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Date of last update: 10/21/2017.

Forum Name: Head and Neck Cancer

Question: Growth on parotid salivary gland

 coach123 - Tue Nov 03, 2009 3:56 pm

Hello, I have recently discovered a lump on my neck. I've had a neck CT done which showed a well circumscribed cystic lesion filled with fluid about 2.9cm in diameter. In addition I have an enlarged lymph node on the other side of my neck which the report said to just monitor as well as a cyst filled with mucus in my nasal passage. I am 28 yrs old and have no health problems but am really worried I have something really bad. I have been to two ENT specialists, one suggested removing the entire parotid gland, the other said he would recommend just removing the cyst. I have recently had a needle biopsy done and am waiting for the results. During the biopsy the doctor sucked out two syringe full of fluid which he though was saliva. The cyst is considerably smaller now to the point where you can't feel it by touching it. The doctor said that the cyst could still be malignant and he would do a tissue biopsy upon extraction. My question is that I have read that a cyst filled with fluid are generally non cancerous, is it better that this is a cyst and not a tumor? Why would I also have an enlarged lymph node (just one)? Are the two problems related and is the lymph node something I should worry about. The doctor doesn't even recommend a biopsy on it at this point.
 Dr.M.Aroon kamath - Wed Nov 18, 2009 8:46 am

User avatar Hi,
Cystic swellings involving the parotid gland can develop in several conditions.

Unilateral parotid cysts secondary to obstruction to one of its ducts have been reported.Also,a unilateral solitary lymphoepithelial cyst in the parotid gland(unrelated to HIV), is occasionally seen in adults.

'Poly-cystic' parotid disease, is congenital and manifests bilaterally in girls and women.

Malignant neoplasms of the parotid gland often have cystic components arising as a result of cellular secretory activity or may represent areas of cystic degeneration.

In practice,cystic involvement of the parotid gland more likely represents either papillary cystadenoma lymphomatosum ( PCL or Warthin’s tumor), or, lymphoepithelial cysts associated with human immunodeficiency virus (HIV) disease.

Similarities between these two pathologic entities exist. Clinically, both are slow-growing, soft, cyst- like, painless masses involving the superficial lobe of parotid gland.Bothh can also at times can be multicentric or bilateral.
What clinically differentiates these two entities is the presence or absence of lymphadeopathy. Lymphadeopathy generally supports a diagnosis of lymphoepithelial cysts as well as elevated CD8 counts.

Incision or excision biopsies of parotid lumps is not advisable.Superficial conservative (facial nerve sparing) parotidectomy is the minimum surgery currently advocated.

Best wishes!
 coach123 - Mon Nov 30, 2009 4:11 pm

Got the results back on the biopsy and they were undiognostic. Not enough cells. You can't feel the cyst anymore. Went to two doctors and both are recommending to wait to see if cyst refills with fluid before doing any kind of surgery. One is suggesting that if it takes a long time to refill I may just need to come in every 6-9months to have the fluid drained. I am 28yrs old, male. In the mean time, the lymp node on the other side of my neck has not gone down. Still swollen. Should I be requesting certain tests at this point or just wait? Doctors want to examine me on a monthly basis.
 Dr.M.Aroon kamath - Mon Dec 07, 2009 10:42 am

User avatar Hi,
As the cyst has become smaller as well as the lymph node, i feel there is not much harm in waiting as long as you are under regular medical supervision.
Best wishes!

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