Mucoepidermoid Carcinoma of the Parotid Gland Presenting as a Fungating Exophytic Mass: A Surgical Challenge Rooted in Extensive Nerve Encasement

Abstract

Parotid glands, which are predominantly composed of serous acini, are the largest salivary glands in the human body. Mucoepidermoid carcinoma (MEC) of the parotid gland is the most common parotid tumour that routinely presents as a painless, fixed mass below the ears. However, its presentation as a fungating mass remains exceedingly rare. Due to the intimate anatomical relationship between the parotid gland and the facial nerve, parotid malignancies can culminate in facial nerve palsy, posing an onerous surgical challenge. In this paper, we chronicle the case of a male who presented with a fungating/exophytic mass and facial nerve weakness. A superficial parotidectomy was performed, and the eventual histopathological workup divulged an advanced mucoepidermoid parotid carcinoma entirely encasing the marginal mandibular nerve. Consequently, the marginal mandibular nerve was sacrificed, alluding to the remarkable surgical challenge encountered. Clinically, this manifested as an impairment of the motor function in the patient's left lower lip.

Metastatic mucoepidermoid carcinoma to the pleura: a case report

“…It frequently affects the parotid gland, followed by the submandibular, sublingual, and minor salivary glands [3]. It can also arise from the nasal cavity, bronchial wall, lungs, and pleura [3][4][5][6].…”

“…MECs are composed of mucinous, epidermoid, and intermediate cells in various degrees in an admixed solid and cystic architecture [6,7]. High-grade mucoepidermoid carcinoma comprises solid sheets of epidermoid and clear cells with necrosis, nuclear pleomorphism, increased mitotic activity, and, rarely, focal keratinization [8,9].…”