Parotid pleomorphic adenoma

Case contributed by Oliver Hennessy


Facial swelling

Patient Data

Age: 85 years
Gender: Male

A mass extending between the inner border of the mandibular ramus and styloid process with widening of the stylo mandibular interval and extending into the masticator space.

It is a precontrast low density mass with post contrast enhancement with some focal areas of contrast puddling. No calcification. The right parapharyngeal space is effaced. The right medial pterygoid is intimately related.

No lymph node enlargement.

Conclusion: It is likely that this mass arises from the deep lobe of the parotid rather than the masticator space and therefore is likely a parotid tumor

Case Discussion

This solid mass lies in the deep parotid lobe and at surgery was a pleomorphic adenoma.

Lesions in the deep parotid lobe may mimic mass lesions arising in the parapharyngeal space such as a minor salivary  gland tumor.

Widening of the stylomandibular space is seen in parotid masses, not seen in primary pathology of the parapharyngeal space. The parapharyngeal space is displaced medially by this mass, again favoring a lesion arising in the parotid.

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