A De Novo Malignant Mixed Tumor (Carcinosarcoma) of the Parotid Gland: Case Report

Abstract

True malignant mixed tumors (carcinosarcomas) of salivary gland origin are exceedingly rare and demonstrate malignant epithelial and stromal components. The subject of this case study is a 61 year-old male who presented with mild left facial swelling with minimal discomfort and without a mass of the parotid gland. He underwent CT imaging which demonstrated a cystic lesion of the parapharyngeal space. CT guided fine needle aspiration of the lesion failed to demonstrate malignancy. The patient ultimately underwent two surgical procedures to fully excise the cancer. Histological and immunological evaluation revealed a carcinosarcoma. Carcinosarcoma (true malignant mixed tumor) of the parotid gland is an extremely uncommon tumor composed of both carcinomatous and sarcomatous elements coexisting together. An understanding of this manifestation is crucial to the management and treatment of this disease. Review of the literature supports combined modality of surgery with postoperative radiation as standard of care for this malignancy although the long-term prognosis for these patients is unclear.