An extremely rare case of giant oncocytic adenolipoma of the
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A 46 year old man, with complaints of huge neck mass in the right side, almost occupying the whole of the right neck from levels 2, 3, 4, and 5. He gave a history of swelling, which was gradually progressive and painless for more than 18 years. However recently, for the past 2 years, the size of the swelling had increased progressively than before. With the fear of cancer, the patient somehow managed to visit the hospital.

On examination, the mass was well defined, multilobulated with a size of approximately 15 × 11 cm at the right side of neck, superiorly up to the level of ear lobule, inferiorly 4 cm above the clavicle, medially up to midline and posterolaterally occupying half of posterior triangle. The overlying skin was free, with no pain or tenderness on palpation, and the mass was firm in consistency, mobile, and multilobulated with a well defined border. CT scan was done, which reported as a huge lobulated mass measuring 15 × 10 × 6.5 cm in the right side of the neck and face. Radiologically, the mass contained enhancing solid areas on the periphery, which was supplied by large vessels and had fat components medially. The CT reported lesion to be suggestive of the fat containing soft tissue tumor as angiolipoma with a differential of liposarcoma.

The surgery was performed under general anesthesia. The vertical incision was given on the right side over the swelling. The subplatysmal flap was elevated. The capsule of the mass was dissected from all around the margin superiorly and inferiorly. The dissection was carried on securing the hemostasis. There were no findings suggestive of malignancy such as adhesions, friability of tissues, or invasion of surrounding tissues. Medially, the tissue was abutting the lower pole of the superficial lobe of the parotid gland. The tumor was seen arising from the part of the superficial lobe of the parotid gland. The mass was excised in toto and sent for histopathological examination. The drain was kept, and the surgical site was sutured. The final diagnosis of oncocytic adenolipoma of parotid gland origin was made.

Source:https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3151?af=R
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