# Effective Management of a Giant Deforming Pleomorphic Adenoma With Airway Displacement in a 93-Year-Old Patient: A Case Report

## TL;DR

A 93-year-old woman successfully underwent surgery for a large, benign salivary gland tumor despite its size and proximity to the airway.

## Contribution

This case report demonstrates the feasibility of curative surgery for giant pleomorphic adenomas in elderly patients.

## Key findings

- Complete resection of a 32 x 30 cm pleomorphic adenoma was achieved without airway infiltration.
- The patient showed no tumor recurrence one month post-surgery despite partial facial nerve paralysis.
- Advanced age should not preclude surgical intervention with proper planning.

## Abstract

Benign salivary gland tumors are a rare and diverse group of neoplasms with significant variations in their site of origin, histological features, and biological behavior. This report describes the case of a 93-year-old woman with a markedly enlarged left cervical mass. Physical inspection uncovered a tumor of approximately 32 x 30 cm, featuring necrotic and ulcerated areas. The neoplasm, diagnosed as a pleomorphic adenoma (PA) through prior biopsies, had been growing gradually over fifteen years, with delayed surgical intervention due to concerns about her age and the tumor’s size. Preoperative contrast-enhanced CT imaging showed a large left-sided cervical mass in close proximity to the airway, but without displacement or infiltration into major structures. An elective surgical approach was undertaken, involving complete resection of the giant PA, confirmed by histopathological evaluation. During the first month of postoperative follow-up, the patient experienced partial facial nerve paralysis but showed no evidence of tumor recurrence. Despite the tumor's considerable size, proximity to the airway, and the patient's advanced age, curative surgical intervention proved feasible. This case underscores that, with meticulous preoperative planning and careful surgical execution, age should not be a contraindication for surgery.