Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2023; 11(18): 4438-4445
Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4438
Removal of unexpected schwannoma with superficial parotidectomy using modified-Blair incision and superficial musculoaponeurotic system folding: A case report
Ha-Jong Nam, Hwan Jun Choi, Je-Yeon Byeon, Syeo-Young Wee
Ha-Jong Nam, Syeo-Young Wee, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Gumi-si 39371, Gyeonsangbuk-do, South Korea
Hwan Jun Choi, Je-Yeon Byeon, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Cheonan-si 31151, Chungcheongnam-do, South Korea
Author contributions: Nam HJ contributed to manuscript writing, visualization, and data collection; Byeon JY contributed to conceptualization and methodology; Choi HJ contributed to project administration; Wee SY contributed to manuscript review, editing, and supervision; all authors have read and approved the final manuscript.
Supported by Soonchunhyang Research Fund, No. 2023-0030.
Informed consent statement: The patient provided written informed consent for the publication and use of her images.
Conflict-of-interest statement: No potential conflict of interest relevant to this article was reported.
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: Syeo-Young Wee, MD, PhD, Doctor, Professor, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, 1 Gongdan-ro 179, Gumi-si 39371, Gyeonsangbuk-do, South Korea. 94061@schmc.ac.kr
Received: April 15, 2023
Peer-review started: April 15, 2023
First decision: April 28, 2023
Revised: May 8, 2023
Accepted: May 23, 2023
Article in press: May 23, 2023
Published online: June 26, 2023
Abstract
BACKGROUND

When a firm facial mass in the cheek region is associated with a high index of clinical suspicion of its being of parotid gland origin, preventive parotidectomy is invariably performed. We report a rare case of a schwannoma that was suspected to be of parotid gland origin in a patient, who underwent successful surgical management using a modified-Blair incision and superficial musculoaponeurotic system (SMAS) layer folding method.

CASE SUMMARY

A 27-year-old woman presented to the hospital for evaluation of a firm, fixed, non-tender mass (2.5 cm × 3.5 cm), located anterior to the right ear, of 1 year’s duration. Contrast-enhanced facial computed tomography revealed a well-encapsulated, low-density mass adherent to the superficial lobe of the right parotid gland, with a high index of clinical suspicion of an accessory parotid gland mass. The patient was scheduled to undergo resection of the mass and superficial parotidectomy. She underwent surgery using a modified-Blair incision, and the SMAS layer was folded posteriorly to reconstruct the defect. Histopathological examination confirmed the diagnosis of a schwannoma., and we observed no postoperative complications such as hematoma, infection, or abnormal facial expressions. The incision scar was unnoticeable 2 mo postoperatively, and the facial contour was maintained without any differences between the affected and unaffected sides.

CONCLUSION

We used a modified-Blair incision and SMAS layer folding method to achieve aesthetically good results following resection of a rare schwannoma with superficial parotidectomy in the cheek region.

Keywords: Schwannoma, Parotid gland, Superficial musculoaponeurotic system, Case report

Core Tip: Schwannoma in the face region is a rare type of tumor that originates from the Schwann cells of ectodermal origin. It can develop in any cranial nerve but rarely originates from peripheral nerves. Masses in the cheek region are usually suspected to be of parotid gland origin, and preventive parotidectomy is usually performed. In our case, the mass was initially diagnosed as arising from the parotid gland, but was finally confirmed to be a schwannoma. Therefore, we should keep in mind the possibility of schwannoma, although rare.