DOI: https://doi.org/10.36347/sjmcr.2025.v13i07.016

Pages: 1589-1591

Introduction: Pleomorphic adenoma is the most common tumor of the major and minor salivary glands. Rarely it is found evolving from an ectopic location of major salivary glandular tissue in the mid-cheek (2%). The palate is considered the most common intraoral site (42.8-68.8 %), followed by the upper lip (10.1 %) and cheek (5.5 %). Case Presentation: 45-year-old woman presented to our institution with a 12 year duration of a slowly growing left cheek soft mass that was causing facial asymmetry. No significant functional or neurosensory dysfunction was appreciated. Radiologic examination MRI showed a well-defined T1 isointense, T2/STIR heterogeneously hyperintense lesion with few cystic lesions within, showing diffusion restriction on DWI, measuring about (3x2.6x1.8) cm noted in the subcutaneous plane of left check region. A clinical suspicion and probable diagnosis was considered as likely to be soft tissue AV malformation (?hemangioma). However, fine-needle aspiration biopsy showed benign salivary gland elements consistent with diagnosis of pleomorphic adenoma was made. The decision was made to perform intraoral extracapsular dissection for removal. The accessory gland was identified and was excised with the accessory duct. Patient had good cosmetic satisfaction with the intraoral approach. Results and Conclusion: To conclude, accessory parotid gland tumours are extremely rare and represent a diagnostic problem. Appropriate pre-operative workup like careful physical examination, MRI, fine needle aspiration biopsy and well-planned surgical approach are necessary for the successful management of these lesions. We recommend an intra-oral approach is safe, effective and cosmetically acceptable.