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ROBERT E. FECHNER, MD
Arch Otolaryngol. 1981;107(5):320-323. doi:10.1001/archotol.1981.00790410058016.
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PATHOLOGIC QUIZ CASE 1 

Steven M. Sobol, MD, Robert J. Gogan, MD, St Louis  A 19-year-old woman complained of a painless swelling of her left cheek that appeared intermittently for six years. This was unrelated to specific activity or food ingestion. The swelling would vary in size, and generally persist for weeks or months. In the three months before her visit, the mass had remained relatively large, causing some degree of cosmetic embarrassment.Physical examination revealed a 6 × 3-cm, rather diffuse, nontender, fluffy, left preauricular-parotid mass (Fig 1). There were no bruits and no skin discoloration. Xerography disclosed no calcification. Sonography confirmed the mass as preponderantly cystic, measuring 5×3 cm. Contrast sialography showed a splaying of the inferior ductal system with no intrinsic disease.After careful discussion with the patient and her parents regarding risks and potential complications, excision was attempted via a parotidectomy approach. A photograph of the

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