A neglected giant parotid gland mass: excision and reconstruction with facial nerve preservation

Carcinoma ex pleomorphic adenoma (CXPA) is a malignant transformed variant of pleomorphic adenoma (PA). Generally it presents with a rapidly growing mass in the parotid gland within a preexisting PA or following surgical resection of PA. Mainstream treatment modality is surgical resection followed by radiotherapy if necessary. Facial nerve preservation and complete resection of the tumor are the main principles of the operation. Giant malignant derivates are not seen frequently and constitute a challenging task for surgeons to achieve the main principles of resection. Prognosis of CXPA is poor and aggressive treatment should be performed immediately after the diagnosis. We present a 82-year-old woman with a giant malignant parotid gland mass who was successfully treated with surgery without any facial nerve injury.