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Case Reports
. 2021 Jan-Jun;11(1):152-155.
doi: 10.4103/ams.ams_121_13. Epub 2021 Apr 15.

Hematological Paraneoplastic Syndrome and Heparin-Induced Thrombocytopenia in Untreated Parotid Acinic Cell Carcinoma - A Case Report

Suthaharan Ragulan  1 , Tom Walker  2 , Prince Modayil  1 , Babatunde Odutoye  1 , Michael Lee  1
Affiliations
Case Reports

Hematological Paraneoplastic Syndrome and Heparin-Induced Thrombocytopenia in Untreated Parotid Acinic Cell Carcinoma - A Case Report

Suthaharan Ragulan et al. Ann Maxillofac Surg. 2021 Jan-Jun.

Abstract

Rationale: Acinic cell carcinoma (ACC) is a rare and indolent malignancy commonly found in the parotid gland. This can give rise to paraneoplastic syndromes, which represent the clinical manifestations of indirect and remote events produced by tumour metabolites.

Patient concerns: A 38-year-old Afro-Caribbean female suffered an indolent parotid mass. She only presented to our tertiary center when it started to ulcerate and bleed.

Diagnosis: She was diagnosed with advanced parotid ACC. She also went on to develop an hematological paraneoplastic syndrome resulting in venous thrombi. This was complicated by her developing heparin-induced thrombocytopenia (HIT).

Treatment: A difficult multidisciplinary decision was made to proceed with surgery despite her extremely poor condition.

Outcomes: After the surgery, the patient made a full recovery.

Take-away lessons: ACC is a relatively uncommon and indolent malignancy that is usually found in the parotid gland. It can be associated with a hematological paraneoplastic syndrome and further complicated by iatrogenic HIT.

Keywords: Heparin-induced thrombocytopenia; malignancy; parotid; thrombosis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Massive fungating parotid tumor
Figure 2
Figure 2
Right transverse sinus thrombosis (arrow showing the absence of contrast)
Figure 3
Figure 3
Postoperative photograph taken 8 months later
See this image and copyright information in PMC

References

    1. Sood S, McGurk M, Vaz F. Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016;130:S142–9. - PMC - PubMed
    1. Spiro RH, Huvos AG, Strong EW. Acinic cell carcinoma of salivary origin. A clinicopathologic study of 67 cases. Cancer. 1978;41:924–35. - PubMed
    1. Al-Zaher N, Obeid A, Al-Salam S, Al-Kayyali BS. Acinic cell carcinoma of the salivary glands: A literature review. Hematol Oncol Stem Cell Ther. 2009;2:259–64. - PubMed
    1. Falanga A, Schieppati F, Russo L. Pathophysiology 1. Mechanisms of Thrombosis in Cancer Patients. In: Soff G, editor. Thrombosis and Hemostasis in Cancer. Cham: Springer International Publishing; 2019. [Last accessed on 2020 Sep 02]. pp. 11–36. Cancer Treatment and Research. Available from: https://doi.org/10.1007/978-3-030-20315-3_2 . - PubMed
    1. Jones AS. Stell and Maran's Head and Neck Surgery, 4th ed. Br J Surg. 2002;89:250.

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