title: Facial Paralysis Secondary to Extensive Perineural Spread of Adenocarcinoma of the Parotid Gland Identified by PET/CT.
abstract: Brain MRI in an 82-year-old man with presumed Bell's palsy revealed a clinically unsuspected right parotid gland mass but no other acute findings. Biopsy revealed poorly differentiated adenocarcinoma. Staging F-FDG PET/CT revealed an FDG-avid parotid mass, abnormal FDG uptake along the course of the facial nerve from mass to skull base, and multiple FDG-avid right level II neck lymph nodes and hepatic metastases. The PET/CT findings and prolonged clinical course suggest that diffuse perineural spread of tumor from a smoldering parotid neoplasm, and not idiopathic Bell's palsy, was responsible for the patient's facial paralysis.
authors.affiliation: From the Nuclear Medicine Service, James A. Haley Veterans' Hospital and Clinics, and University of South Florida Morsani College of Medicine, Tampa, FL.
authors.forename: Dwight M
authors.initials: DM
authors.lastname: Achong
authors.forename: Martin
authors.initials: M
authors.lastname: Zloty
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000369:Aged, 80 and over; D005158:Facial Paralysis / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009423:Nervous System Neoplasms / Q000150:complications* / Q000556:secondary*; D010306:Parotid Gland / Q000294:innervation; D010307:Parotid Neoplasms / Q000473:pathology*; D000072078:Positron Emission Tomography Computed Tomography