Stankevicius D, Petroska D, Zaleckas L, Kutanovaite O. Hybrid intercalated duct lesion of the parotid: A case report. World J Clin Cases 2022; 10(33): 12358-12364 [PMID: 36483828 DOI: 10.12998/wjcc.v10.i33.12358]
Corresponding Author of This Article
Dominykas Stankevicius, MD, Surgeon, Centre of Oral and Maxillofacial Surgery, Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio g. 117, Vilnius LT-08217, Lithuania. dominykas.st@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dominykas Stankevicius, Linas Zaleckas, Centre of Oral and Maxillofacial Surgery, Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius LT-08217, Lithuania
Donatas Petroska, Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
Otilija Kutanovaite, Department of Head and Neck Surgery and Oncology, National Cancer Institute, Vilnius LT-08660, Lithuania
Author contributions: Kutanovaite O performed the surgery, took the photographs, and revised the manuscript; Stankevicius D collected the available literature and wrote the manuscript; Petroska D performed the microscopic examination and wrote the histopathological part; Zaleckas L performed the ultrasound guided biopsy and critically revised the manuscript; All authors contributed to the discussion and approved final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dominykas Stankevicius, MD, Surgeon, Centre of Oral and Maxillofacial Surgery, Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio g. 117, Vilnius LT-08217, Lithuania. dominykas.st@gmail.com
Received: August 8, 2022 Peer-review started: August 8, 2022 First decision: September 5, 2022 Revised: September 10, 2022 Accepted: October 11, 2022 Article in press: October 11, 2022 Published online: November 26, 2022
Abstract
BACKGROUND
Intercalated duct lesions (IDLs) are considered relatively benign and rare tumors of salivary glands, that were only described recently. Their histopathological appearance may range from ductal hyperplasia to encapsulated adenoma with hybrid patterns of both variants. It is thought that IDLs may be the precursor for malignant proliferations, therefore their correct diagnosis remains crucial for proper lesion management. It is the first reported IDL case arising from the accessory parotid gland (APG), which stands for less frequent but higher malignancy rate tumor developmental area.
CASE SUMMARY
A 24-years-old male with no accompanying diseases was referred to the hospital with a painless nodule on the right cheek. On physical examination, the stiff, immobile, and painless mass was palpable in the anterior portion of the right parotideomasseteric region, just superior to the parotid duct. Ultrasound examination demonstrated 1.5 cm × 1.0 cm hypoechogenic mass on the anterior part of the right parotid gland. Ultrasound-guided fine needle aspiration cytology, followed by liquid-based fine needle aspiration biopsy were performed. However, the results were uninformative. A contrast-enhanced magnetic resonance imaging (MRI) of the parotid was obtained, demonstrating a 1.5 cm × 1.0 cm × 0.5 cm tumor with high intensity capsule together with low intensity core in the very anterior part of right superficial lobe, situated in the APG. An MRI features were uncharacteristic to common parotid tumors, therefore surgical resection followed up. After histopathological examination, the final diagnosis of hybrid IDL was confirmed.
CONCLUSION
Fine needle aspiration biopsy might not always be diagnostic, and given the malignant potential, the surgical resection of such lesion remains the treatment of choice.
Core Tip: In this article we present a clinical case of a patient diagnosed with a hybrid intercalated duct lesion (IDL) tumor of the accessory parotid gland. It is the first reported IDL case arising from such location, which stands for less frequent but higher malignancy rate tumor developmental area. We also discuss potential diagnostic pitfalls associated with unusual growth site, describe the further treatment choice, and review the available literature.
