A giant sarcoma of the parotid gland: A case report and review of the literature

Case Report: Primary low-grade fibromyxoid sarcoma (LGFMS) is an extremely rare tumour of the salivary glands and arises from undifferentiated pluripotential mesenchymal cells. We report a case of a huge (17 x 11 x 10 cm) primary LGFMS of the parotid gland of a 57-year-old woman. Clinically, a 12 x 8 cm firm, non-tender, left parotid mass was observed, facial nerve function was not impaired and no enlarged lymph nodules were palpated on the neck. A contrast axial CT scan showed intense enhancement of the enlarged left parotid gland. The fine needle aspiration biopsy (FNAB) was compatible with sarcomatous tissue. The tumour was removed en bloc and the facial nerve was sacrificed; surgical margins were free from disease. Microscopically, the tumour consisted of fibrous and myxoid tissue with varying grades of cellularity and gradual transitions between the two. Post-operative radiotherapy was carried out on the left neck region and parotid tumour bed. Thirty-six months after surgery the patient presents good general conditions without any evidence of local or regional disease. Conclusion: The largest primary LGFMS of the parotid gland described in the literature is reported and a review of the literature on such neoplasms is also provided.