Parotid Cystadenoma Presenting as Recurrent Parotitis: A Five-Case Retrospective Series and Preliminary Clinicopathological Features
摘要
Parotid cystadenoma is an uncommon benign epithelial salivary gland neoplasm. Rarely, it may present with recurrent inflammatory episodes, creating diagnostic uncertainty and operative complexity. To the authors’ knowledge, this represents the largest reported case series specifically focused on histologically confirmed parotid cystadenoma presenting with recurrent parotitis. This case series describes five such patients and outlines preliminary clinicopathological features that may support recognition of this presentation, while acknowledging the exploratory nature of the observations.
MethodsWe performed a retrospective descriptive case series from a specialist parotid surgical practice. Five consecutive patients managed by the primary author with histologically confirmed parotid cystadenoma and a clinical history of recurrent parotitis were included. Clinical presentation, imaging, tissue sampling, operative findings, histopathology, facial nerve status and 12-month follow-up were reviewed from clinical records. No formal diagnostic criteria were developed or validated.
ResultsAll patients had unilateral cystic parotid lesions with recurrent inflammatory symptoms. Imaging demonstrated benign-appearing cystic lesions, varying from well-circumscribed superficial-lobe cysts to multiloculated lesions extending into the deep lobe. Preoperative core biopsy was non-diagnostic in all cases, usually yielding cyst fluid, inflammatory debris or degenerate cells. Surgical excision established the diagnosis in each patient. Histology confirmed cystadenoma, predominantly oncocytic; intraluminal crystalloids were identified in two cases, both associated with suppurative or inflammatory change. No patient had preoperative facial nerve dysfunction. At 12-month follow-up, no recurrence or persistent postoperative facial nerve deficit was recorded in any case.
ConclusionParotid cystadenoma should be included in the differential diagnosis of recurrent parotitis associated with a cystic parotid lesion, particularly when tissue sampling is inconclusive. The proposed clinicopathological features are preliminary observations from a small retrospective series and require validation in larger cohorts before use as diagnostic criteria.