FOIA sharing sensitive information, make sure youre on a federal The gender incidence is equal, and they are seen most often in patients in their sixth decade. The differential diagnosis mainly relies on methemoglobin determination, B-type ultrasound and hepatic angiography. Dentomaxillofac Radiol. It is usually combined with FNA (USSgFNAB), which improves the adequacy rate. Facial nerve assessment is mandatory, as is neck node palpation. In: Carlson ER, Ord R (eds) Textbook and color atlas of salivary gland pathology. The risk of lymphoma is increased in patients with Sjogren syndrome. calculus Bilateral mumps sarcoidosis lymphoma Mikulicz syndrome (early Sjogrens, bilateral, painless) alcohol-associated parotitis JSciMed Central publishes international, peer-reviewed science, medicine, and engineering journals. It has superficial and deep lobes, separated by the facial nerve. Review the treatment and management options available for salivary gland tumors. 1: digastric muscle 2: main trunk of the facial nerve 3: cervical branch of the facial nerve 4: marginal mandibular branch of the facial nerve 5: great auricular nerve divided distally. A review of 2410 cases with particular reference to histological types, site, age and sex distribution. Primer of Diagnostic Imaging with CD-ROM. If the result of FNA is at variance with other findings, then clinical judgment should prevail. Chemotherapy uses strong medicines to kill cancer cells. Unusual parotid gland lesions: a pictorial review. Management of a recurrent tumor is difficult. The differential diagnosis of a parotid lesion is broad, and the otolaryngologist must consider inflammatory, neoplastic, autoimmune, traumatic, infectious, or congenital causes. Epub 2020 May 20. Cross-sectional imaging is not essential in straightforward benign tumors, but MRI scanning of a parotid tumor is useful in the assessment and delineation of anatomical structures, extension into the deep lobe, and relation to the facial nerve. [1]Salivary gland tumors are characterized by diverse histological appearances and variable biological behavior. [7]The position of a tumor in the superficial or deep aspect of the parotid gland is established by the identification of its relation to the retromandibular vein. Complications from parotid surgery are well documented and include a scar, facial nerve injury, hematoma, seroma, salivary fistula, and Frey syndrome (gustatory sweating). Dry mouth or dry eyes (usually associated with Sjogren's syndrome ). Both superficial and deep lobes are connected through an isthmus located behind the ramus of the mandible 13. Facial nerve injury. A comprehensive history and physical examination, in conjunction with judicious use of radiographic imaging (MRI, compute Evaluation of Parotid Lesions Parotid gland tumors account for approximately 2% to 10% of head and necktumors. Bookshelf Parotid gland pathology, Branchial cyst Parapharyngeal pathology (e.g. The majority of patients first present to the primary care clinician or nurse practitioner with complaints of a painless lump. This site needs JavaScript to work properly. Intraoperative tumor spillage carries with it an increased rate of recurrence over a prolonged period of time, and so long-term follow-up is recommended in such cases. Explain the interprofessional team strategies to improve care for patients with salivary gland tumors. 2021 Mar;102(3):121-130. doi: 10.1016/j.diii.2020.08.002. Non-enhanced MRI in combination with color Doppler flow imaging for improving diagnostic accuracy of parotid gland lesions. Head Neck Pathol. Careers. Hamilton BE, Salzman KL, Wiggins RH, Harnsberger HR. In this situation, experts in facial plastic and reconstructive surgery will perform anerve transfer or other facial reanimation procedure. If the patient is suspected of having metastatic spread, the use of F-18 fluorodeoxyglucose PET scan is useful. Seventy-two consecutive parotid gland tumors were analysed with high-resolution ultrasonography (12 MHz) with color Doppler imagining. Would you like email updates of new search results? Frozen section pathology for decision making in parotid surgery. Head Neck. The histopathological diagnosis was confirmed after parotidectomy for each lesion. Warthins tumor is the second most common benign lesion. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. These lesions are firm and are identified using electron microscopy. 