An 81-year-old woman presented with a 3-month history of a slow-growing mass in her left cheek. She denied having any symptoms, tenderness, numbness, or facial nerve weakness. Physical examination revealed a mass in the buccinator space that was smooth, was nontender to palpation, and had no overlying cutaneous changes. A contrast-enhanced maxillofacial computed tomography scan demonstrated a 1.8 × 1.8 × 1.9-cm rounded, well-circumscribed lesion at the anterior aspect of the left masticator space (Figure 1). The mass was abutting the parotid duct, which did not appear dilated, and appeared to have a peripheral rim of hyperenhancing soft tissue with a central cystic/necrotic component. Results of ultrasound-guided fine-needle aspiration revealed rare epithelial cells with degenerative changes and inflammatory cells present. Findings from a core biopsy demonstrated a spindle cell neoplasm of uncertain origin. On immunostaining, spindle cells were CK8/18, S100, and SOX10 negative; myosin and smooth muscle actin (SMA) negative; and CD31 negative. However, STAT6 staining was diffusely positive.
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Corresponding Author: Karthik Rajasekaran, MD, Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, 800 Walnut St, 18th Floor, Philadelphia, PA 19107 (firstname.lastname@example.org).
Published Online: August 11, 2022. doi:10.1001/jamaoto.2022.2249
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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