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A 41-year-old woman presented with a right parotid mass, which had been noted by her primary care physician 3 weeks earlier. She described vague symptoms of dysesthesias and paresthesias in her face and hands that had gotten worse over the previous 2 months. She had associated anorexia, fatigue, poor sense of taste, and shortness of breath with exertion. She also described a 5- to 7-kg weight loss. She denied fevers, cough, and dysphagia. Her medical history was noncontributory. Physical examination revealed a diffuse enlargement of the right parotid gland that was not tender or fixed. The overlying skin was normal in appearance, without erythema, edema, or induration. The left parotid gland was normal to palpation. Her facial nerve function was intact and symmetrical bilaterally. She had no cranial nerve deficits and no cervical adenopathy.
Leuin SC, Faquin WC, Pilch BZ, Rocco JW. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2009;135(6):617. doi:10.1001/archoto.2009.42-a