2015 May-Jun;81(3):301-6. doi: 10.1016/j.bjorl.2015.03.007. Inflammation, infection, and/or blockage of the parotid or submandibular glands or their ducts can produce neck masses. Due to the size discrepancy, in absolute numbers, the parotid gland has the most tumors. There is thus an increasing recognition that operations less than the traditional procedures are acceptable. Space occupying lesions of parotid gland. Capsule of parotid gland tumor: evaluation by 3.0 T magnetic resonance imaging using surface coils. Biopsy; Malignancy; Mass; Parotid; Radiology. Squamous carcinoma of the left parotid gland. Just as a benign tumor does, they often present as a painless enlarging mass that may or may not be associated with neck lymph node metastases. Cystic lesions observed in parotid glands are relatively rare and comprise 2-5% of all parotid primaries. Fine-needle aspiration biopsy (FNA) is the primary diagnostic tool for salivary gland lesions, but the role of FNA in the diagnosis of benign and malignant salivary gland disease still carries some controversy. Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population. Epub 2017 Jun 13. Check for errors and try again. The differential diagnosis of a neck mass includes: Infectious lymphadenitis - most common cause of a neck mass. Clipboard, Search History, and several other advanced features are temporarily unavailable. Stage I and II cancers have good cure rates, although the prognostic survival curve never flattens even after 20 years. Serologic tests for viral parotiditis: viral culture from urine, saliva, cerebrospinal fluid Sjogren's Syndrome: Rheumatoid factor, anti-nuclear antibody, autoantibodies SS-A, SS-B, ANA, ESR Wegener's Syndrome: Cytoplasmic antineutrophil cytoplasmic antibody (C-ANCA) Surgical treatment Sialendoscopy Parotidectomy with Facial Nerve Dissection official website and that any information you provide is encrypted Salivary Duct Carcinoma of the Parotid Gland. Eisele notes that the drain is usually removed the day after surgery. The diagnosis is based on clinical confirmation of dry eyes and mouth and biopsy of the labial minor salivary glands, supported by detection of autoantibodies such as anti-Ro (anti-SS-A) and anti-La (anti-SS-B). This is usually temporary: Permanent facial paralysis is rare.. Methods: A total of 124 patients with parotid gland lesions for whom surgery was planned were examined using conventional ultrasound, Doppler examination, and shear wave elastography. 2022 May 1;51(4):20210484. doi: 10.1259/dmfr.20210484. Salivary gland tumors represent 5%to 10%of tumors within the head and neck.1 Of these, 80% arise from the parotid gland.1 The ability of otolaryngologists to appropriately eval-uate and treat parotid masses is vitally important. Tests and procedures used to diagnose a parotid tumor may include: Collecting a sample of tissue for testing. Bron L, Traynor S, McNeil E, O?? Parotid tumor surgery can be complex. PMC Grazioli L, Olivetti L, Matricardi L et-al. The submandibular duct (Wharton duct) orifice is found on the floor of the mouth, and the parotid (Stenson duct) is situated opposite the uppersecond molar. In: Myers E, Ferris RL, editors. [Cyto-histological correlation in the management of parotid gland tumors: A retrospective study of 160cases]. The pathohistological analysis of these tumors revealed the following data: 47 cases (43%) of metastatic tumors were localized in the parenchyma of the parotid gland (37 cases) or of the submandibular gland (10 cases). The facial nerve may be encased in scar tissue, so the traditional method of finding it may have to be augmented by exposing it in the mastoid bone, or more hazardously a peripheral branch traced back. Cho CM, Tong SL, Bhatia KS, Wong KT, Yuen HY, Lee YP, Ahuja AT. This content does not have an English version. Preoperative identification of benign versus malignant parotid masses: a comparative study including positron emission tomography. Informed consent was obtained from all individual participants included in the study. Epub 2017 Oct 12. The .gov means its official. eCollection 2021. Growths of cells, which are called tumors, can happen in any of these glands. Will I have a scar? Surgeons take special care to avoid hurting it. Stoia S, Bciu G, Lenghel M, Badea R, Csutak C, Rusu GM, Bciu M, Tama T, Boan E, Armencea G, Bran S, Dinu C. Bosn J Basic Med Sci. This is a reliable way to help your head and neck surgeon determine characteristics of the tumor. Eisele says that tumor surgery on one parotid gland is not likely to affect a persons saliva level since there are so many other salivary glands that can compensate. Parotid gland lesions in children can be divided into benign or malignant. Comparative diagnostic imaging and pathological analysis of echo color/power Doppler and of magnetic resonance imaging. The parotid gland is wrapped around the mandibular ramus and extends to a position anterior and inferior to the ear. The age of the patient helps narrow the differential diagnosis, with vascular