous bone of the right temporal bone, with surrounding bone destruction. Surgical pathology confirmed the diagnosis of mucoepidermoid carcinoma of the parotid gland, with intermediate grade and nerve invasion. The tumor had also invaded the jugular foramen region.
INTERVENTIONS: The patient underwent skull base lesion resection via the infratemporal fossa approach, parotidectomy, cervical lymph node dissection, abdominal fat filling, and external auditory canal closure. And he was treated with postoperative radiotherapy and chemotherapy.
OUTCOMES: After 1 year and 4 months of follow-up, there was no recurrence of the tumor. The patient presented with significant deglutition-related aspiration, prompting surgical intervention to enhance quality of life. Following vocal cord augmentation performed in our department, the patient demonstrated marked improvement in both aspiration symptoms and vocal quality.
LESSONS: This case highlights the importance of detailed differential diagnosis and a comprehensive understanding of the jugular foramen region in avoiding misdiagnosis and ensuring timely treatment.