MRI
Axial T1
Coronal T1 C+ fat sat
Axial T2 fat sat
Coronal T2 fat sat
Axial T1 C+ fat sat
Axial DWI
Within the tail of the left parotid gland is a large lesion measuring 3.2 x 2.2 by 2.4 cm. It is of intermediate low signal on T1, of heterogeneous and high signal on T2 with central regions of low signal, and has poorly defined margins.
On post-contrast sequences demonstrates heterogeneous but vivid enhancement, with a central poor enhancement corresponding to the low T2 components. It is located superficial to the retromandibular vein, which is displaced around its medial margin.
Inferiorly and especially medially, no normal parotid tissue can be seen between the mass and adjacent fat.
Large pituitary mass is noted incidentally. The remainder of the neck appears unremarkable.
Conclusion:
Large left parotid mass has indeterminate imaging features, but ill-defined margins raise the possibility of it being malignant. High T2 signal can be seen in mucoepidermoid carcinoma, Warthin's tumour, and a pleomorphic adenoma.