Case No. 1: 36 year old male
with a left sided parotid mass.

The correct answer is "d". No studies are needed. The clinical presentation is typical for a benign tumor, especially a pleomorphic adenoma.

Diagnostic Studies:

The most important diagnostic procedure for benign and malignant parotid tumors is surgical resection of the tumor. Termed "the grand biopsy" by Conely (1970), this approach removes the tumor in it's entirety while providing a diagnosis and curative therapy for most parotid tumors.

There are many tests available to aid in the diagnosis of major salivary gland tumors, but they are not often necessary. These include sialogram, CT sialogram, fine needle aspiration (FNA), CT scan, and MRI scan. CT scan and MRI scan are helpful in the evaluation of extent of tumor and lymph node involvement where this information is necessary for appropriate surgical management.

Fine needle aspiration offers the clinician the ability to distinguish between salivary gland tumors and non-salivary pathology, such as metastatic disease or lymphoma. However, FNA remains controversial in the diagnosis of salivary gland tumors as the variety of cell types and morphology which can be demonstrated make definitive diagnosis difficult.

Question #2:

What is the most common tumor of the parotid gland?

  1. Warthin's Tumor
  2. Pleomorphic Adenoma
  3. Oncocytoma
  4. Mucoepidermoid carcinoma
  5. Adenocarcinoma