Reminder of an important clinical lesson: breast cancer metastasis to the parotid gland

BMJ Case Rep. 2019 Oct 8;12(10):e226494. doi: 10.1136/bcr-2018-226494.

Abstract

A 59-year-old woman presented to an otolaryngology clinic with an 8-week history of a painless lump over her left parotid gland. Her medical history included an invasive ductal carcinoma (33 mm) and a ductal carcinoma in situ (70 mm) of the right breast, for which she had a mastectomy and various adjuvant therapies. The primary tumour presented 8 years prior to the metachronous metastasis. This patient was a non-smoker and had no significant family history. Post-superficial parotidectomy pathology revealed the parotid gland tumour to be oestrogen receptor-positive and HER2 receptor-positive, thus ruling out the initial differential diagnosis of a pleomorphic adenoma. A consequential total parotidectomy with a posterolateral neck dissection was performed with sparing of the facial nerve. The patient recovered well having only encountered a self-resolving salivary fistula. She portrayed no signs of facial nerve palsy and subsequent imaging scans showed no abnormalities.

Keywords: Breast cancer; Cancer intervention; Ear, nose and throat/otolaryngology; Head and neck cancer.

Publication types

  • Case Reports

MeSH terms

  • Biopsy, Fine-Needle / methods
  • Breast Neoplasms / complications
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Breast Neoplasms / secondary*
  • Diagnosis, Differential
  • Female
  • Humans
  • Middle Aged
  • Parotid Gland / pathology*
  • Parotid Gland / surgery
  • Parotid Neoplasms / pathology
  • Parotid Neoplasms / secondary*
  • Parotid Neoplasms / surgery
  • Positron Emission Tomography Computed Tomography / methods
  • Receptor, ErbB-2 / metabolism
  • Treatment Outcome

Substances

  • ERBB2 protein, human
  • Receptor, ErbB-2