R. NICKBRYANMDPATRICIA A.HUDGINSMD
A 58-year-old Chinese man presented with a 7-year history of prominent soft tissue swellings in the head and neck region. On examination, a 3.0 × 2.5-cm soft mass was palpable in the tail of the right parotid gland, causing displacement of the ear. There was also a 2.0 × 1.5-cm lymph node in the right jugulodigastric area and another soft mass (4.0 × 2.0 cm) superficial to the left masseter muscle. A chest x-ray film demonstrated no abnormalities. The Figure 1 shows the right parotid mass, with involvement of the overlying skin, and the lesion superficial to the left midmasseter muscle. One year earlier, a similar lesion had been removed from the patient's left submandibular triangle, followed by a small palpable recurrence. Interestingly, when the submandibular mass was removed, the other lesions increased in size but stabilized with a 5-day course of oral prednisolone (30 mg/d). The patient is currently on an oral regimen of prednisolone (5 mg/d) to control the disease process. Previous blood tests revealed eosinophilia and elevated levels of IgE.
Persaud R, Upile T, Tudge S, Beale T, Howard D. Radiology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2004;130(10):1237-1238. doi:10.1001/archotol.130.10.1237