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Clinical Challenge | Pathology

A Lesion in the Parotid Gland QUIZ

Christopher A. Burgess, FRCS1; Neil M. Foden, MRCS1; Stuart C. Winter, FRCS1
[+] Author Affiliations
1Department of ENT Surgery, The John Radcliffe Hospital, Oxford, England
JAMA Otolaryngol Head Neck Surg. 2015;141(9):845-846. doi:10.1001/jamaoto.2015.1412.
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A woman with a history of localized invasive ductal carcinoma of the right breast treated with wide local excision 13 years previously presented with right-sided lower motor neuron facila nerve palsy and discomfort around her right ear. What is the diagnosis?

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A, Axial fast spoiled gradient echo gadolinium-enhanced magnetic resonance imaging (MRI) scan with fat suppression demonstrating lesion of the right parotid gland (arrowhead). B, Right parotid core biopsy specimen. C, Cells with hyperchromatic vesicular nuclei and moderate amounts of eosinophilic cytoplasm. D, Immunohistochemical (IHC) analysis for estrogen receptor.

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