Atypical localisation of pleomorphic adenoma issue from heterotopic salivary tissue in the supraclavicular region: diagnosis and management

Abstract

Heterotopic salivary tissue (HST) is a normal salivary tissue located outsides the major and minor salivary glands. Multiple sites of localisation of heterotopias have been described, the occurrence of HST in the neck is rare and it may have several clinical manifestation. We report the case of 72-year-old Caucasian man presenting a suspect mass on the left-sided supraclavicular region. He is known for melanoma of the right elbow, surgically treated 11 years ago. The final diagnosis of pleomorphic adenoma of HST was retained. Methods of diagnosis and management are documented. Neoplasms arising from HST are uncommon with approximately 80% of benign tumours. Warthin's tumour is the most frequent. The localisation of these neoplasms in the lower neck is very rare and often causes a diagnostic pitfall. Histological analysis provides certainty of diagnosis, defines management and follow-up.

Keywords: ear; nose and throat; oncology; radiology (diagnostics).

Figure 1

(A) Cytological slide shows a discohesive of myoepithelial cells. (B) Cytological slide shows cluster of oncocyte cells. (C) Cytological slide shows cluster of atypical epithelial cells. (D) PET-CT axial view shows a metabolic hyperactivity of the supraclavicular mass on the left side. (E) PET-CT axial view shows a metabolic hyperactivity on both palatine tonsils on favour the right side.

Figure 2

(A) Macroscopic slide of the supraclavicular mass shows an elastic nodule. (B) Macroscopic slide of the supraclavicular mass shows a lymph node with. Basophilic and acidophilic cells. (C) Microscopic slide of the supraclavicular mass shows grouping of epithelial and myoepithelial cells with chondromyxoid stroma. (D) Microscopic slide of the supraclavicular mass cluster of oncocyte cells.