Best of five
- A. Pleomorphic adenoma
- B. Warthin tumour
- C. Metastatic cutaneous squamous carcinoma to intraparotid and cervical nodes
- D. Acute bacterial parotitis
- E. Thyroglossal cyst
FRCS (ORL-HNS) · SECTION 1 SBA
Cutaneous SCC parotid metastasis
An older patient with previous scalp cutaneous squamous carcinomas develops a firm parotid-tail mass and upper-neck node. What diagnosis should be assumed until disproved?
C. Metastatic cutaneous squamous carcinoma to intraparotid and cervical nodes
The parotid contains lymph nodes draining the scalp and face. In this context, metastatic cutaneous SCC is more likely than a new benign salivary tumour and requires skin review, imaging, tissue diagnosis and MDT planning.
Why every option is right or wrong
A. Pleomorphic adenoma: History and synchronous neck disease make a benign primary unsafe to assume.
B. Warthin tumour: Warthin tumours may be bilateral but do not explain a malignant neck node.
C. Metastatic cutaneous squamous carcinoma to intraparotid and cervical nodes: The parotid contains lymph nodes draining the scalp and face. In this context, metastatic cutaneous SCC is more likely than a new benign salivary tumour and requires skin review, imaging, tissue diagnosis and MDT planning.
D. Acute bacterial parotitis: There is no inflammatory syndrome.
E. Thyroglossal cyst: The anatomical site and history are incompatible.
What if the scenario changed?
If no cutaneous primary were found and cytology showed salivary differentiation, a primary parotid carcinoma pathway would be followed.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
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