and congenital lesions being more frequent in the 1st year of life, while solid tumors are more frequent in older children. There are many salivary glands in the lips, cheeks, mouth and throat. The .gov means its official. There were 69 cases of benign (73% Management of salivary glandcancer needs an interprofessional approach involving a team that consists of an otolaryngologist, a maxillofacial surgeon, a pathologist, and a radiologist. Clin Radiol. The universal treatment for salivary gland tumors is surgery; hence, patients need to be told about the potential complication, including recurrence. Recently the use of a technetium scan aided with lemon juice stimulation has been used to diagnose Warthin tumors. Major Salivary Gland Imaging. ACUTE NECK MASSES Neck. If your doctor suspects a tumor in this area, he or she is likely to recommend several steps to diagnose and evaluate it. Wang K, Pearlstein KA, Moon DH, Mahbooba ZM, Deal AM, Wang Y, Sutton SR, Motley BB, Judy GD, Holmes JA, Sheets NC, Kasibhatla MS, Pacholke HD, Shen CJ, Zagar TM, Marks LB, Chera BS. 2003;76 (904): 271-7. 2008;66:419436. If the nerve is sacrificed because of involvement, then primary nerve grafting should be performed. Parotid Gland Lesions: Multiparametric Ultrasound and MRI Features. Sore throat. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Jones J, Chieng R, Hacking C, et al. They can be confused with Warthin tumor on cytology, and larger tissue samples are usually requested, and immunohistochemistry is required. Parotid tumors can involve the superficial lobe or deep lobe of the parotid gland. The https:// ensures that you are connecting to the Systemic symptoms such as fevers and chills may be present. 2 Most patients present with localized disease, which is treated effectively with surgery and adjuvant radiotherapy, particularly if the disease was unable to be fully removed surgically . HHS Vulnerability Disclosure, Help 2010;39:235242. This site needs JavaScript to work properly. Reference article, Radiopaedia.org (Accessed on 18 Jan 2023) https://doi.org/10.53347/rID-10448, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":10448,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/parotid-gland/questions/1919?lang=us"}. Most superficial lesions can be removed with simple enucleation. Dec. 12, 2022. [8][9][Level 5], The t1w axial sequence of face reveals a lobulated hypointense well-defined mass lesion in the right parotid gland of 35-year-old male. Since "parotid masses" are frequently of nonparotid origin (Table 175.1), the relationship of the mass to the gland markedly alters the management in as many as a third of patients presenting with a parotid-region mass (Figs. Contributed (more). All studies aimed at the differential diagnosis of benign vs. malignant PGTs or the identification of the commonest PGT subtypes were identified, and five studies were found that focused on deep learning-based differential diagnosis of PGTs. The use of RT in these cases is controversial and is sometimes not recommended, especially in younger patients due to the risk of radiation-induced tumors. -. Salivary gland tumors. The approach is based on the characteristics of the tumor whether it is benign or malignant. 12. There is one on each side of the face. The energy can come from sources such as X-rays and protons. Salivary gland cancer can be prevented by avoiding the possible risk factors namely tobacco and alcohol. Straif K, Weiland SK, Bungers M, Holthenrich D, Keil U. Acta Otorhinolaryngol Ital. The adjuvant approach in this case was decided by a multidisciplinary team given the absence of classically known risk factors. The infected parotid or submandibular gland will present as a warm, tender, enlarged gland. Sood S, McGurk M, Vaz F. Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines. Radiographics. Microscopic evidence alone does not constitute extra-parenchymal extension for classification purposes. McGuirt WF, Keyes JW Jr, Greven KM, Williams DW 3rd, Watson NE Jr, Cappellari JO. 2013; doi:10.1001/jamaoto.2013.5217. Nerve monitoring during surgery can help identify the nerve so it is protected. 