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Abstract : |
Lipomas are the most commonly encountered benign mesenchymal tumors, arising in any location where fat is normally present. Their occurence in the head and neck area is relatively rare (25% of lipomas). Lipomatous lesions accounted for only 0.6-4.4% of all parotid tumors and, therefore, are often not considered in the initial differential diagnosis of a parotid mass. 14 cases of lipomatous tumors of the parotid glands (1.5% of all parotid tumors) have been diagnosed and treated in our department during 15 year-period (1992-2006); six were focal lesions and eight were diffuse lipomatosis. The most common presentation was that of a slowing enlarging, soft and painless mass. Clinical examination alone is insufficient to identify the nature and location of parotid lipomas. Ultrasonography, high-resolution CT scanning, magnetic resonance imaging (MRI) and fine needle aspiration biopsy (FNAB) may be helpful in diagnosis. None of these preoperative examinations allows an absolute reliable distinction between a lipoma and a liposarcoma. All patients were treated by surgical excision. Superficial parotidectomy was the treatment of choice and no recurrence was detected in 3 years (mean period) of follow-up. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus, knowledge of the anatomy and meticulous surgical technique are essential. The postoperative aesthetic and functional results were the major concerns. The complete surgical excision will minimize the possibility of a recurrence and will also lead to a definitive diagnosis., |