A Rare Parotid Tumor Successfully Removed at Kailash Hospital Noida

Tumors of the parotid gland can vary widely in nature, ranging from benign swellings to rare malignant conditions requiring highly specialized surgical management. Early evaluation and accurate diagnosis are crucial, especially in uncommon tumors where imaging and pathology play a defining role in treatment planning.

At Kailash Hospital, a 60-year-old female patient with a long-standing parotid swelling was successfully treated under the expert care of Dr. Manish Sahni. Consultant Surgical Oncologist. The case later turned out to be an exceptionally rare diagnosis of Clear Cell Oncocytoma of the Parotid Gland.

Presentation of Symptoms (if any)

The patient presented with:

• Slowly progressive swelling over the left parotid region 
• Gradual increase in size over the last four years 
• No major neurological symptoms or facial weakness initially 

Due to the persistent increase in size, further evaluation was advised to rule out malignancy.

Diagnosis

A detailed clinical and radiological workup was performed.

MRI Findings

MRI of the face revealed:

• A heterogeneous solid-cystic mass measuring approximately 4 × 4 cm 
• Located in the superficial lobe of the left parotid gland 
• Associated with a few small left level 1 and level 2 cervical lymph nodes 

FNAC Findings

Ultrasound-guided FNAC from the swelling showed:

• Suspicion of malignancy: Based on these findings, surgical management was planned.

Condition Overview

The parotid gland is the largest salivary gland, and tumors arising from it can often mimic one another clinically and radiologically.

What made this case particularly rare and clinically significant was the final diagnosis of Clear Cell Oncocytoma, an extremely uncommon tumor of the parotid gland. Such tumors are rarely encountered in routine surgical oncology practice and often require:

• Advanced histopathological evaluation 
• Immunohistochemistry (IHC) for confirmation 
• Careful differentiation from other malignant clear cell tumors 

Accurate diagnosis is essential because treatment approach and long-term prognosis depend heavily on precise pathological classification.

Treatment Plan

After detailed counseling and preoperative optimization, the patient underwent surgery under general anesthesia.

1. Left Superficial Parotidectomy

• Complete removal of the superficial lobe tumor was performed 
• Special attention was given to preserving the facial nerve, which runs through the parotid gland 

2. Frozen Section Examination

• Intraoperative frozen section analysis suggested a low-grade malignancy 

3. Selective Neck Dissection

• Due to suspicious neck nodes, a left selective neck dissection was also performed to ensure complete oncological clearance 

4. Histopathology & Immunohistochemistry

Final pathological examination combined with Immunohistochemistry confirmed the diagnosis of:

• Clear Cell Oncocytoma of the Parotid Gland: This advanced pathological analysis was crucial in reaching the precise diagnosis.

Outcome and Follow-Up

The patient had an excellent postoperative recovery.

Most importantly:

• She developed no facial paresis or facial palsy, which is one of the major concerns in parotid surgeries 
• Recovery remained smooth and uneventful 
• She was discharged on Post-Operative Day 4 in stable condition 

The successful preservation of facial nerve function and accurate diagnosis made this case particularly rewarding from both surgical and oncological perspectives.

Conclusion

This case highlights the importance of:

• Early evaluation of long-standing parotid swellings 
• Advanced imaging and FNAC in suspicious lesions 
• Expert surgical management with facial nerve preservation 
• The critical role of Histopathology and Immunohistochemistry in diagnosing rare tumors 

The successful management of this rare Clear Cell Oncocytoma underlines the expertise available at Kailash Hospital in handling complex and uncommon oncological cases.

Under the skilled care of Dr. Manish Sahni, Surgical Oncologist at Kailash Hospital, Noida, the patient received timely diagnosis, precise surgery, and an excellent functional outcome—demonstrating how multidisciplinary cancer care can successfully manage even the rarest tumors.