Abstract
A 46-year-old woman was referred to our hospital on September 19, 2001, with a chief complaint of swelling of the left parotid gland. She first noticed the lesion 3 years prior to this visit. She had a medical history of hyperthyroidism. Laboratory examination data revealed that her TSH was 0.05μU/ml; 1.3ng/ml for T3; 4.30pg/ml for FT3; 10.5μg/dl for T4 and 2.11ng/dl for FT4, indicating that her thyroid function is well controlled with propylthiouracil (Thiuragyl®).
Clinical examination revealed a 40×45mm painless swelling in the left parotid gland. Magnetic resonance imaging (MRI) revealed that the tumor was of low intensity in the T1-weighted image, and of high intensity in the T2-weighted image. Clinical diagnosis of parotid tumor was established. On October 18, 2001, superficial parotidectomy was performed under general anesthesia, in order to resect the tumor with an adequate surgical margin and to manage the patient under a stress free-condition. Her blood pressure was controlled at 85-95/45-55mmHg, with a heart rate of 60-80/min during the operation. Methimazole (Mercazole®) (30mg) was infused intravenously. The post-operative course was uneventful without any symptom of thyrotoxic storm. There was no evidence of recurrence at 2 years and 10 months postoperatively. Histopathologically, the tumor demonstrated a reticular growth pattern; and the tumor cells were polygonal to relatively short spindle-like in shape with uniform appearing oval to round nuclei. Diagnosis of ‘myoepithelioma reticular variant’ was established pathologically.
