title: Parotid or carotid? Misled by site.
abstract: We present an interesting scenario where a 64 years old male presented with a long standing painless, infra-auricular swelling, which had progressively increased in size. Based on the site, the clinical impression was of a salivary gland lesion and FNAC was performed. The smears were unusually cellular and had necrotic background. The cytological diagnosis was a cystic neoplasm of salivary gland, possibly mucoepidermoid carcinoma. Warthin's tumor was also kept in differential. However, the radiological investigations, which were made available after the FNAC report were conflicting with cytological diagnosis of a malignancy and were characteristic of a carotid body tumor, generally a benign neoplasm. Surgical excision of the tumor with regional lymph node sampling was done and histopathological examination solved the puzzle by revealing metastasis of paraganglioma to right posterior triangle lymph nodes. This case is unique because of the unusual presentation of a malignant paraganglioma as an infra-auricular swelling, which was clinically considered as a parotid tumor. The clinician as well as the pathologist need to be aware of such diagnostic pitfall. Diagn. Cytopathol. 2017;45:569-573. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India.
authors.forename: Ruchita
authors.identifier: http://orcid.org/0000-0002-4504-5996
authors.initials: R
authors.lastname: Tyagi
authors.affiliation: Department of ENT, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Munjal
authors.affiliation: Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India.
authors.forename: Pavneet
authors.initials: P
authors.lastname: Kaur
authors.affiliation: Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India.
authors.forename: Harpreet
authors.initials: H
authors.lastname: Kaur
authors.affiliation: Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India.
authors.forename: Neena
authors.initials: N
authors.lastname: Sood
mesh_terms: D044963:Biopsy, Fine-Needle; D002345:Carotid Body Tumor / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000473:pathology*; D010307:Parotid Neoplasms / Q000473:pathology*
keywords: carotid body tumor; infra-auricular; lymph node; malignant; metastasis