presented in RRC patna 2018 ...

1. A case of
parotid tumorBY- DR. NISHI KUMARI
2ND YEAR PG STUDENT
NALANDA MEDICAL COLLEGE,PATNA

2. MD. PAPPU
52 yr old /male
Presented with c/o-
gradually enlarging
painless mass in left
upper part of neck for 5
months

3. History of presenting illness
 The swelling was insidious in onset
 Started as a swelling of size( 1*2 )cm and
gradually attained its present size
 no association of fever or pain with the
swelling

4. History of presenting illness
 No history of pain or increase in size
associated with mastication
 No history of sudden increase in size
of swelling
 No history of difficulty in deglutition
/difficulty in respiration/change in
voice

5. No history of difficulty in opening the
mouth
No history suggestive of tuberculosis

6. Past medical and surgical history
 No co morbid illness in past
 No surgical intervention in past

7. Personal history
 Mixed diet
 Bowel and bladder habit normal
 Sleep and appetite normal
 Addicted to smoking since 20 years

8. Physical examination and general
survey
 Ht – 170 cm
 Wt-89 kg
 Bmi- 30.7
 Hydration status-well maintained
 No pallor,icterus,cyanosis, clubbing or edema
 No lymphadenopathy
 Pulse-82/min
 Bp-130/80 mm of hg
 Rr-18/min

9. Examination of head
and neck
A spherical swelling
Size ( 4*5) cm
In left parotid region
Well defined margin
Surface –smooth
Skin over the swelling- normal
No other swelling noted in neck
The swelling is displacing the ear
lobule upward and outward
Obliterating the groove between
ramus of mandible and mastoid process

10. On palpation
No local rise of
temperature/tenderness
Firm
Not fixed to underlying
muscle/overlying skin
No cervical lymphadenopathy

11. Examination of oral cavity
Mouth opening is
adequate
No medial displacement
of tonsillar region
Rest oral cavity – normal
Parotid duct and parotid
duct opening- normal
Temporomandibular joint-
normal

12. Examination of facial nerve

13.  Opposite parotid gland and other
salivary glands- normal
 Systemic examination- normal

14. Provisional diagnosis
This is a case of benign parotid tumor

15. Differential diagnosis
 Pleomorphic adenoma
 Adenolymphoma
 Carcinoma
 Sebaceous cyst
 Lipoma
 Enlarged pre auricular or parotid lymph node
 Ameloblastoma (admantinoma)

16. Investigations
 Usg
 Usg guided fnac
 Mri/ct
 Routine blood tests
 Ecg
 Pulmonary function tests

17. Thank you