# Unraveling an Unusual Presentation of Parotid Malignancy: A Case Report

## TL;DR

A case report describes a rare presentation of parotid gland cancer as post-auricular swelling, highlighting the diagnostic challenges and treatment approach.

## Contribution

This case report adds to the understanding of unusual clinical presentations of parotid malignancy and emphasizes the need for multidisciplinary diagnosis.

## Key findings

- Post-auricular swelling can be a rare presentation of mucoepidermoid carcinoma of the parotid gland.
- Accurate diagnosis requires a combination of clinical suspicion, radiological investigations, and histopathological assessment.
- Early diagnosis and treatment with surgery and radiotherapy improve outcomes in such cases.

## Abstract

Mucoepidermoid carcinoma (MEC) is a salivary gland tumor commonly arising from the parotid gland. MEC has various presenting symptoms, including a painless, slow-growing mass below or anterior to the ear lobule. However, an unusual presentation can also be in the form of post-auricular swelling. Other more common benign differentials for post-auricular swelling include lymphadenopathy, epidermoid cysts, and lipomas. Thus, diagnosing a postauricular swelling as MEC solely based on clinical presentation is challenging, and a high suspicion, as well as a multidisciplinary approach with various radiological investigations such as computed tomography (CT) and magnetic resonance imaging (MRI), are required in collaboration with histopathological assessment for an accurate diagnosis of this malignancy. Prognosis depends on various factors, including the grade of the tumor, the patient's age, and comorbidities, as well as the stage at the time of diagnosis. Early diagnosis and surgical intervention are the mainstays of treatment, which can be followed by adjuvant radiotherapy based on the stage of the malignancy. This is a report of a patient who presented with post-auricular swelling, which was initially misdiagnosed as a benign necrotic lymph node. After further evaluation, it was found to be a mucoepidermoid carcinoma of the parotid gland, which was managed by surgical excision and radiotherapy.