28/12/2025
I am sharing a recent complex oncologic case involving an extensive adenoid cystic carcinoma with involvement of the superficial and deep temporal regions, extending into the ipsilateral lateral pharyngeal space, posterior pharyngeal wall, and contralateral parapharyngeal space.
Surgical management required careful preoperative oncologic planning and a thorough understanding of skull base, parapharyngeal, and infratemporal anatomy. A critical component of the procedure was meticulous facial nerve identification and dissection, ensuring maximal tumor clearance while preserving neural integrity and postoperative function.
This case underscores several key principles:
• The infiltrative and perineural nature of adenoid cystic carcinoma
• The importance of wide, anatomically guided resection despite its indolent growth pattern
• The necessity of precise nerve-sparing techniques in advanced head and neck malignancies
• The value of coordinated multidisciplinary care in achieving optimal outcomes
I am grateful to the surgical, anesthesia, pathology, and perioperative teams for their expertise and collaboration. Managing advanced head and neck tumors such as this remains both technically demanding and academically rewarding.
OncologicSurgery
OMFS
