Presentation, pp.11, 2013
Case presentation: A 67-year-old female referred to aspiration biopsy for her parotidal mass. There were two masses, one in the parotid measured 34.1 mm and the other adjacent to parotid measured 34.2 mm. Cytological findings of the parotidal mass revealed a cellular tumor displaying fibrochondroid matrix and epithelial/myoepithelial cells. In some areas pleomorphic cells highly suspicious for a malignant tumor were also detected. The second mass showed a lymphoid cell-rich background and sheets of malignant epithelial cells. Fine needle aspiration biopsy findings were found to be compatible with a pleomorphic adenoma ex carcinoma and the second mass was supposed to be a lymph node metastasis. Surgery was performed and pathological examination showed a pleomorphic adenoma ex salivary ductus carcinoma of the parotid gland with lymph node metastasis. Conclusion:Pleomorphic adenoma ex carcinomas are rare tumors comprising 10% of pleomorphic adenomas. High grade morphology, clinically rapid growth in the mass and facial paralysis should raise a suspicion of a secondary malignancy. Salivary ductus carcinoma (SDC) is a special type of high grade salivary gland carcinomas which mimics breast carcinoma and prostate carcinoma by morphology and immunohistochemistry, respectively. SDC is the second most seen malignancy following adenocarcinoma in a pre-existing pleomorphic adenoma. Our case is an example of a rare tumor with demonstrative cytologic findings.