Ultrasound - US parotid glands
There is a relatively well-defined ovoid mass within the posterior aspects of the right parotid gland, extending into the deep lobe as well, measuring 37 x 24 x 26 mm. It has a heterogeneous solid echotexture with multiple ill-defined hypoechogenic foci (cystic changes?) and demonstrating prominent internal vascularity on colour Doppler. A few small intraparotid lymph nodes are also noted, and they show preserved morphology. The left parotid gland demonstrates two adjacent smaller solid nodular lesions in its superficial lobe that have similar morphology, echotexture, and vascularity compared to the lesion in the right gland.
Conclusion: Although the sonographic appearances are completely nonspecific, multiple solid parotid masses in this epidemiology raises the possibility of Warthin tumours over the other differentials.