Malignant Peripheral Nerve Sheath Tumor Presenting as a Chronic Parotid Gland Mass: A Case Report

Malignant peripheral nerve sheath tumors (MPNSTs) affecting the parotid gland represent only about 2.8% of all head and neck MPNSTs. We present this rare parotid tumor to contribute to published data, raise awareness of its clinical presentation and to improve surgical management. A 22-year-old male presented with a 10-year history of gradual right-sided hemifacial weakness, later developing a mass at the right preauricular area. Preoperative ultrasound showed a right parotid hypovascular mass exhibiting heterogenous echopattern and microcalcifications. A multidisciplinary team of surgeons from surgical oncology and plastic surgery performed total parotidectomy followed by a minimal access cranial suspension lift and supra brow lift to address the right sided facial drooping. Histopathology revealed a solid cluster of pleomorphic spindle cells which stained positive for S-100 and vimentin consistent with MPNST. There was improvement of the facial asymmetry and he did not undergo radiotherapy.