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A forgotten facial nerve tumour: granular cell tumour of the parotid and its implications for treatment

Published online by Cambridge University Press:  25 November 2010

B Lerut
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Luzern, Switzerland
J Vosbeck
Affiliation:
Institute of Pathology, Kantonsspital Luzern, Switzerland
T E Linder*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Luzern, Switzerland
*
Address for correspondence: Prof Dr Thomas E Linder, Chairman, Dept of Otorhinolaryngology, Head & Neck Surgery, Kantonsspital Luzern, Spitalstrasse, 6000 Luzern, Switzerland Fax: 0041 41 205 49 95 E-mail: thomas.linder@ksl.ch

Abstract

We present a rare case of a facial nerve granular cell tumour in the right parotid gland, in a 10-year-old boy. A parotid or neurogenic tumour was suspected, based on magnetic resonance imaging. Intra-operatively, strong adhesions to surrounding structures were found, and a midfacial nerve branch had to be sacrificed for complete tumour removal. Recent reports verify that granular cell tumours arise from Schwann cells of peripheral nerve branches. The rarity of this tumour within the parotid gland, its origin from peripheral nerves, its sometimes misleading imaging characteristics, and its rare presentation with facial weakness and pain all have considerable implications on the surgical strategy and pre-operative counselling. Fine needle aspiration cytology may confirm the neurogenic origin of this lesion. When resecting the tumour, the surgeon must anticipate strong adherence to the facial nerve and be prepared to graft, or sacrifice, certain branches of this nerve.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2010

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