CASE REPORT
Radical Total Parotidectomy for Locally Advanced Parotid Cancer
Radical Total Parotidectomy for Locally Advanced Parotid Cancer
Curative resection of a locally advanced low-grade mucoepidermoid carcinoma of the right parotid gland in a 90-year-old patient, with immediate flap reconstruction.
Patient Age
90 Years
Tumor Dimensions
7.5 × 6.5 × 6 cm
Mucoepidermoid carcinoma
Low-grade
Distant metastasis
None
Clinical history
A 90-year-old male presented with a progressively enlarging swelling of the right parotid gland. Clinical examination revealed a massive right parotid tumor with overlying skin involvement, infiltration of the masseter muscle, and suspected involvement of the facial nerve, raising concern for a high risk of local progression. Core needle biopsy was consistent with a low-grade mucoepidermoid carcinoma. Positron Emission Tomography–Computed Tomography (PET-CT) fused with Magnetic Resonance Imaging (MRI) demonstrated a 7.5 × 6.5 × 6 cm metabolically active cystic-solid mass in the right parotid gland, extending into the periparotid soft tissues and adherent to the masseter muscle, with no evidence of distant metastasis.
Despite advanced age, comprehensive fitness assessment confirmed the patient was a suitable candidate for definitive surgical treatment.
Complete resection of the right parotid gland, including the tumor and involved surrounding structures, to achieve oncologic clearance.
Regional lymph node clearance performed to address locoregional disease control.
Immediate soft-tissue reconstruction using a pedicled Pectoralis Major Myocutaneous (PMMC) flap, completing complete oncologic resection with restoration of soft-tissue coverage.
Outcome
The patient had an uneventful postoperative recovery and was discharged in stable condition; final histopathology is awaited to guide adjuvant treatment planning.
