Facial paralysis caused by a lymphoepithelial cyst located in the parotid gland

Abstract

We report the case of an acute onset facial paralysis which was caused by a benign lymphoepithelial cyst found in the parotid, an association which is a rarity in the literature. The diagnosis and surgical management is discussed. This report emphasises the clinical principle that parotid masses causing an acute facial palsy are not necessarily malignant in nature. Intra-operative frozen section histology is helpful in saving the patient from unnecessarily radical surgery.

Facial nerve palsy due to a parotid abscess: Two case reports and a review of literature

“…Therefore, a malignancy should be ruled out in patients with a parotid mass and facial nerve dysfunction. There are, however, several case reports in the literature that have described benign lesions such as pleomorphic adenoma [17] , (cystic) Warthin tumors [18] , [19] , (lympho)epithelial cysts [20] , [21] , epidermoid cysts [22] , keratocystomas [23] , oncocytomas [24] and intraparotid facial nerve schwannomas [25] to cause peripheral facial nerve palsy.…”

Reversible facial nerve palsy due to parotid abscess

“…Palsy of the extratemporal part of the facial nerve, as opposed to the intracranial part, is a very rare clinical manifestation in inflammatory processes and in benign lesions and in these cases a malignant process must always be excluded. However as early as 1969, there are reports of benign lesions causing facial nerve palsy; benign mixed tumors, lymphoepithelial cysts, 3 adenolymphomas, 4 epidermoid and epithelial cysts, 5 inflammatory pseudotumour 6 are implicated in the literature. Suppuration and abscess formation in the parotid are also benign extremely rare causes of facial nerve palsy and very few cases have been reported.…”