Primary salivary gland neuroendocrine carcinoma with multidisciplinary insights

Primary large cell neuroendocrine carcinoma (LCNEC) of the parotid gland is exceedingly rare, with fewer than 30 cases reported. This case report documents a 68-year-old male with primary parotid LCNEC diagnosed by positron emission tomography-computed tomography, immunohistochemical profiling and imaging that revealed two hypermetabolic nodules confined to the parotid gland without distant metastasis. Histopathology confirmed a high-grade neuroendocrine carcinoma with Ki-67 index >40%. The patient underwent total parotidectomy with immediate facial nerve grafting followed by adjuvant chemoradiotherapy. No recurrence or metastasis was observed at 4-month follow-up. This case illustrates the approach to diagnosis and multidisciplinary management of this rare entity.