Benign lymphoepithelial cysts of the parotid: long-term surgical results

Abstract

Benign lymphoepithelial cysts are a widely recognized cause of parotid gland swelling in patients infected with the human immunodeficiency virus (HIV). These cysts are pathognomonic for HIV. The cysts frequently grow to be exceptionally large, causing physical deformity and gross asymmetry of facial contour. This clinical commentary analyzes this cosmetically deforming disease entity and the many treatments that accompany it. The patient presented in this paper is a surgical case-control. The case is a microcosm for our findings upon review of the literature. Treatment options for benign lymphoepithelial cysts include repeated fine-needle aspiration and drainage, surgery, radiotherapy, sclerotherapy, and conservative therapy, with institution of highly active antiretroviral therapy medication. Based on this surgical case-control and our review of the literature, it is concluded that surgical intervention offers the best cosmetic result for these patients.

Keywords: benign lymphoepithelial cyst; cosmetic surgery; head and neck surgery; human immunodeficiency virus; parotid; parotidectomy.

Figure 1

Patient with HIV BLEC of the left parotid gland. Notes: Patient is status postsuperficial parotidectomy on the right side 6 years ago (complete resolution). Patient routinely wears multiple accessories daily to distract others from her obvious facial lesion (32-year-old patient, May 2010). Abbreviation: BLEC, benign lymphoepithelial cyst.

Figure 2

Patient 6 weeks postoperatively after left superficial parotidectomy. A similar result can be seen as compared to the right side. Facial contour and symmetry has been restored with excellent cosmetic outcome.