Palomino-Payan Julio A, Guillen-Valles Jessica, Meza-Martinez Daniel A, Urias Fernanda, Montes de Oca-Gordoa Luis D
General Surgery, Instituto Mexicano del Seguro Social, Hospital General de Zona No. 33, Monterrey, MEX.
Oncology, Instituto Mexicano de Seguros Social (IMSS) Unidad Medica de Alta Especialidad No. 25, Monterrey, MEX.
Cureus. 2024 Aug 30;16(8):e68175. doi: 10.7759/cureus.68175. eCollection 2024 Aug.
Benign salivary gland tumors are a rare and diverse group of neoplasms with significant variations in their site of origin, histological features, and biological behavior. This report describes the case of a 93-year-old woman with a markedly enlarged left cervical mass. Physical inspection uncovered a tumor of approximately 32 x 30 cm, featuring necrotic and ulcerated areas. The neoplasm, diagnosed as a pleomorphic adenoma (PA) through prior biopsies, had been growing gradually over fifteen years, with delayed surgical intervention due to concerns about her age and the tumor's size. Preoperative contrast-enhanced CT imaging showed a large left-sided cervical mass in close proximity to the airway, but without displacement or infiltration into major structures. An elective surgical approach was undertaken, involving complete resection of the giant PA, confirmed by histopathological evaluation. During the first month of postoperative follow-up, the patient experienced partial facial nerve paralysis but showed no evidence of tumor recurrence. Despite the tumor's considerable size, proximity to the airway, and the patient's advanced age, curative surgical intervention proved feasible. This case underscores that, with meticulous preoperative planning and careful surgical execution, age should not be a contraindication for surgery.
涎腺良性肿瘤是一组罕见且多样的肿瘤,其起源部位、组织学特征和生物学行为存在显著差异。本报告描述了一名93岁女性患者,其左侧颈部肿块明显增大。体格检查发现一个约32×30厘米的肿瘤,有坏死和溃疡区域。该肿瘤经先前活检诊断为多形性腺瘤(PA),在15年中逐渐生长,由于担心患者年龄和肿瘤大小,手术干预延迟。术前增强CT成像显示左侧颈部有一个大肿块,紧邻气道,但未移位或侵犯主要结构。采用择期手术方法,完整切除巨大PA,组织病理学评估证实。术后随访的第一个月,患者出现部分面神经麻痹,但未显示肿瘤复发迹象。尽管肿瘤体积巨大、紧邻气道且患者年龄较大,但根治性手术干预证明是可行的。该病例强调,通过精心的术前规划和仔细的手术操作,年龄不应成为手术的禁忌证。