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DISTANT METASTASIS - The Trigeminal Nerve

Now viewing: Case 9

Case 9 - Adenoid cystic carcinoma of left parotic gland with metastasis to facial nerve

Operative findings: there was a large necrotic tumor involving the deep lobe of the left partoid gland with involvement of the facial nerve. In the region of the stylomastoid foramen, the tumor mass was firmly around the main trunk of the facial nerve which could not be dissected off the facial nerve. Left radical partoidectomy was performed with sacrifice of the the facial nerve. Histopathology revealed adenoid cystic carcinoma of the left partoid gland and distorted carcinoma involving facial nerve. Tumor cells were present at the margins of resection, perineural invasion is also present.
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Axial post-contrast T1-weighted MR image (TR 500/TE 12) at the level of the external auditory canal: contrast enhanced soft tissue tumor mass in the left parotid and left infra temporal fossa (arrows). Sagittal, 45mm to the left, post-contrast T1-weighted MR image (TR 600/TE 11): slight contrast enhancement of the superior portion of the mastoid segment and the lateral portion of the tympanic segment of the facial nerve is well shown (arrows).

case_09a.gif (8511 bytes)

Axial post-contrast T1-weighted MR image (TR 600/TE 30) at the level of the cavernous sinus: the right gasserian ganglion is enlarged with high signal intensity
(arrow). The left gasserian ganglion is normal in appearance.

 

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