A 71-year-old male was referred to ENT outpatients with a left-sided facial swelling. The patient had been aware of a painless lump in the pre-auricular area for some months, but an increase in size in the previous month had precipitated his referral.

There were no associated symptoms and the patient was a non-smoker with no relevant past medical history. On physical examination a round mobile swelling approximately 1.5cm in size was present over the pre-auricular area. The parotid duct and facial nerve function were both normal. The mass was believed most likely to represent a pleomorphic adenoma and a fine needle aspirate was performed for cytological examination. Subsequent computed tomography (CT) scan confirmed a well-defined solid mass within the superficial lobe of the left parotid gland and enhanced sections through the neck showed no lymph node enlargement. The routine full blood count and serum estimation of electrolytes and liver function were within normal parameters. The patient underwent a superficial parotidectomy and the specimen was sent for histological examination.

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