Rethinking Retromandibular Vein Assessment in Parotid Tumors: Highlighting the Necessity of 3D Imaging

Pleomorphic adenoma of parotid gland is the most frequently occurring benign tumour in salivary glands and involvement of superficial or deep lobe is determined in relation to the retromandibular vein on imaging. This case report discusses a 69-year-old female who had pleomorphic adenoma in superficial lobe of parotid gland but misinterpreted as involvement of both lobes on imaging when assessed in relation with retromandibular vein on an MRI. Although extensive literature is available on the anomalous variations in the relationship between the retromandibular vein and the facial nerve, no case reports have documented peritumoral nodule of the superficial lobe growing beneath the retromandibular vein and mimicking as a deep lobe lesion on radiological evaluation. Thus, highlighting the importance of 3D imaging for proper preoperative assessment and to choose an appropriate surgical plan for parotid gland tumors.