An Unusual Case of Adenolymphoma of the Parotid Gland

Abstract

Case Report H.A., aged 70, attended the Surgical Outpatients' Department at Fulham Hospital in 1948, with a large painless swelling in the left parotid region which had gradually increased in size since he had noticed it first about 1943. He declined operative treatment. In March I95I he attended again, for a strangulated right femoral hernia, and agreed during convalescence to have the tumour aspirated as it had grown considerably (Fig. 3). A greenish mucilaginous material was obtained. This continued to issue from the puncture wound and a mild infection occurred which caused sufficient discomfort to make him request removal of the tumour. On examination the swelling in the region of the left mandibular angle was about io: 8: 8 cm. in size, hemispherical and somewhat pendulous, with a smaller similar lump close above the upper pole. The tumours were uniformly soft, smooth and, in large parts, fluctuant. They were mobile in all directions. They were not attached to the overlying skin, nor obviously to bone or underlying soft tissues. They were superficial to the stemomastoid muscle. The large tumour was moderately tender, but after a course of antibiotic treatment the tenderness disappeared. There was a black, sharply limited pit in the skin beneath the ear which looked like a punctum. Based upon site, softness and fluctuation,