International Journal of Clinical & Medical Images

Case Presentation A 44-year-old Algerian male presented with a five year history of swelling of the right submandibular region. His medical history included hypertension. Physical examination revealed elastic, somewhat hard mass measuring 33.8 × 18.5 cm in the right submandibular region. No salivation from either of the bilateral sublingual caruncles was detected. The parotid and lacrimal glands were not swollen, and cervical lymphadenopathy was absent. Computed tomography (CT) showed enlargement of the right submandibular gland and atrophy of the left submandibular gland with a salivary stone. Ultrasonography revealed internal heterogeneity of the right submandibular gland without normal glandular tissue. Magnetic resonance imaging (MRI) demonstrated a sharply margined mass measuring 33.5 × 20.3 × 10.9 cm, which showed relatively heterogeneous contrast enhancement (Figure 1). On dynamic MRI, the time-intensity curve indicated an early peak of enhancement and a low washout pattern categorized as type C by Yabuuchi et al. suggesting malignancy.

Treatment The patient was admitted to the operating room. A lateral cervical incision was made; the dissection of the tumor was easy with a good cleavage plane with respect to vascular and nervous axes. The tumor was resected in its totality. Pathological examination revealed an adenoid cystic carcinoma. The patient received radiotherapy