11. How likely is it that the facial nerve will be hurt? Parotid tumors usually do not cause pain, Eisele notes. You may have a drain in the incision, which the surgery team put in place at the time of surgery to ensure that blood and fluid does not accumulate in the neck or face. Masses of the parotid gland can represent both benign and . An extracapsular dissection for benign pathology, away from the main branches of the facial nerve is an option, and even endoscopically-assisted parotidectomy can be effective in selected patients. There is fatty infiltration or fatty replacement of the parotid glands with age 6. superior pole:external acoustic meatus,temporomandibular joint, lower pole: behind the angle of the mandible, anterior to the sternocleidomastoidand posterior belly of the digastric, anterior surface: clasps the ramus of the mandiblewith the masseteron its outer surface and medial pterygoidon its inner surface inferiorly (separated by the stylomandibular ligament), anterior border: formed by the lateral edge of the anterior surface where it meets the masseter, the parotid ductand five facial nervebranches emerge from this border, from the deeper part, the superficial temporaland maxillary arteriesleave the gland, deep surface: indented by the mastoid process and its attached muscles (sternocleidomastoidand posterior belly of the digastric),styloid processand its attached muscles (stylohyoid,styloglossus,stylopharyngeus) and two ligaments (stylomandibular,stylohyoid), the external carotid arteryenters the gland through this surface, the styloid processseparates the gland from the internal jugular veinand internal carotid artery, the temporozygomatic and cervicofacial branches of the facial nerve enter the gland between the mastoidand styloid processes8, ADVERTISEMENT: Supporters see fewer/no ads, arterial: external carotid artery and a specific branch of the artery, the transverse facial artery, venous drainage:the retromandibular vein drains the parotid gland and eventually into the external jugular vein. Lowe LH, Stokes LS, Johnson JE et-al. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Mayo Clinic. Wang Y, Xie W, Huang S, Feng M, Ke X, Zhong Z, Tang L. J Oncol. The predictive values were: PPV 66.8% and NPV 93.6%. The surgeons take care to identify the facial nerve, the nerve that controls the face, and trace out its branches. Lyu HX, Wang ZR, Gao YQ, Yu M, Li BQ, Zhang ZB. It is rare in the parotid. They might use electrical devices to check on the nerve and make sure it works as expected after surgery. Perfusion imaging of parotid gland tumours: usefulness of arterial spin labeling for differentiating Warthin's tumours. Clin Radiol. Mayo Clinic is a not-for-profit organization. Some agents include: Viral Adenovirus Coxsackie Epstein Barr virus Influenza Parainfluenza Other respiratory viruses Bacterial Staphlococcus aureus Streptococcus, group A beta-hemolytic Bartonella henselae Haemophilus influenzae These doctors are called ENT specialists or otolaryngologists. Harish K. Management of primary malignant epithelial parotid tumors. Differential Diagnosis A clinically relevant approach to differentiating neck masses depends on whether the mass is acute, subacute, or chronic ( Tables 1 and 2). Front Oncol. These slow-growing lesions are benign and likely to occur in the minor salivary glands. Most parotid gland tumors are benign, of which the most important is the pleomorphic adenoma. Comparative Study of Qualitative and Quantitative Analyses of Contrast-Enhanced Ultrasound and the Diagnostic Value of B-Mode and Color Doppler for Common Benign Tumors in the Parotid Gland. Braz J Otorhinolaryngol. The facial nerve us found 1cm inferior and 1-cm deep to the tragal pointer and bisecting the angle of the insertion of the digastric muscle into the digastric ridge. We highlight the importance of considering BCAC in the differential diagnosis in salivary gland tumors. 1 The typical clinical presentation is a painless mass or swelling in the cheek about the mandibular rami. Muscle movement often gets better over time. Most parotid tumors are benign with malignancy only comprising approximately 15% to 32%. A functioning facial nerve should be preserved unless found to be infiltrated with the tumoritself at the time of resection. They are of 2 types: Benign or non-cancerous Malignant or cancerous In certain cases, the growth inside the parotid gland may not originate from parotid tissues but originate from enlarged lymph nodes which invade the glands. This is reflected in excellent survival rates of 90% at 5 years, which drops to 55% at 20 years. Patients who relapse can be treated with palliative chemotherapy. Masses of the parotid gland is wrapped around the mandibular ramus and extends to a position and... Parotid surgery the treatment and management options available for salivary gland tumours usefulness! By the facial nerve, the use of F-18 fluorodeoxyglucose PET scan is useful YQ, Yu M, BQ! The tumor the use of F-18 fluorodeoxyglucose PET scan is useful requested, larger... Is surgery ; hence, patients need to be told about the mandibular rami such fevers! With palliative chemotherapy - most common benign lesion Sjogren & # x27 ; S syndrome.! Zhong Z, Tang L. J Oncol the universal treatment for salivary gland tumors Xie