Introduction: Breast cancer metastasis at the parotid gland is uncommon. There were only 21 cases reported until the recent year, and none of them came from Indonesia. The reports showed that breast cancer metastasis is more often found at the liver, lung, bone, and brain. Therefore, any masses found on the parotid are usually considered as a double primer.Case Presentation: We report a case of a woman, firstly diagnosed with luminal A stage IIA breast cancer at 39 years old. The patient had undergone breast-conserving therapy (BCT), followed by adjuvant hormonal therapy before being diagnosed with bone metastasis four years later. She also complained about a painful mass on her left upper neck. Ultrasonography and CT-scan resulted in insignificant abnormality. After a year with increasing painful mass, we performed FNAB. The result showed metastatic adenocarcinoma with a suspicious breast cancer origin. We did total parotidectomy with facial nerve preservation to alleviate the pain. Pathology results showed a confirmed diagnosis of breast cancer metastasis. The patient was given radiotherapy as local control and was scheduled to receive chemotherapy as systemic therapy.Conclusions: Parotid mass with a clinical symptom in the patient with the history of breast cancer should be evaluated firstly by imaging and may be followed by cytology or pathology evaluation to confirm whether it is primary or secondary malignancy. If the parotid metastasis from breast cancer is confirmed, we should consider adding systemic therapy after completing the local control.
Epithelioid hemangioma is a rare benign vascular tumor manifested as slow-growing subcutaneous or dermal nodules. A previously therapeutic strategy involved surgical excision and sclerotherapy. However, no standard treatment has been established. Here, we reported an atypical case of epithelioid hemangioma that had a locally aggressive behavior and was successfully treated with everolimus, a rapamycin analog used for cancer therapy. A 1-year-old boy presented with an ulcerated lump in the left palmar region. The imaging test results, confirmed through histopathologic examination, suggested a diagnosis of epithelioid hemangioma. Targeted therapy with everolimus was administered orally because of a minimal response to initial transarterial sclerotherapy. The patient achieved a satisfactory response with a significantly reduced lesion size and improved hand function after a 2-year follow-up. This finding showed that patients with locally aggressive forms of epithelioid hemangioma may significantly benefit from everolimus as a potential targeted therapy.
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