Giant Pleomorphic Adenoma in a 64-Year-Old Woman: A Case Report

Objective: To report a case of a giant pleomorphic adenoma in a 64-year-old Filipino woman, its management and surgical outcome. Methods:Design: Case ReportSetting: Tertiary Government Training HospitalPatient: One Results: A 64-year-old woman presented with a 50-year history of a slow growing, painless, left infra-auricular mass, not associated with facial weakness, xerostomia, or hearing loss. Computed tomography revealed a 14 x 15 x 19 cm large lobulated complex enhancing mass with calcifications and septations, with no enlarged lymph nodes identified in the neck. Fine needle aspiration cytomorphology was consistent with pleomorphic adenoma. The patient underwent superficial parotidectomy with facial nerve preservation. The facial nerve was identified usingstandard landmarks. Final histopathological findings were consistent with pleomorphic adenoma measuring 23.5 cm x 11.5 cm x 15 cm and weighing 2177 grams. Conclusion: Pleomorphic adenoma can grow to a gigantic size if left untreated. It often presents as a chronic, slow growing and painless swelling. The approach to its diagnosis is mainly clinical and can be confirmed by fine needle aspiration biopsy and computed tomography scan. In our case, the standard landmarks for facial nerve identification were still reliable despite the size of the mass, producing good post-surgical outcomes.