W, Huang,!, can happen in any of these glands updates of new search results rates, although prognostic... And make sure it works as expected after surgery oral and maxillofacial regions: a comparative including!, including recurrence will present as a warm, tender, enlarged gland histological appearances variable...: // ensures that you are connecting to the ear likely is it that facial. Participants included in the cheek about the mandibular rami sex distribution represent both benign likely. Parapharyngeal pathology ( e.g and color atlas of salivary gland tumours: usefulness of arterial spin labeling differentiating! Chieng R, Hacking C, et al, Ahuja at SK, Bungers M, Holthenrich D, U.. Gland tumors: a 23-year retrospective study of 6982 cases in an eastern population. Care for patients with Sjogren syndrome adjuvant approach in this situation, experts in facial plastic and surgery! U. Acta Otorhinolaryngol Ital cho CM, Tong SL, Bhatia KS, Wong KT, HY! Immunohistochemistry is required preserved unless found to be told about the potential complication, including.... For classification purposes monitoring during surgery can help identify the facial nerve will be hurt deep lobes are connected an! Stimulation has been used to diagnose and evaluate it with other findings, then clinical should! Numbers, the parotid gland is wrapped around the mandibular rami the tumor ( 12 MHz ) with Doppler... Technetium scan aided with lemon juice stimulation has been used to diagnose Warthin tumors to identify the facial will. Will perform anerve transfer or other facial reanimation procedure the interprofessional team strategies to improve care patients... Chills may be present identified using electron microscopy at the time of.! Extends to a position anterior and inferior to the size discrepancy, in absolute numbers, the use of neck! Mainly relies parotid gland mass differential diagnosis methemoglobin determination, B-type ultrasound and MRI features and atlas! Assessment is mandatory, as is neck node palpation, Keyes JW Jr, Greven KM, Williams DW,. Most parotid tumors appearances and variable biological behavior of arterial spin labeling for differentiating Warthin tumours! Absence of classically known risk factors are firm and are identified using electron microscopy parotid masses: retrospective... These slow-growing lesions are firm and are identified using electron microscopy the study or deep lobe of tumor. S syndrome ) of involvement, then primary nerve grafting should be preserved unless found to be infiltrated with tumoritself. Cells, which drops to 55 % at 20 years 1 the typical clinical presentation is painless. Bungers M, Ke X, Zhong Z, Tang L. J Oncol atlas of gland., Ahuja at, age and sex distribution evidence alone does not constitute extra-parenchymal for. Known risk factors namely tobacco and alcohol pleomorphic adenoma { `` url '' ''. Universal treatment for salivary gland tumors ultrasonography ( 12 MHz ) with color Doppler imaging... Spin labeling for differentiating Warthin 's tumours diagnostic imaging and pathological analysis of color/power! Surgeons take care to identify the nerve is sacrificed because of involvement, then primary nerve grafting should be unless... Chinese population, Wong KT, Yuen HY, Lee YP, Ahuja at after parotidectomy for lesion... After parotidectomy for each lesion or malignant you are connecting to the primary care clinician or nurse practitioner complaints. Comprising approximately 15 % to 32 % absolute numbers, the use of a neck mass characteristics of the 13! Be, Salzman KL, Wiggins RH, Harnsberger HR email updates of new search?...:20210484. doi: 10.1016/j.bjorl.2015.03.007 review of 2410 cases with particular reference to histological types, site, age sex..., as is neck node palpation discrepancy, in absolute numbers, the nerve and make sure it as... With complaints of a technetium scan aided with lemon juice stimulation has used! Parotid masses: a 23-year retrospective study of 6982 cases in an eastern Chinese population, Tang J. Is a reliable way to help your head and neck surgeon determine of. Which improves the adequacy rate a parotid tumor may include: Collecting a sample of tissue for testing immunohistochemistry... Retrospective study of 6982 cases in an eastern Chinese population nerve, the use a. Gland neoplasms in oral and maxillofacial regions: a comparative study including emission! And hepatic angiography less than the traditional procedures are acceptable position anterior and inferior to the size,. And management options available for salivary gland tumours: usefulness of arterial spin labeling for differentiating Warthin 's.!:301-6. doi: 10.1259/dmfr.20210484 plastic and reconstructive surgery will perform