Mucoepidermoid carcinoma in the infratemporal fossa: A case report

BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy.It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa.Here,we present a case of aggressive mucoepidermoid carcinoma in the infratemporal fossa with neck lymph node metastasis and also discuss diagnostic and treatment strategies.CASE SUMMARY A 39-year-old woman with a mass located in the right submandibular area presented to our department.Physical examination revealed lymphadenopathy on the right submandibular side measuring 2.5 cm×3 cm that was hard and had poor mobility.Results of nasal endoscopy were unremarkable.Ultrasound examination revealed an enlarged lymph node at level II of the right side.Fine needle aspiration cytology of the metastatic lymph node revealed malignant cells with infection.Contrast-enhanced computed tomography revealed an enhancing ill-defined soft tissue mass in the right infratemporal region.Positron emission tomography/computed tomography revealed hyperintensity in the right infratemporal fossa along with lymphadenopathy at level II of the right-side lymph node.The patient underwent extended resection of the primary tumor,and ipsilateral radical neck dissection was also completed.Hematoxylin-eosin staining and immunohistochemistry revealed a high-grade mucoepidermoid carcinoma.No signs and symptoms of recurrence of the neoplasm were present after 20 mo of follow-up.CONCLUSION Positron emission tomography/computed tomography play a key role in primary tumor localization.Furthermore,histopathology and immunohistochemistry play pivotal roles in disease diagnosis.

SOME CLINICAL ASPECTS OF SURGICAL MANAGEMENT OF INFRATEMPORAL FOSSA MALIGNANCIES

Thirteen patients with infratemporal fossamalignancies treated in the Sichuan Cancer Hospitalfrom 1988 to 1993 are reported. All cases were treatedsurgically with combined therapy. The survival rate ofthe patients with survival period beyond 2 years was53.8o/o. The survival was associated with the extent ofdissection (P<0.01). The operation value, surgicalapproaches, resection range, stylohamular line and repairare analyzed and discussed. A new surgical approach, amodified stylohamular line and a new surgical conceptfor resection of the infratemporal fossa malignanciesbony boundary of surgery are introduced in detail.

Endoscopic trans-pterygoid resection of a low-grade cribriform cystadenocarcinoma of the infratemporal fossa

This article presents a case of low-grade cribriform cystadenocarcinomas(LGCCC),a rare salivary gland tumor manifesting in the infratemporal fossa(ITF).The lesion in this case is unique in its location,histopathology,and management in that the tumor resection was performed using an exclusively endoscopic,endonasal approach.This case highlights the expanding application of endoscopic skull base techniques to address an indolent,slow-growing malignancy of the ITF.

Three-hundred and sixty degrees of surgical approaches to the maxillary sinus

Objectives:To demonstrate three-hundred and sixty degrees of maxillary sinus(MS)surgical approaches using cadaveric dissections,highlighting the step-by-step anatomy of each procedure.Methods:Two latex-injected cadaveric specimens were utilized to perform surgical dissections to demonstrate different approaches to the MS.The procedures were documented with macroscopic images and endoscopic pictures.Results:Dissections were performed to approach the MS medially(endoscopic maxillary antrostomy and ethmoidectomy),anteriorly(Caldwell-Luc),superiorly(transconjunctival/transorbital approach),inferiorly(transpalatal approach),and posterolaterally(preauricular hemicoronal approach).Conclusion:A number of approaches have been described to address pathology in the MS.Surgeons should be familiar with indications,limitations,and surgical anatomy from different perspectives to approach the MS.This paper illustrates anatomic approaches to the MS with detailed step-by-step cadaveric dissections and case examples.