Case Report
Less than 200 cases have been reported since the first description of this condition by von Stubenrauch in 18949,10. Tuberculous parotitis usually presents as a localized mass resulting from intracapsular or periglandular lymph nodes. The disease involves the parenchyma of the gland, either through hematogenous spread or from infection of the lymph nodes within or around the parotid gland. The diagnosis of parotid tuberculosis needs a high degree of clinical suspicion. If there is no history of pulmonary tuberculosis and no relevant symptoms, diagnosis can be extremely difficult. Therefore it is generally overlooked by otolaryngologists and most cases are undergoing unnecessary surgery.
55-year old female patient admitted to our department of otorhinolaryngology with complaining of swelling localized in the right parotid region during 9-10 years. There was no tuberculous in the patient’s history of previous. During his physical examination, we noticed a soft mass, of movable, painless, without heat rise and the sensitivity, of aproximately 4×7 cm in diameter, in the right parotid region. It was observed that there was no palpable lympfadenopathy in the neck examination.
We determined a minimal edema in the mouth of stenon’s channel. The patient’s routine findings such as whole blood count, biochemistry and chest x-ray were normal. However, sedimentation rate was 27 mm/hr. It was observed non-specific results in sialography. In parotid ultrasonography examination, we determined also a solid mass with small cystic areas, septated and diameter of 4×7 cm. It was observed non-specific results in fine needle aspiration cytology (FNAC). The right superficial parotidectomy was performed to the patient under general anesthesia and the mass was removed. It was reported by pathology as granulomatous (tuberculous) parotitis. In addition, it was observed acid-alcohol resistant bacteria in tissue with EZN stain.
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