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Case Example  Parotid Lipoma-like Liposarcoma

Return to:Parotidectomy with Facial Nerve Dissection

see also: Case example neck apocrine cystadenoma presenting clinically similar to lipoma

Parotid Mass

Preop CT:  Well circumscribed fatty dense lesion in the left parotid gland.
This could represent lipomatous tumor such as lipoma.

Preop MRI: Left parotid lipomatous tumor, containing small enhancing lesion
with differential of vascular structure versus solid lesion. Repeat
ultrasound to further define the possible vasculature is recommended.

Initial resection:

      Atypical lipomatous neoplasm, favor well differentiated, lipoma-like
        liposarcoma, 2.3 cm in greatest dimension, abutting the lateral
        surgical resection margin.

Comment: This lipomatous tumor shows nuclear pleomorphism and irregularity, and
given the sub-fascial location, the tumor is best interpreted as
lipoma-like liposarcoma.  This low-grade tumor may have a small risk of
local reoccurrence given the close lateral margin. Spindle cell lipoma was
also a consideration, however the CD34 stain is negative.

Second resection 7 days later:

    no residual neoplasm, all margins clear.






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