62 year old male suddenly noticed painful swelling below ear which increased in size significantly overnight. H/O tobacco for 30 years . no open sores or discharge.skin over swelling normal. no other apparent symptoms. ideas?

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appears to be a parotid abscess. do a CT to confirm the diagnosis and plan a drainage

a lump can be felt on palpation..
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did you check intra orally.. this might be due to lower 3rd molars with abscess.. how is the mouth opening??

only slight swelling seen on the inside near the third molar..mouth opens normally no pain felt .
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Parotitis.

Parotitis.

any pathology related to lower 3rd molar? impacted? advise n opg, if negative it may b a parotid swelling

nope intraorally everything normal
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. AMIT GUPTA Collected: 09-05-2016 12:09:00 Received: 10-05-2016 12:21:05 Reported: 11-05-2016 13:39:39 Report Status: Final CYTOPATHOLOGY REPORT @ CYTOPATH NO : [36061-36063] Specimen type / collection method : Right post-auricular swelling, FNAC. Clinical history : Right post-auricular swelling measuring 1.5 x 1 cm. H/o Tobacco chewing + Gross : Received 3 slides Specimen preparation & stains : 2 alcohol fixed and 1 air dried smears. Stains: H&E & Papanicoloau / Giemsa Specimen Adequacy : Adequate Microscopic : Smears are cellular comprising of fair number of squamous epithelial cells showing nuclear pleomorphism. General categorization : Atypical - Suspicious. Impression : Features suspicious of Metastatic Squamous Cell Carcinoma. Comments/Recommendations : - Clinical and radiological correlation and work up. - Biopsy with HPE for confirmation. Dr. Praveen Dr. Bharti Varshney Dr Meenu Gaur Dr Gaurav Jain

Best is to advise fnac

Parotid inflammed Periocoronitis 3rd molar Opg

sudden onset parotid swelling.. is there fever could be mumps or any viral parotitis wait for one week before any procedures.

no fever but patient keeps complaining of chills
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if parotid abscess there is no fluctuation palpable bcoz of tough parotid fascia r/o intraoraly origin USG will help for diagnosis abscess or lymphadenopathy

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