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First bite syndrome as presenting symptom of parapharyngeal adenoid cystic carcinoma

Published online by Cambridge University Press:  27 January 2011

A Deganello ,
G Meccariello ,
M Busoni ,
A Franchi  and
O Gallo
A Deganello*
Affiliation:
Otolaryngology / Head and Neck Surgery Clinic, Department of Surgical Sciences, University of Florence, Italy
G Meccariello
Affiliation:
Otolaryngology / Head and Neck Surgery Clinic, Department of Surgical Sciences, University of Florence, Italy
M Busoni
Affiliation:
Otolaryngology / Head and Neck Surgery Clinic, Department of Surgical Sciences, University of Florence, Italy
A Franchi
Affiliation:
Section of Human Pathology, Department of Critical Care and Surgery, University of Florence, Italy
O Gallo
Affiliation:
Otolaryngology / Head and Neck Surgery Clinic, Department of Surgical Sciences, University of Florence, Italy
*
Address for correspondence: Dr Alberto Deganello, Otolaryngology / Head and Neck Surgery Clinic, Department of Surgical Sciences, University of Florence, V le Morgagni 85 Florence, Italy Fax:  + 39 055 435649 E-mail: [email protected]
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Abstract

Introduction:

First bite syndrome refers to the development of pain in the parotid region after the first bite of each meal.

Case report:

A man was referred to our institution with first bite syndrome as his only symptom. Magnetic resonance imaging of the head and neck revealed a deep lobe parotid mass in close contact with the external carotid artery. Computed tomography guided fine needle biopsy indicated adenoid cystic carcinoma. Total parotidectomy was performed, with en bloc resection of the infiltrated external carotid artery and a selective neck dissection of levels Ib to III. High-weight ion radiotherapy was administered post-operatively.

Conclusion:

First bite syndrome has hitherto only been described following parapharyngeal space surgery. We present the first case of parotid gland adenoid cystic carcinoma presenting with first bite syndrome as the only symptom. The presence of first bite syndrome should prompt the clinician to investigate the parapharyngeal space and deep lobe of the parotid gland, especially in the absence of other signs or symptoms.

Keywords

CarcinomaAdenoid CysticParotid GlandSigns And SymptomsFacial Pain
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 4 , April 2011 , pp. 428 - 431
Copyright
Copyright © JLO (1984) Limited 2011

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