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Actinomycosis of the parotid masquerading as malignant neoplasm.

Varghese BT, Sebastian P, Ramachandran K, Pandey M - BMC Cancer (2004)

Bottom Line: We present here a case of primary actinomycosis of the parotid gland presenting with a parotid mass lesion with erosion of skull bones.Clinical presentation of cervico-facial actinomycosis is characterized by the presence of a suppurative or indurative mass with discharging sinuses.The lesion demonstrates characteristic features on fine needle aspiration cytology and histology, however at times the findings are equivocal.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical Oncology, Regional Cancer Centre, Trivandrum 695011, Kerala, India. geenu@eth.net

ABSTRACT

Background: Primary actinomycosis of the parotid gland is of rare occurrence and can mimic a malignant neoplasm both clinically as well as radiologically.

Case presentation: We present here a case of primary actinomycosis of the parotid gland presenting with a parotid mass lesion with erosion of skull bones.

Conclusions: Clinical presentation of cervico-facial actinomycosis is characterized by the presence of a suppurative or indurative mass with discharging sinuses. The lesion demonstrates characteristic features on fine needle aspiration cytology and histology, however at times the findings are equivocal.

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Clinical photograph of the patient at initial presentation showing the parotid swelling.
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Figure 1: Clinical photograph of the patient at initial presentation showing the parotid swelling.

Mentions: A 38-year-old man presented with a 5 × 4 cm rapidly progressive, firm swelling in the left parotid region with discharging sinuses on the overlying skin. The swelling was not painful and its size did not change with meals. There was no history of fever, malaise, cough, breathlessness, haemoptysis, trauma, surgery, recent tooth extraction, or dental infection. There was no history suggestive of Hansen's disease or sexual contact. He was not diabetic or immunocompromised. The swelling was confined to the parotid region (Fig 1, 2) rest of the face including submandibular region appeared normal. A 1.5 × 1.5 cm firm jugulodiagastric lymph node was palpable in the neck. Oral cavity, oropharynx, and indirect laryngoscopic examinations were normal. Mouth opening was adequate and there was no facial nerve palsy. Routine investigations including blood counts, erythrocyte sedimentation rate and chest X-ray were normal. ELISA test for HIV antibody was negative. The computerized tomographic (CT) scan showed a large parotid swelling extending to the base of skull with involvement of the skull bone (Figure 3). The mass lesion was seen extending into the parapharangeal space with thinning of the lateral wall of the maxilla on the left side (figure 4). The picture was suggestive of malignant neoplasm of the parotid gland.


Actinomycosis of the parotid masquerading as malignant neoplasm.

Varghese BT, Sebastian P, Ramachandran K, Pandey M - BMC Cancer (2004)

Clinical photograph of the patient at initial presentation showing the parotid swelling.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC375533&req=5

Figure 1: Clinical photograph of the patient at initial presentation showing the parotid swelling.
Mentions: A 38-year-old man presented with a 5 × 4 cm rapidly progressive, firm swelling in the left parotid region with discharging sinuses on the overlying skin. The swelling was not painful and its size did not change with meals. There was no history of fever, malaise, cough, breathlessness, haemoptysis, trauma, surgery, recent tooth extraction, or dental infection. There was no history suggestive of Hansen's disease or sexual contact. He was not diabetic or immunocompromised. The swelling was confined to the parotid region (Fig 1, 2) rest of the face including submandibular region appeared normal. A 1.5 × 1.5 cm firm jugulodiagastric lymph node was palpable in the neck. Oral cavity, oropharynx, and indirect laryngoscopic examinations were normal. Mouth opening was adequate and there was no facial nerve palsy. Routine investigations including blood counts, erythrocyte sedimentation rate and chest X-ray were normal. ELISA test for HIV antibody was negative. The computerized tomographic (CT) scan showed a large parotid swelling extending to the base of skull with involvement of the skull bone (Figure 3). The mass lesion was seen extending into the parapharangeal space with thinning of the lateral wall of the maxilla on the left side (figure 4). The picture was suggestive of malignant neoplasm of the parotid gland.

Bottom Line: We present here a case of primary actinomycosis of the parotid gland presenting with a parotid mass lesion with erosion of skull bones.Clinical presentation of cervico-facial actinomycosis is characterized by the presence of a suppurative or indurative mass with discharging sinuses.The lesion demonstrates characteristic features on fine needle aspiration cytology and histology, however at times the findings are equivocal.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical Oncology, Regional Cancer Centre, Trivandrum 695011, Kerala, India. geenu@eth.net

ABSTRACT

Background: Primary actinomycosis of the parotid gland is of rare occurrence and can mimic a malignant neoplasm both clinically as well as radiologically.

Case presentation: We present here a case of primary actinomycosis of the parotid gland presenting with a parotid mass lesion with erosion of skull bones.

Conclusions: Clinical presentation of cervico-facial actinomycosis is characterized by the presence of a suppurative or indurative mass with discharging sinuses. The lesion demonstrates characteristic features on fine needle aspiration cytology and histology, however at times the findings are equivocal.

Show MeSH
Related in: MedlinePlus