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Case Presentation. SKKU School of Medicine Otorhinolaryngology, Head and Neck Surgery 2007313075 Son Eui Young. Chief Complaint. M / 52 Right infraauricular mass Onset(remote) : 4YA. Present illness. 2009-04-27(3YA)

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Case presentation

Case Presentation

SKKU School of Medicine Otorhinolaryngology, Head and Neck Surgery

2007313075 Son Eui Young


Chief complaint

Chief Complaint

  • M / 52

  • Right infraauricular mass

    • Onset(remote) : 4YA

Page 2


Present illness

Present illness

  • 2009-04-27(3YA)

    • 약 1년전 우연히 발견한 right infraauricular mass로 size 증가하여 SMC ENT 외래로 내원. 진찰 상 크기 약 1cm

  • 2009-06-03

    • Salivary CT상 3cm의 mass 보임. FNAB에서 pleomorphic adenoma

    • 수술 예정이었으나 환자 원하여 delayed

Page 3


Present illness1

Present illness

  • 2012-02-08 (3MA)

    • 수술 위해 ENT 외래로 재내원함. P/Ex 상 hard, mobile, about 2cm mass

  • 2012-02-24

    • Superficial parotidectomy 예정, 수술 날짜 결정

  • 2012-05-07

    • 수술 위해 입원

Page 4


Other histories

Other Histories

  • Past Medical History

    • Hypertension (+) : 15YA, on medication

    • DM (-), Hepatitis (-), Tb(-), Alllergy(-), antibiotics allergy(-)

  • Social History

    • Alcohol (+), Smoking (+)

Page 5


Review of system

Review of System

  • General

    • General weakness (-), Fever(-)

  • Ear

    • Itching sense(-/+) (1MA)

Page 6


Physical exam

Physical Exam

  • General

    • General appearance : not so ill looking

    • Mental status : alert

  • Neck

Page 7


Imaging

Imaging

2.9 x 1.7 x 1.9 cm lobulating solid mass in the right parotid gland, aspiration.

US

Page 8


Fna guided biopsy

FNA guided Biopsy

Page 9


Imaging1

Imaging

Salivary gland CT

Page 10


Imaging2

Imaging

Salivary gland CT

Page 11


Imaging3

Imaging

Salivary gland CT

Page 12


Problem list

Problem List

#1. Right infraauricular mass

#2. Underlying Hypertension

Page 13


Assessment operation

Assessment & Operation

  • Right parotid gland mass

    • r/o pleomorphic adenoma

    • r/o Warthin’s tumor

  • Total parotidectomy with facial nerve preservation(Right)

    • Histopathologic type : pleomorphic adenoma

    • Tumor size : 3cm

    • Greater auricular n. :Ant. branch (saved)Post. branch (saved)

    • Facial n. : Zygomatic branch (saved)Temporal branch (saved)Buccal branch (saved)Marginal mandibular branch (saved)Cervical branch (saved)

    • Stenson's duct : ligated

Page 14


Hospital course

Hospital Course

  • POD #0

    • V/S stable, Pain tolerable

    • Wound clear, no immediate complication

    • family nurse practitioner (-)

Page 15


Disease review

Disease Review

Salivary gland tumor

2007313075 Son Eui Young


Case presentation

역학

Page 17


Case presentation

병리조직학적 분류

Page 18


Case presentation

임상양상

Page 19


Case presentation

진단

Page 20


Case presentation

병기

Page 21


Pleomorphic adenoma

다형선종 (Pleomorphic adenoma)

Page 22


Case presentation

치료원칙 & 예후

Page 23


Case presentation

이하선 절제술

Page 24


Reference

Reference

  • <이비인후과학, 두경부외과학> 개정판, 일조각

    • Vol II, Chapter 2, Chapter 7

Page 25


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