Rogalska Marta, Scierski Pawel, Gamrot-Wrzol Marta, Misiolek Maciej, Scierski Wojciech
Department of Otorhinolaryngology and Oncological Laryngology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Marii Curie-Sklodowskiej 10, 41-800, Zabrze, Poland.
Student Scientific Circle at the Department of Otorhinolaryngology and Oncological Laryngology, Medical University of Silesia in Katowice, Zabrze, Poland.
J Med Case Rep. 2025 Aug 11;19(1):401. doi: 10.1186/s13256-025-05472-z.
Most malignant melanomas occurring in the parotid gland are presumed to be of metastatic origin from cutaneous, sporadically mucosal, or ocular primary sites in the head and neck region. We present an unusual case of a patient with a history of conjunctival malignant melanoma and subsequent metastasis to the parotid gland.
A 39-year-old East Slavic male patient presented with a 6-month history of a gradually enlarging, painless swelling of the left preauricular area. The clinical examination disclosed a firm, hardly movable mass over the central part of the left parotid gland with no overlying skin changes. Fine-needle aspiration biopsy revealed a cytological image of a nonepithelial malignant tumor. Collecting a thorough past medical history unveiled that the patient underwent the surgical excision of the ipsilateral conjunctival nevus a few years earlier, with subsequent lesion recurrence and transformation into conjunctival malignant melanoma, treated with a wide local excision and an oral mucosa transplant. No signs of local melanoma recurrence or distant metastases were observed at the time of presentation. Left-sided total parotidectomy with the subsequent ipsilateral neck dissection was performed. Histopathological examination revealed melanoma metastasis to the intraparotid lymph node without extranodal extension. The patient was then qualified for adjuvant immunotherapy and remained disease-free at the 8-month follow-up.
In the case of a suspected malignancy within the parotid gland, exhaustive medical history taking and analysis of the patient's previous photographs might direct to the malignant melanoma diagnosis. The high potential for regional and distant metastasis in individuals with conjunctival malignant melanoma underscores the significance of ongoing research to enhance the understanding of its biological behavior and develop a standardized algorithm for its management and surveillance.
大多数发生在腮腺的恶性黑色素瘤被认为是由头颈部皮肤、偶发的黏膜或眼部原发部位转移而来。我们报告一例罕见病例，患者有结膜恶性黑色素瘤病史，随后发生腮腺转移。
一名39岁的东斯拉夫男性患者，左耳前区逐渐肿大、无痛性肿物已有6个月病史。临床检查发现左侧腮腺中部有一个质地坚硬、活动度差的肿块，其上皮肤无改变。细针穿刺活检显示为非上皮性恶性肿瘤的细胞学图像。详细询问既往病史发现，患者几年前曾接受同侧结膜痣手术切除，随后病变复发并转变为结膜恶性黑色素瘤，接受了广泛局部切除和口腔黏膜移植治疗。就诊时未观察到局部黑色素瘤复发或远处转移迹象。遂行左侧全腮腺切除术及同侧颈部淋巴结清扫术。组织病理学检查显示黑色素瘤转移至腮腺内淋巴结，无淋巴结外浸润。患者随后接受辅助免疫治疗，8个月随访时无疾病复发。
对于腮腺内疑似恶性肿瘤的病例，详尽的病史采集和对患者既往照片的分析可能有助于诊断恶性黑色素瘤。结膜恶性黑色素瘤患者发生区域和远处转移的可能性很高，这凸显了持续研究以加深对其生物学行为的理解并制定标准化管理和监测算法的重要性。
