Sebaceous adenoma of the parotid gland in a 2-year-old male.

Sebaceous adenomas of the major salivary glands are uncommon tumors. Although sebaceous differentiation within the major salivary glands is a frequent histopathologic finding (approximately 20% to 42% of parotid glands), sebaceous neoplasms of salivary gland origin are not. A number of publications review the clinical and histologic features of sebaceous neoplasms, however, these reports focus on adult patients. The finding of these tumors in a pediatric patient is exceedingly rare. We present a case of a sebaceous adenoma of the parotid in a 2-year-old male. Our patient is a 2-year-old full-term healthy male who was referred to the University of Maryland Department of Otorhinolaryngology with a 1-year history of a progressively enlarging painless left-sided neck mass. An MRI (Fig 1) revealed a mildly to moderately enhancing heterogenous mass that measured 4.7 3.0 5.2 cm in the vicinity of the left parotid gland. There was no associated lymphadenopathy. Before the referral, he had undergone an open biopsy that was interpreted as a dermoid tumor. Our review of the biopsy specimen favored the diagnosis of a sebaceous neoplasm. Physical examination revealed an otherwise healthy appearing Asian-American male. He had a 5-cm nontender mass in the location of the left parotid gland. The overlying skin was normal in appearance with the exception of the previous biopsy scar. There was no facial nerve weakness on examination. A clinical diagnosis of a sebaceous neoplasm was made, and the patient underwent a left total parotidectomy with facial nerve preservation. An encapsulated mass that occupied the superficial and deep lobes of the parotid gland was identified and removed with preservation of the facial nerve.