An unusual intraparotid foreign body simulating a tumour: shrapnel from the Spanish Civil War

A foreign body lodged for decades in the parotid gland, entering through the oral cavity or the skin, is extremely rare. Even less common is the clinical presentation of a foreign body lodged in the parotid gland simulating a tumour. The authors report the finding of a fragment of shrapnel lodged in the parotid gland for 63 years. The case is unusual owing to the rare clinical presentation, the length of time between the injury and the occurrence of symptoms and the associated mandibular osteolysis in the panoramic radiograph. Initial diagnoses considered were a tumour emerging in the parotid gland, a large odontogenic cyst or an odontogenic tumour with soft tissue extension. Sometimes neither fine needle aspiration nor radiology is capable of providing an accurate diagnosis before surgery.