[Lipoma of the deep lobe of the parotid gland]

Lipomas of the parotid gland are benign tumors developing from the fatty tissue in the gland. They are rare, accounting for 0.6-4.4% of all benign tumors. Those located in the deep lobe of the gland are uncommon. Clinically, they are very difficult to diagnose. CT scan and especially MRI can support the diagnosis. Surgery is the treatment of choice but its modalities remain controversial. We report the case of a 52-year old female patient, with no particular past medical history, presenting with asymptomatic left preauricular mass evolving over 1 year and gradually increasing in volume. Clinical examination showed painless elastic swelling, measuring 2 × 1.5 × 1 cm, extending from the ear lobule to the left mandibular angle. Stensen duct wasn't obstructed and saliva was clear. The patient showed no facial paralysis. CT scan showed perfectly delimited unilobular hypodense homogeneous mass in the deep lobe of the parotid gland. No suspected cervical lymphadenopathy was detected. MRI confirmed the presence of homogeneous, lipomatous intraparotid tissue process. After superficial parotidectomy and translocation of the branches of the facial nerve, a yellowish mass appeared under the buccal and mandibular branches of the facial nerve. The patient underwent complete resection up to the left parapharyngeal space. The postoperative course was uneventful. Anatomo-pathological examination confirmed the diagnosis of lipoma of the deep lobe of the parotid gland.