Читать книгу Salivary Gland Pathology - Группа авторов - Страница 111

With a preoperative clinical diagnosis of synchronous, multicentric bilateral Warthin tumors, the patient underwent staged superficial parotidectomies beginning with the larger tumors in the left parotid gland. With a modified Blair incision (Figure 2.85h), the patient underwent left superficial parotidectomy that began with the identification of the parotid capsule (Figure 2.85i). The main trunk of the facial nerve was identified and preserved with superficial elevation of the specimen (Figure 2.85j). The specimen was delivered (Figure 2.85k and l). Two Warthin tumors were later diagnosed in the specimen on permanent sections (Figure 2.85m). The resultant tissue bed and facial nerve dissection is appreciated (Figure 2.85n). At five months following left superficial parotidectomy, the patient was prepared for right superficial parotidectomy (Figure 2.85o–q). His facial nerve was intact bilaterally. He underwent repeat CT scanning (Figure 2.85g) that demonstrated one tumor in the superficial lobe of the right parotid gland (Figure 2.85r–t) that was larger than that noted on the initial CT scan obtained five months earlier. He underwent right superficial parotidectomy with identification and preservation of the facial nerve (Figure 2.85u–x). Final pathology confirmed the presence of one Warthin tumor (Figure 2.85y). The patient's postoperative course was unremarkable and he sustained no morbidity with either surgical procedure.