An Unusual Case of an Extra-salivary Subcutaneous Multifocal Pleomorphic Salivary Adenoma

A 36-year-old woman was referred to the Oral and Maxillofacial Surgery clinic at Pinderfields Hospital, Wakefield, with multiple subcutaneous swellings on the right side of the face, overlying the parotid region and extending below the mandibular border. Magnetic resonance imaging (MRI) revealed several macrocystic subcutaneous lesions, and ultrasound-guided fine-needle aspiration confirmed a diagnosis of pleomorphic salivary adenoma (PSA). The lesions were excised via a modified Blair incision and were found to be superficial to the parotid capsule. Histopathological evaluation showed myxoid-rich PSAs without any associated salivary gland tissue, confirming an extrasalivary origin. This case illustrates a rare presentation of multifocal, subcutaneous PSAs occurring independently of the parotid gland. The patient remains disease-free and continues under routine surveillance for potential recurrence.