Presentation
Progressive painless swelling of the right parotid region, suddenly increased in size the last few days.
Patient Data
There is a multiseptated cystic mass with thick septa arising from the right parotid gland.
The left parotid gland (not shown) was normal.
The MRI sequences demonstrate a multilobulated multiseptated cystic mass (6.8 x 4.6 x 3.6 cm), involving both superficial and deep lobes of the right parotid gland. It displays an iso-to low signal to the normal parotid gland on T1, high signal on T2 with a sediment of low signal (intracystic hemorrhage). The postcontrast sequences show a heterogeneous enhancement mainly of the septa. An extension to the submandibular space is noted with a mass effect on the ipsilateral submandibular gland which is displaced anteromedially.
Case Discussion
Ultrasound and MRI features are most consistent of a cystic lymphangioma with intracystic bleed of the parotid gland.
Hemorrhage, infection, and mass effect are the main complications of the cervicofacial cystic lymphangioma.