Possible right parotid mass. Per epic: right cheek swelling. This began 1-1/2 years ago. She has episodes that come and go that are associated with pressure and a subsequent salivary 'gush." There is focal dilatation of the right parotid duct overlying the masseter muscle, measuring up to 4 mm in diameter. There is diffuse enhancement of the parotid duct walls, but no associated discrete mass lesions. The right parotid gland is atrophic and does not display ductal dilatation. The left parotid gland and bilateral submandibular glands are unremarkable. There is an enhancing 4 mm diameter nodular lesion in the right buccal space inferior to the level of the parotid duct. There is otherwise no significant lymphadenopathy in the imaged portions of the neck. The osseous structures, paranasal sinuses, orbits, and imaged intracranial structures are unremarkable.
1. Focal dilatation of the right parotid duct overlying the masseter muscle, measuring up to 4 mm in diameter, along with diffuse enhancement of the parotid duct walls, but no associated discrete mass lesions. These findings may represent chronic ductal inflammation, perhaps secondary to a partially obstructive stricture, with resultant right parotid gland atrophy.2. A 4 mm diameter nodular lesion in the right buccal space inferior to the level of the parotid duct may represent a mildly reactive lymph node or perhaps a neoplasm.