A 50-year-old male presents with a painless, slow-growing mass in the parotid gland for 10 years. On CT, the mass is well-defined with areas of T2 hyperintensity on MRI suggesting cartilaginous or myxoid material. The most likely diagnosis is:

• A Pleomorphic adenoma ✓
• B Warthin tumor (papillary cystadenoma lymphomatosum)
• C Mucoepidermoid carcinoma
• D Acinic cell carcinoma

Explanation

Pleomorphic adenoma (benign mixed tumor) is the most common parotid tumor and typically presents as a slow-growing, painless, well-encapsulated mass. On MRI, it shows high T2 signal due to its myxoid and cartilaginous stroma — a characteristic imaging feature. Warthin tumor is bilateral in 10% of cases and typically shows characteristic 'hot spot' on Tc-99m pertechnetate scan due to oncocytic cells. Malignant tumors like mucoepidermoid carcinoma tend to have irregular margins, pain, and facial nerve involvement.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.