Accessory parotid gland tumors are relatively rare and the histopathological types vary. We report a 41-year-old woman with mucoepidermoid carcinoma that developed in the accessory parotid gland. Both CT and MRI demonstrated a solid and smooth 20-mm tumor lying on the masseter muscle, but it was not adjacent to the parotid gland. The tumor was surgically removed via the standard extended pre-auricular approach, and mucoepidermoid carcinoma low-grade malignancy was diagnosed by histopathology. The buccal branches of the facial nerve and the parotid duct were sacrificed in the secondary surgery. Multiple additional resections were performed because of multiple recurrence. In the 4th surgery, the defect was reconstructed using a free rectus abdominis musculocutaneous flap and intercostal nerve transplantation.
As the incidence of malignant tumors of the accessory parotid gland is higher than that of the parotid gland, the possibility of malignancy should be considered. The patient has remained free of recurrence during two years of follow-up.
