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A 53-year-old woman presented with a posterior left retroauricular mass, that was discovered 10 months ago and resected respectively at a local hospital.
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Ten days after this operation, a pruritic, painless lesion of a size 2 cm x 2 cm was observed at the incision area.
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The patient had no history of migraine, loss of hearing, drug allergy, or trauma.
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Otoscope examination revealed an external auditory meatus protrusion, with a normal tympanic membrane.
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Magnetic resonance imaging (MRI) revealed a heterogeneous lesion.
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The patient underwent extended left parotidectomy.
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An s-incision of 10 cm long was made extending from the earlobe towards the mandibular angle.
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With palpation, the tumour was located in the parotid gland.
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The superficial lobe of the parotid gland was gradually removed with caution to the facial nerve trunk.
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The tumour had invaded the deep lobe of the parotid gland and the posterior wall of the external auditory canal.
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The deep lobe of the parotid gland was removed simultaneously, and the left cervical lymph node dissection was performed in levels II-IV, with its adipose connective tissue.
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The diameter of the larger lymph node being 2 cm.
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A method of sleeve resection was used to remove the protruding posterior wall of the external auditory canal.
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A drainage tube was inserted.
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There was no complication, the operation was completed and the patient recovered well.
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The pathological results showed that the tumour of about 2 cm x 2 cm x 1.4 cm, involved the epidermis, vessels, and nerves.
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There was a distribution of the lymph node with metastasis and distribution of the external auditory canal with mucoepidermoid carcinoma.
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Immunohistochemistry results showed CK7 (+), calponin (-), CK5/6 (+), P63 (+), S-100 (-), Dog-1 (+), CD117 (-), Ki-67 (+5%), P53 (-), and EMA (+).
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Hematoxylin and eosin (H&E) staining indicated a D-PAS positive.
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The clinical diagnosis was pleomorphic adenoma.
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