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[Pseudotumor in the parotid region].
H B Olin1, K Pedersen, H Hansen
1H:S Rigshospitalet, øre-, naese- og halsklinikken.
Ugeskrift for Laeger
|October 4, 2000
Summary
Tophaceous pseudogout, a rare condition, can mimic tumors in the head and neck. This case highlights calcium pyrophosphate dihydrate crystal deposition mimicking a parotid tumor.
Area of Science:
- Rheumatology
- Pathology
- Oncology
Background:
- Tophaceous pseudogout is a rare manifestation of calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.
- Head and neck region involvement is common, accounting for half of reported cases.
- Accurate diagnosis can be challenging due to its varied presentations.
Observation:
- A patient presented with a parotid mass initially suspected to be malignant based on imaging and cytology.
- Surgical exploration revealed a tumor extending to the skull base.
- Histological analysis showed inflammatory cells, macrophages, metaplastic chondroid cells, and foreign-body giant cells.
Findings:
- Histopathology confirmed the presence of inflammatory infiltrates and cellular changes consistent with crystal deposition.
- X-ray diffraction identified two crystalline forms of calcium pyrophosphate dihydrate (CPPD).
- The parotid mass was diagnosed as tophaceous pseudogout rather than a malignancy.
Implications:
- This case underscores the importance of considering rare crystal deposition diseases in the differential diagnosis of head and neck masses.
- Radiological and cytological findings can be misleading, necessitating thorough histological and crystallographic examination.
- Early and accurate diagnosis of tophaceous pseudogout is crucial to avoid unnecessary aggressive treatment for suspected malignancies.