Male, 64 years old, with left parotid mass. Evaluate for extent. A mass is present in the left parotid gland occupying the entire deep lobe and part of the superficial lobe measuring 38 x 28 mm in the axial plane (image 34 series 401), and 43 mm craniocaudal (image 28 series 601). Lesion margins are well-defined. The lesion itself is predominantly T2 intermediate in signal with small areas of higher T2 signal potentially representing cystic or necrotic material. On postcontrast images, a majority of the lesion demonstrates solid enhancement.The lesion contacts the posterior cortex of the angle and ramus of the mandible. No definite marrow signal abnormality is seen, though the possibility of mild cortical erosion is raised. The lesion also contacts the mastoid tip without obvious invasion of the air cells. No pathologically enlarged lymph nodes are demonstrated. A jugulodigastric node on the left is, however, mildly prominent measuring 12 x 10 mm (image 25 series 401). No definite evidence of perineural spread is seen along the fifth or seventh cranial nerves.The remaining salivary glands are free of focal lesions. The palatine tonsils are slightly prominent but otherwise unremarkable. Degenerative disc disease is seen in the cervical spine with probable moderate spinal canal stenosis at C3-4. Spinal cord signal characteristics are within normal limits.
A mass is present in the left parotid gland occupying all of the deep lobe and a portion of the superficial lobe. Lesion margins are well-defined and the lesion itself is predominantly solid with a few small scattered areas of cystic or necrotic material. The lesion abuts the posterior cortex of the mandible and the possibility of some cortical erosion is raised, though this would be better assessed on CT. The lesion also contacts the mastoid tip without obvious invasion of the air cells. No definite findings are seen to suggest perineural spread. No frankly pathologic lymph nodes are observed though there is a mildly prominent left jugulodigastric node as above.