ABSTRACT
Pilomatricoma is a benign skin tumor originating from the matrix cells of the hair follicles. Sometimes, its diagnosis can be difficult, especially in the preauricular region, where in the differential diagnosis, in addition to other dermal and subcutaneous masses, primary and secondary parotid gland tumor lesions must be also considered. A 34-year-old female was referred to our Institution with a right preauricular swelling over 12 months, which enlarged in the last two months. The ultrasonography confirms the origin of the tumoral mass in the skin of the preauricular region and not from the superficial lobe of the right parotid gland. The patient underwent complete tumor excision and the histopathology and immunohistochemical exams confirmed the diagnosis of a conventional pilomatricoma evolving to a late regressive lesion. She was discharged considered as cured and no recurrences were reported within a period of eight months of follow-up. This is the first reported case in the last 30 years, in this location, in the Department of Oral and Maxillofacial Surgery our Institution. Regarding the rarity of these tumors, especially in this location, we must keep in mind to consider a broader differential diagnosis that includes both tumoral and non-tumoral skin lesion and also parotid gland lesions.
Subject(s)
Parotid Region/abnormalities , Pilomatrixoma/diagnosis , Adult , Female , Humans , Immunohistochemistry , Parotid Region/pathology , Pilomatrixoma/pathologyABSTRACT
OBJECTIVE: The aim of this study was to primarily investigate the usefulness of computerized tomographic (CT) fistulography in the diagnosis and management of branchial cleft fistulae and sinuses. STUDY DESIGN: Fifteen patients with confirmed branchial fistulae or sinuses who had undergone CT fistulography were included. The diagnoses were confirmed by clinical, radiologic, or histopathologic examinations. The internal openings, distribution, and neighboring relationship of the lesions presented by CT fistulography were analyzed to evaluate the usefulness in comparison with x-ray fistulography. RESULTS: Nine patients were diagnosed with first branchial fistulae or sinuses, 2 with second branchial fistulae, and 4 with third or fourth branchial fistulae. The presence and location of the lesions could be seen on x-ray fistulography. The distribution of the lesions, internal openings, and neighboring relationship with parotid gland, carotid sheath, and submandibular gland could be clearly demonstrated on CT cross-sectional or volume-rendering images. CONCLUSIONS: CT fistulography could provide valuable information and benefit surgical planning by demonstrating the courses of branchial anomalies in detail.
Subject(s)
Branchial Region/abnormalities , Branchial Region/diagnostic imaging , Craniofacial Abnormalities/diagnostic imaging , Fistula/congenital , Fistula/diagnostic imaging , Multidetector Computed Tomography , Pharyngeal Diseases/diagnostic imaging , Adolescent , Child, Preschool , Cutaneous Fistula/congenital , Cutaneous Fistula/diagnostic imaging , Female , Humans , Male , Middle Aged , Neck Muscles/abnormalities , Neck Muscles/diagnostic imaging , Parotid Region/abnormalities , Parotid Region/diagnostic imaging , Pharyngeal Diseases/congenital , Young AdultABSTRACT
The parotid is the largest salivary gland in humans producing an essentially serous secretion, which normally reaches the oral cavity through a sole duct (the parotid duct) after the latter making its way through the buccinator muscle to reach the mucosa lining the mouth at the level of the cheek. The present study reports on a rare case of double parotid duct found during the dissection the right side of the face of a cadaver of a 46-year-old male individual. The superior (Dl) and inferior (D2) ducts were 26.49 mm and 37.25 mm long, respectively. Based on the diameter of both ducts (Dl and D2) taken in the posterior (3.05 mm and 2.84 mm, respectively) and mid (2.84 mm and 2.68 mm, respectively) thirds, as well as on the histological findings, both ducts were considered to be main parotid ducts. These two ducts merged at the level of the anterior third forming one sole opening into the oral cavity. The data hereby reported are relevant to the various clinical and surgical procedures involving the parotid gland.
La parótida es la glándula salival más grande presente en el hombre y su producto de secreción, básicamente seroso, es normalmente dirigido hasta la cavidad oral, a través de un único canal parotídeo que, luego de perforar el músculo buccinador, desemboca en la mucosa de la mejilla. Este trabajo muestra un caso raro de doble canal parotídeo hallado durante la diseccción de un cadáver de sexo masculino, de 46 años de edad, en el lado derecho del rostro. Los canales superior (DI) e inferior (D2), presentaron una longitud de 26,49 mm y 37,25 mm, respectivamente. En base a los diámetros presentados por los canales en los tercios posterior (DI 3,05mm; D2 2,84 mm) y medio (DI 2,84mm; D2 2,68 mm) y de acuerdo con los hallazgos histológicos, ambos fueron considerados principales. En el tercio más anterior los canales se fusionaron, presentando una única apertura en la cavidad oral. Las informaciones presentadas en este documento son relevantes para diferentes procedimientos clínicos y quirúrgicos que tengan relación con la glándula parótida.
