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Clinical Problem Solving: Pathology
June 2004

Pathology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2004;130(6):790. doi:10.1001/archotol.130.6.790

A 39-year-old Vietnamese man presented with a 3-month history of progressive swelling of the left parotid gland. He had no other significant medical history. He denied having any otologic symptoms, facial weakness, pain, twitching, trismus, odynophagia, dysphagia, fevers, chills, or weight loss. He also stated that he did not use tobacco or alcohol.

Physical examination revealed a diffuse 3-cm area of fullness in the tail of the left parotid gland, with a firm, cordlike mass that extended anteriorly along the course of the parotid duct. The findings of the rest of the head and neck examination were normal. There was no evidence of cervical adenopathy. Computed tomography demonstrated irregularity in the tail of the parotid gland, with a well-circumscribed mass extending along the parotid duct. Subsequent magnetic resonance imaging of the neck with gadolinium contrast showed a 2.0-cm mass within the superficial lobe of the left parotid gland (Figure 1) and a dilated left parotid duct with slight enhancement (Figure 2). The results of fine-needle aspiration of the mass were inconclusive.

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