Introduction Mucoepidermoid carcinoma (MEK) is one of the most common malignant tumours of the
salivary glands. The age peak is between 30 and 50 years of age. MEK in childhood
and adolescence is rare.
Method A 13-year-old patient with a suspected malignant tumor of the right parotid gland
presented to the Department of Otorhinolaryngology at the Unfallkrankenhaus Berlin.
Approximately 6 months previously, the mass had been detected in an MRI scan for a
Chiari malformation and was described as 26x24x28 mm in size. Under sonographic control,
the mass had progressed in size over the following months and antibiotic therapy was
sine effectu. A laterofacial parotidectomy was performed. Intraoperatively, an infiltrative
growing tumor was found. Postoperatively, an incomplete facial nerve palsy was found.
The histopathological work-up revealed a low grade (G1) mucoepidermoid carcinoma (pT2L0V0Pn0)
with R1 status. The tumor conference therefore recommended to perform a total parotidectomy
with nerve reconstruction, lid weight implantation and selective ipsilateral neck
dissection. The new histopathological work-up revealed an R0 status with tumor-free
lymph nodes.
Results of the literature review The treatment for low to medium grade tumors involves surgery alone. In cases of
lymph node involvement, extension with ipsilateral neck dissection is recommended.
Radiotherapy is reserved for high-grade and/or advanced MEC in the primary stage.
For high-grade tumors without massive lymph node involvement, the radiation volume
can be limited to the primary area given the risk of long-term side effects of radiation
therapy in children.
Conclusion MEK are rare tumors of childhood and adolescence and have a good prognosis with a
5-year survival rate of approx. 95%.
