A Rare Presentation of Carcinosarcoma in a Long Standing Parotid Mass

A Rare Presentation of Carcinosarcoma in a Long Standing Parotid Mass

Introduction: Parotid tumours represent one of common tumours seen in the field of Otorrhinolaryngology. Common benign tumours include pleomorphic adenoma and warthins tumour while most common malignant parotid gland tumour is mucoepidermoid carcinoma. This case, however, highlights a rare parotid tumour in a long standing parotid mass.

Objective: To present a rare case of parotid carcinosarcoma ex pleomorphic adenoma.

Clinical Report: A 35 year old Malay gentleman with no prior medical illness first presented on 22nd October 2013 with history of left parotid swelling for more than 10 years in which he had not seeked treatment before. He was compelled to seek treatment after a drastic increase in size within 2 weeks prior to swelling. Patient has been an active smoker past 20 years. Examination revealed a large, lobulated left parotid mass measuring 10 cm x 9 cm x 8 cm which was hard, not tender and fixed to overlying skin. There were no palpable neck nodes and facial nerve was intact. Fine needle aspiration cytology revealed mucoepidermoid carcinoma ex pleomorphic adenoma. He underwent tracheostomy, left extended total parotidectomy, left supraomohyoid neck dissection with soft tissue reconstruction with free fasciocutaneous anterolateral thigh (ALT) flap on 11th March 2014. Histopathological examination of the parotid mass revealed carcinosarcoma ex pleomorphic adenoma.

Conclusion: This case report highlights a rare malignant transformation of a long standing parotid mass to form carcinosarcoma of the parotid gland.