Lipomatosis of the parotid gland in a child

Lipoma of Parotid Gland: Report of Two Cases

INTRODUCTION

Lipoma is a benign mesenchymal tumor originating from adipose tissue cells. In the head and neck, this tumor is not common. The occurrence of lipomas in the parotid gland is extremely rare, ranging between 0.6 and 4%.

CASE REPORTS

In this article, we present two clinical cases of lipomas of the superficial lobe of the parotid gland.

DISCUSSION

Clinical diagnosis of parotid gland lipomas is difficult, while usually, they are asymptomatic and presented as a painless swelling of the parotid gland. Tomographic imaging modalities are very accurate in preoperative diagnosis in contrast to FNA or FNAB which is not helpful in the case of lipoma. This pathological entity should be considered in the differential diagnosis of parotid gland's mass lesions. The usual indication for surgical intervention is cosmetic appearance. Meticulous surgical excision should be performed to avoid disturbing adverse events.

Surgical treatment of a giant lipoma in the parotid gland

Recently, a case of deep-lobe lipoma with enucleation was reported, but frozen-section biopsy for the confirmation of the malignancy was not done. It has been suggested that lipoma in the deeper tissues should be regarded as a well-differentiated liposarcoma and be treated with wide excision. Our experience is that of a 75-year-old woman who had a mass with fat density in the deep lobe of the right parotid gland, which extended through the parapharyngeal and the buccal spaces. Lumpectomy with frozen-section biopsy was performed, not only preserving branches of facial nerve but also ruling out the malignancy. Frozen-section biopsy showed a lipomatous lesion without malignancy, so further treatment such as total parotidectomy was not needed.

Sialolipoma of the parotid gland with diffuse sebaceous differentiation in a female child

Sialolipoma of the salivary gland is a tumor with ambiguous histogenesis. Histologically, this lesion is composed of mature adipose tissue and salivary glandular components. To the best of our knowledge, only 12 documented cases of sialolipoma have been reported in the literature. Except for 1 congenital case, all of the cases were found in adult patients. In this report, we present a unique case of sialolipoma with diffuse sebaceous differentiation in a 3-year-old female child. The differential diagnoses are discussed.

Congenital sialolipoma of the parotid gland first reported case and review of the literature

Tumours of the parotid gland in children are uncommon, and represent only 1.3% of all benign salivary tumours. Lipomas of the parotid are also rare, and account for 0.5% of all parotid gland tumours. Sialolipoma is a new variant of salivary gland lipoma, consisting of adipose and glandular tissue that was first proposed by Nagao et al. in 2001. Ten cases of parotid gland lipoma associated with glandular elements have been previously reported in the literature. All have been in adults and none in children. We present the first reported case of congenital sialolipoma that had developed in a female infant. It was managed successfully by superficial parotidectomy undertaken at ten weeks of age.