0:02

Here we have another example of a mucoepidermoid

0:05

carcinoma, in this case, an MRI scan.

0:08

The characteristic features are a

0:10

mass that has irregular borders.

0:14

That on T2-weighted scan is not bright.

0:19

And with gadolinium enhancement, usually

0:23

does show some enhancement. It.

0:26

What we want to do on the scrolling here is to

0:30

identify whether or not there's any lymphadenopathy.

0:33

It's probably best detected on the T2-weighted

0:36

imaging. In this case,

0:38

we have this lymph node which appears to be enlarged

0:41

on the ipsilateral side in level two,

0:44

a jugular chain where I would be

0:47

worried about malignant spread.

0:50

We want to look more superiorly at foramen ovale

0:56

as well as stylomastoid foramen to determine whether or

1:00

not there is any evidence of perineural

1:03

spread up the 7th cranial nerve.

1:07

Or the third division of the fifth cranial nerve,

1:13

the mandibular nerve. In this case, all clear.

1:16

So the thing we have to worry about here is just the

1:19

lymph nodes and that might require separate aspiration

1:27

in this case, in particular post-gadolinium.

1:30

I would say.

1:32

Could I show this case as an example of an oncocytoma?

1:36

I think so. I mean, it kind of vanishes on the T2

1:41

and on the post-gad T1 it kind of vanishes

1:45

into the normal parotid tissue.

1:47

So the vanishing parotid tumor may overlap.

1:53

That is, the oncocytoma may overlap in its signal intensity

1:56

characteristics of some of the malignancies as well.

2:01

In this case,

2:02

because it is relatively dark on T2-weighted scan,

2:05

would be more concerned with a medium to lower-grade,

2:09

lower-differentiated mucoepidermoid carcinoma.

2:12

Most well-differentiated mucoepidermoid carcinomas

2:15

are relatively bright on T2-weighted imaging.

Parotid Mucoepidermoid Carcinoma

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