Brain Pathology Case of the Month - April 2002

Contributed by Elsa K Malcolm, MD and M Beatriz S Lopes, MD
Division of Neuropathology, University of Virginia Health Sciences Center, Charlottesville, VA
Published on line in April 2002


A 35-year-old man with no significant past medical history developed a firm mass below the right ear over the past several months. There was no pain or other symptoms. His past surgical history consisted only of a tonsillectomy and adenoidectomy. Due to the facial nerve involvement by the tumor, an 8 mm incisional biopsy of the mass only was performed at an outside institution. No definitive diagnosis was given at that time. Post-biopsy, he developed immediate facial paralysis.


An MRI revealed a 1.5 X 1.5 x 4.5 cm. lobulated mass with heterogenous enhancement (Figure 1) which arose out of the posterior genu of the right facial nerve and descended through the stylomastoid foramen and exited through the deep and superficial portions of the parotid gland. The internal auditory canal was normal. A superficial parotidectomy with en bloc resection of the involved facial nerve and a cable graft anastomosis were performed.



International Society of Neuropathology