Mucoepidermoid carcinoma in the infratemporal fossa: A case report.

Background: Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy. It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa. Here, we present a case of aggressive mucoepidermoid carcinoma in the infratemporal fossa with neck lymph node metastasis and also discuss diagnostic and treatment strategies.

Case Summary: A 39-year-old woman with a mass located in the right submandibular area presented to our department. Physical examination revealed lymphadenopathy on the right submandibular side measuring 2.5 cm × 3 cm that was hard and had poor mobility. Results of nasal endoscopy were unremarkable. Ultrasound examination revealed an enlarged lymph node at level II of the right side. Fine needle aspiration cytology of the metastatic lymph node revealed malignant cells with infection. Contrast-enhanced computed tomography revealed an enhancing ill-defined soft tissue mass in the right infratemporal region. Positron emission tomography/computed tomography revealed hyperintensity in the right infratemporal fossa along with lymphadenopathy at level II of the right-side lymph node. The patient underwent extended resection of the primary tumor, and ipsilateral radical neck dissection was also completed. Hematoxylin-eosin staining and immunohistochemistry revealed a high-grade mucoepidermoid carcinoma. No signs and symptoms of recurrence of the neoplasm were present after 20 mo of follow-up.

Conclusion: Positron emission tomography/computed tomography play a key role in primary tumor localization. Furthermore, histopathology and immunohistochemistry play pivotal roles in disease diagnosis.