History and Examination: A 30-year lady presented to the General Surgery OPD with complaints of a slow-growing painless swelling in the right parotid region for 1 year. A single, 4×3 cm, vertically oval, firm, non-tender, freely mobile swelling was palpated in the right parotid region.
Investigations: Ultrasonogram revealed a well-defined hypoechoic lesion in the superficial lobe of the parotid gland- possible Pleomorphic adenoma. USG guided FNAC from the swelling showed features of Pleomorphic adenoma.
Treatment: Total conservative parotidectomy.
Histopathology: Sections from the superficial lobe showed salivary gland characteristics with few lymphoid follicles. The deep lobe showed histopathological features suggestive of Pleomorphic adenoma.
Conclusion: A diagnosis of pleomorphic adenoma of the superficial lobe of the parotid was made basing on clinical examination & investigations, and was planned for superficial parotidectomy. However to our surprise, apart from the essentially normal superficial lobe of the parotid gland, a tumor in the deep lobe of the parotid gland was found, and hence proceeded with total conservative parotidectomy.