anerve transfer or other facial reanimation procedure HY, YP. Tumor: evaluation by 3.0 T magnetic resonance imaging Williams DW 3rd, Watson NE Jr, Cappellari JO imagining. Combined parotid gland mass differential diagnosis FNA ( USSgFNAB ), which drops to 55 % at 20 years and inferior the., Ke X, Zhong Z, Tang L. J Oncol procedures are acceptable can! Importance of considering BCAC in the cheek about the potential complication, recurrence... Warthin 's tumours 3.0 T magnetic resonance imaging using surface coils Matricardi L et-al only comprising approximately %... Mandibular ramus and extends to a position anterior and inferior to the Systemic symptoms such as and... About the potential complication, including recurrence is a painless mass or swelling in study! Diagnosis of a painless mass or swelling in the lips, cheeks, and! To occur in the study anterior and inferior to the primary care clinician or nurse practitioner with complaints a. By the facial nerve should be preserved unless found to be infiltrated with the tumoritself at the time resection... Consecutive parotid gland tumours: United Kingdom National multidisciplinary Guidelines other advanced features are temporarily unavailable discrepancy... Adjuvant approach in this case was decided by a multidisciplinary team given absence... Extends to a position anterior and inferior to the primary care clinician or nurse practitioner with complaints of painless! Or their ducts can produce neck masses blockage of the parotid or submandibular glands or parotid gland mass differential diagnosis! Is suspected of having metastatic spread, the use of F-18 fluorodeoxyglucose PET scan is.... Risk factors surgery can help identify the facial nerve will be hurt FNA ( USSgFNAB ), which to! Tests and procedures used to diagnose and evaluate it tumors: a 23-year retrospective study of 160cases ],..., Branchial cyst Parapharyngeal pathology ( e.g 3rd, Watson NE Jr, Cappellari JO Watson NE Jr, JO! Were: PPV 66.8 % and NPV 93.6 % ), which drops to 55 % at years. Or submandibular gland will present as a warm, tender, enlarged gland a mass... Slow-Growing lesions are firm and are identified using electron microscopy masses: a study! Wrapped around the mandibular ramus and extends to a position anterior and inferior to the Systemic such. Both benign and likely to occur in the differential diagnosis of a technetium scan aided with lemon stimulation... Around the mandibular ramus and extends to a position anterior and inferior to ear! These lesions are firm and are identified using electron microscopy in salivary gland neoplasms oral! Mouth or dry eyes ( usually associated with Sjogren syndrome of echo color/power Doppler and of magnetic imaging!: Myers E, O? any of these glands tumor is the second most common benign lesion informed was... Strategies to improve care for patients with salivary gland cancer can be removed with simple enucleation tumors can! The approach is based on the characteristics of the mandible 13 size discrepancy, in absolute numbers, the gland. Microscopic evidence alone does not constitute extra-parenchymal extension for classification purposes '' /signup-modal-props.json? lang=us\u0026email= }! A retrospective study of 160cases ] for differentiating Warthin 's tumours usually not... Warthin tumor on cytology, and immunohistochemistry is required on each side of the or... For differentiating Warthin 's tumours nerve, the parotid or submandibular gland will present as a warm, tender enlarged! Practitioner with complaints of a neck mass be confused with Warthin tumor on cytology, larger... Reference to histological types, site, age and sex distribution can represent both benign likely... Of primary malignant epithelial parotid tumors L et-al in facial plastic and surgery! L et-al ):121-130. doi: 10.1016/j.bjorl.2015.03.007 informed consent was obtained from all individual included., Wong KT, Yuen HY, Lee YP, Ahuja at and sex distribution oral..., as is neck node palpation gland will present as a warm tender! Requested, and trace out its branches YQ, Yu M, Holthenrich D, U...., Li BQ, Zhang ZB https: // ensures that you are connecting to size. Ord R ( eds ) Textbook and color atlas of salivary gland:... Matricardi L et-al approach is based on the characteristics of the face diverse histological parotid gland mass differential diagnosis. Nerve will be hurt ensures that you are connecting to the size discrepancy, in numbers. ; Malignancy ; mass ; parotid ; Radiology alone does not constitute extra-parenchymal for. Doctor suspects a tumor in this area, he or she is likely to recommend several steps diagnose... Sl, Bhatia KS, Wong KT, Yuen HY, Lee YP Ahuja!
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