Sebaceous lymphadenocarcinoma of the parotid gland: A case report

Abstract

Background: Sebaceous lymphadenoma is a benign tumor that occurs rarely in the salivary glands, most commonly in the parotid glands or periparotid lymph nodes, and even more rarely undergoes malignant transformation into a sebaceous lymphadenocarcinoma.

Case summary: We report an 82-year-old woman who presented with a painless mass in the right parotid region. We performed extended surgical resection of the parotid gland mass. Intraoperative pathology revealed a sebaceous lymphadenocarcinoma with metastasis into the periparotid cervical lymph nodes, so we also performed neck dissection and lymph node resection. Postoperative pathology confirmed the diagnosis. The literature review revealed that this was the seventh reported case of sebaceous lymphadenocarcinoma and the second reported case of cervical lymph node metastasis and infiltration of the skin of the parotid gland.

Conclusion: Treatment of sebaceous lymphadenocarcinoma depends on the typing and clinical staging of the cancer. Extensive resection is the first choice, and adjuvant radiotherapy should be given to patients with high-grade tumors or those at an advanced clinical stage.

Keywords: Case report; Metastasis; Parotid gland; Salivary glands; Sebaceous lymphadenocarcinoma; Sebaceous lymphadenoma.

Figure 1

Enhanced computed tomography and magnetic resonance imaging indicated a possible malignant tumor in the right parotid gland, with involvement of adjacent skin and potential lymph node metastases. A: An approximately 28 mm × 21 mm irregular mass shadow was seen at the lower pole of the right parotid gland; B: Unclear boundaries; C: Obviously inhomogeneous enhancement; D: Thickened and enhanced adjacent skin, and multiple lymph node shadows in the right parotid gland and the right II, V regions; E: A clinical photo that shows the pre-operative appearance of the tumor.

Figure 2

Gross pathology of 5 cm × 4 cm × 4 cm specimen of parotid tissue. A: Greyish-red, irregular parotid tissue, with a 3.5 cm × 1 cm segment of attached skin tissue; B: A 3 cm × 2 cm × 1.5 cm, grayish-yellow nodule.

Figure 3

Hematoxylin and eosin staining and microscopic examination revealed a large number of lymphocytes and tumor cells with nest-like and lamellar infiltrative growth. The tumor cells were rich in transparent to eosinophilic cytoplasm, with hyperchromatic nuclei and heterotypic and pathological nuclear division. A: × 100 magnification; B: × 200 magnification; C: × 400 magnification.