Surgical management of a giant parotid gland pleomorphic adenoma in Northern Sri Lanka: A case report.

INTRODUCTION: Pleomorphic adenoma is the most common benign tumour of the parotid gland. It is commonly observed in middle-aged women. Usually, pleomorphic adenomas are asymptomatic with a slow-progressing tendency. There is a substantial risk of malignant transformation if left untreated. Imaging modalities and fine needle aspiration cytology are highly valuable preoperative diagnostic tools and aid in selecting therapeutic interventions. Surgical technique is chosen based on clinical grounds. PRESENTATION OF CASE: A 48-year-old woman presented with a painless extensive mass in the left-sided face. A provisional diagnosis of the benign parotid tumour was made based on clinical evaluation. Imaging studies and cytological assessment suggested pleomorphic adenoma of the left parotid gland, and left-sided total parotidectomy with facial nerve dissection was performed. DISCUSSION: Pleomorphic adenoma involving the deep lobe of the parotid gland is rare. It typically grows slowly. If left untreated, it can present as a giant mass, as in our case. The extensive tumour mass can also involve adjacent structures, including facial nerve. Therefore, surgical dissection must be involved facial nerve and adjacent muscles. CONCLUSION: Surgical dissection of giant pleomorphic adenoma is challenging and often leads to significant deformities postoperatively. Early intervention will improve surgical outcomes and quality of life.

A case report: Female primary urethral carcinoma presenting as vulval mass.

INTRODUCTION: Primary urethral carcinoma is a rare disease with overall poorer outcomes in the past. It is relatively more uncommon in female sex. CLINICAL PRESENTATION: We present a case of a female with primary urethral carcinoma that presented atypically as a vulval mass without any features of storage, voiding lower urinary tract symptoms, or gross haematuria. DISCUSSION: As primary urethral carcinoma is rare in occurrence, prospective studies are limited so as the recommendations to guide treatment options. Treatment recommendations are still on development from different small-scale studies as well as from data in higher volume centers. Management options depends on location, extent, histology of the lesion as well as on sex of the patient and fitness of the patient. CONCLUSION: Early diagnosis and treatment with multidisciplinary consult and multimodality will improve the overall survival rate and quality of life of the patients.