Sebaceous adenoma of the parotid gland encasing the facial nerve: Case report and review of the literature

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Abstract

Background

Sebaceous adenoma of the salivary glands are uncommon benign neoplasms, comprising about 0.1 % of salivary tumors. These tumors can be difficult to recognize with heterogeneous appearance on imaging.

Case report

A 67-year-old man presented with a painless, progressively growing left parotid mass. Imaging showed a heterogenous, partially cystic mass in the superficial and deep lobes of the parotid with some areas of adipose density. Intraoperatively, a mass with sebaceous differentiation was found to be encasing the main trunk and pes anserinus of the facial nerve, requiring nerve sacrifice for en bloc resection. Final pathology revealed a sebaceous adenoma with intense xanthomatous reaction compressing the facial nerve.

Conclusion

Although benign and associated with little risk of recurrence, sebaceous adenomas may be difficult to recognize on preoperative workup and may be locally aggressive. Complete surgical resection is the mainstay of therapy, but rehabilitation may be required in the event of facial nerve involvement.
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包裹面神经的腮腺皮脂腺瘤:病例报告和文献综述
背景唾液腺的浆液性腺瘤是一种不常见的良性肿瘤,约占唾液腺肿瘤的 0.1%。病例报告一名 67 岁的男子因无痛性、逐渐增大的左侧腮腺肿块就诊。影像学检查显示,腮腺浅叶和深叶有异质、部分囊性肿块,部分区域有脂肪密度。术中发现,一个皮脂腺分化的肿块包裹着面神经主干和鞍上神经,需要牺牲神经进行全切。最后的病理结果显示,皮脂腺瘤伴有强烈的黄瘤反应,压迫了面神经。结论皮脂腺瘤虽然是良性肿瘤,复发风险很小,但术前检查可能难以识别,而且可能具有局部侵袭性。完全手术切除是治疗的主要方法,但如果累及面神经,可能需要进行康复治疗。
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