A previously healthy 8-year-old boy presented to an outpatient clinic for further evaluation of a fluctuating right parotid mass that had been present for 3 years. The patient was not immunocompromised and denied any trauma to the area. In the 2 months prior, he had received multiple rounds of antibiotics from other health care professionals. Outside computed tomography of the face showed a 3-cm cystic structure in the superficial aspect of the right parotid gland with associated lymphadenopathy. An outside health care professional had attempted incision and drainage of the area with negative cultures. The patient presented to our clinic with an isolated right 2-cm fluctuant and tender mass overlying the parotid gland. There was no accompanying cervical lymphadenopathy, and facial nerve function remained fully intact. The patient denied fevers or systemic symptoms. Results of laboratory evaluation revealed normal complete blood cell count and erythrocyte sedimentation rate levels with negative infectious workup results for Epstein-Barr virus, cytomegalovirus, HIV, and tuberculosis (TB). Magnetic resonance imaging showed a 1.9-cm peripherally enhancing, centrally necrotic lesion overlying the superficial right parotid gland with multiple subcentimeter necrotic lymph nodes within the right parotid gland (Figure 1).
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Corresponding Author: Phayvanh P. Pecha, MD, Department of Otolaryngology–Head & Neck Surgery, College of Medicine, Medical University of South Carolina, Rutledge Tower, 135 Rutledge Ave, MSC 550, Ste 1130, Charleston, SC 29425 (firstname.lastname@example.org).
Published Online: January 6, 2022. doi:10.1001/jamaoto.2021.3879
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient’s mother for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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