Case Presentation SKKU School of Medicine Otorhinolaryngology, Head and Neck Surgery 2007313075 Son Eui Young 1

Chief Complaint M / 52 Right infraauricular mass Onset(remote) : 4YA 환자분 71세 남자로 40년전부터 생긴 왼쪽에 생긴 비폐색을 주소로 내원하였습니다. Page  2

Present illness 2009-04-27(3YA) 2009-06-03 약 1년전 우연히 발견한 right infraauricular mass로 size 증가하여 SMC ENT 외래로 내원. 진찰 상 크기 약 1cm 2009-06-03 Salivary CT상 3cm의 mass 보임. FNAB에서 pleomorphic adenoma 수술 예정이었으나 환자 원하여 delayed Page  3

Present illness 2012-02-08 (3MA) 2012-02-24 2012-05-07 수술 위해 ENT 외래로 재내원함. P/Ex 상 hard, mobile, about 2cm mass 2012-02-24 Superficial parotidectomy 예정, 수술 날짜 결정 2012-05-07 수술 위해 입원 Page  4

Other Histories Past Medical History Social History Hypertension (+) : 15YA, on medication DM (-), Hepatitis (-), Tb(-), Alllergy(-), antibiotics allergy(-) Social History Alcohol (+), Smoking (+) Page  5

Review of System General Ear General weakness (-), Fever(-) Itching sense(-/+) (1MA) PND : postnasal drip Sneezing 재채기 Itching 가려움 Autophonia 자성강청, 내 목소리가 크게 들리는거 Page  6

Physical Exam General Neck General appearance : not so ill looking Mental status : alert Neck Page  7

Imaging 2.9 x 1.7 x 1.9 cm lobulating solid mass in the right parotid gland, aspiration. US 2.9 x 1.7 x 1.9 cm lobulating solid mass in the right parotid gland, aspiration. Page  8

FNA guided Biopsy 2.9 x 1.7 x 1.9 cm lobulating solid mass in the right parotid gland, aspiration. Page  9

Imaging Salivary gland CT Page  10

Imaging Salivary gland CT Page  11

Imaging Salivary gland CT Page  12

Problem List #1. Right infraauricular mass #2. Underlying Hypertension Page  13

Assessment & Operation Right parotid gland mass r/o pleomorphic adenoma r/o Warthin’s tumor Total parotidectomy with facial nerve preservation(Right) Histopathologic type : pleomorphic adenoma Tumor size : 3cm Greater auricular n. : Ant. branch (saved) Post. branch (saved) Facial n. : Zygomatic branch (saved) Temporal branch (saved) Buccal branch (saved) Marginal mandibular branch (saved) Cervical branch (saved) Stenson's duct : ligated Page  14

Hospital Course POD #0 V/S stable, Pain tolerable Wound clear, no immediate complication family nurse practitioner (-) Page  15

Salivary gland tumor 2007313075 Son Eui Young Disease Review Salivary gland tumor 2007313075 Son Eui Young 16

역학 Page  17

병리조직학적 분류 Page  18

임상양상 Page  19

진단 Page  20

병기 Page  21

다형선종 (Pleomorphic adenoma) Page  22

치료원칙 & 예후 Page  23

이하선 절제술 Page  24

Reference <이비인후과학, 두경부외과학> 개정판, 일조각 Vol II, Chapter 2, Chapter 7 Page  25