Primary Lymphoepithelial Carcinoma of Parotid Gland: Inadequate Preoperative Assessment Resulting in Extensive Surgery

Parotid lymphoepithelial carcinoma is extremely rare, and makes up only 0.4% of cases among the anaplastic variant salivary gland carcinoma. We present a 63-year-old man who had progressive enlarging right neck swelling for one year. He sought treatment in another centre underwent superficial parotidectomy, following an ultrasound assessment mass that was suggestive benign parotid tumour. There no fine needle aspiration cytology or other radiological imaging performed prior to surgery. However, surgeon encountered difficulty intraoperatively abandoned The incisional biopsy tumour reported as then presented us with progression residual malignant CT MRI showed locally aggressive infiltrated subcutaneous tissue, external auditory canal, facial nerve, multiple ipsilateral metastatic cervical lymph nodes. Subsequently, patient total parotidectomy nerve resection, lateral temporal bone resection modified radical dissection. surgical site defect reconstructed anterolateral thigh myocutaneous free flap. Concurrent static reanimation fascia lata sling performed. received adjuvant chemoradiation extent local infiltration by resulting surgery could have been reduced if properly assessed excised at initial stage. A complete preoperative essential avoid misdiagnosis, unexpected intraoperative finding delay definitive treatment.