Recurrent lymphoepithelial cysts after parotidectomy in an undiagnosed HIV-positive patient

Abstract

A benign lymphoepithelial cyst (BLEC) is defined as a rare, benign lesion composed of single or multiple cysts found within salivary glands or the lateral cervical area. Increasing reports suggest an association between BLEC and human immunodeficiency virus (HIV), although its pathogenesis remains unclear. We report a 51-year-old male who presented with recurrent bilateral BLECs after initial parotidectomy of cyst. An HIV panel was then performed with a positive result. We review the surgical and medical managements of BLEC while also discussing further treatment recommendations. Clinicians should be aware that BLEC recurrence postparotidectomy may be the initial presenting symptom of HIV in a patient with no risk factors.

Figure 1

Maxillofacial Axial CT with contrast in the area of clinical interest demonstrating a 4 × 4.4 × 2 cm (AP, vertical transverse) well-circumscribed lesion in the right parotid superficial gland.

Figure 2

(a) Maxillofacial Axial CT with contrast showing multiple bilateral parotid gland lesions demonstrating internal enhancing septations with the largest lesion located in right parotid tail, measuring 1.9 x 2.1 cm and (b) associated PET CT scan showing bilateral hypermetabolic parotid lesions measuring up to a maximum standardized uptake value (SUV) of 10.0 on the left and 9.0 on the right.