Presentation
Left parotid swelling.
Patient Data
The left parotid gland shows a fairly defined, rather homogeneously enhancing soft tissue mass lesion that measures about 4.5 x 3 x 3 cm along its maximal dimensions. The lesion is seen located mainly in the superficial lobe with mild extension to the deep lobe noted posterior to the mandibular ramus, imaging feature highly suggestive of pleomorphic adenoma. Preserved left stylo-mandibular distance and para-pharyngeal fat planes. Bilateral small accessory parotid lobes are noted along their ducts. Few enlarged intra-parotid and bilateral upper deep cervical (level II) lymph nodes that show homogenous enhancement, could be reactive.
Case Discussion
Pleomorphic adenoma is the most common parotid space tumor accounting for about 80% and is seen mainly at the superficial lobe.
Warthin tumor is an important differential diagnosis and represents the second most common parotid tumor. It is multicentric in 20% of the cases and appears as a well-circumscribed intra-parotid mass with inhomogeneous enhancement.
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