Primary Parotid Tumor Thrombosis: Immunohistologic Features and Awareness of Metastatic Potential.

Antonio Dekhou, Oakland University William Beaumont School of Medicine Medical Student
Rafey Rehman, Oakland University William Beaumont School of Medicine Medical Student
Jacob S. Parzen, Beaumont Health Resident
Thomas J Quinn, Beaumont Health
Ping L. Zhang, Beaumont Health
Matthew Rontal, Beaumont Health
Samir Noujaim, Beaumont Health
Martin Tapia, Beaumont Health
Rohan Deraniyagala, Beaumont Health


Tumor thrombosis is a poor prognostic feature and an exceptionally rare occurrence in salivary gland malignancies. We present a case of primary parotid myoepithelial carcinoma (MC) with tumor thrombosis in the external jugular vein (EJV). An 82-year-old man presented with a right-sided facial mass. MRI with and without gadolinium demonstrated a mass of the right parotid gland with a filling defect of the right EJV. The patient underwent right parotidectomy and selective neck dissection. Tumor thrombosis was found intraoperatively within the EJV. Final pathology demonstrated a poorly differentiated MC. Adjuvant radiation therapy without concurrent systemic therapy was administered. Three months later, restaging positron emission tomography (PET) with CT revealed numerous bilateral pulmonary nodules with biopsy, demonstrating poorly differentiated MC without locoregional relapse. Given that primary parotid tumor thrombosis is associated with a poor prognosis, the use of early systemic therapy should be investigated.