Left parotid mass. PER EPIC note: In 8/2016 possibly related to travel to Mexico, the patient acutely developed left neck pain and swelling associated with a mass. She underwent CT and ultrasound guided biopsy and drainage. The biopsy was negative for malignancy. On 10/2016, she underwent a thyroid ultrasound which demonstrated bilateral thyroid nodules. She underwent a CT after the FNA and aspiration on 11/2016 which demonstrated a 1.4 cm lesion in the left parotid gland suggestive of an intra-parotid LN and 1.7 cm left thyroid nodule. There is an intrinsically T1 hyperintense, peripherally enhancing mass in the left parotid gland that involves both the superficial and deep portions of the gland and measures up to 12 x 30 mm in axial section. Portions of the tumor appear to be somewhat ill-defined. There are mildly prominent lymph nodes in the superficial left submandibular gland, measuring up to 6 x 10 mm in axial section. There are also mildly prominent left level 2A lymph nodes, measuring up to 9 x 12 mm in axial section. The right parotid gland and bilateral submandibular gland are unremarkable. There is mild diffuse prominence of the tongue base. There is a partially imaged left thyroid nodule. The imaged intracranial structures, paranasal sinuses, and orbits are unremarkable. There is degenerative cervical spondylosis with a posterior disc osteophyte that abuts the spinal cord at C5-6.
1. A mass in the left parotid gland that involves both the superficial and deep portions of the gland and measures up to 30 mm and mildly prominent regional lymph nodes may represent reactive lymphadenopathy based on the prior FNA results, although neoplasm is a differential consideration based on imaging. 2. Partially imaged left thyroid nodule. Please refer to the prior thyroid ultrasound report for additional details. 