Massive Recurrent Parotid Carcinoma in a 90-Year-Old Patient: A Case Report and Review of Management Strategies

Carcinoma ex pleomorphic adenoma is a rare malignant salivary gland tumor arising from the malignant transformation of a pre-existing pleomorphic adenoma and is associated with significant diagnostic and therapeutic challenges. We report the case of a 90-year-old male with a long-standing history of recurrent pleomorphic adenoma of the parotid gland, who presented with a rapidly enlarging parotid mass associated with facial nerve involvement and parapharyngeal extension. Histopathological examination confirmed the diagnosis of epithelial-myoepithelial carcinoma ex pleomorphic adenoma. This case highlights the clinical presentation, radiological findings, and histopathological features of this uncommon malignancy and adds to the existing literature by emphasizing the diagnostic complexity and management considerations of carcinoma ex pleomorphic adenoma in elderly patients.