Primary squamous cell carcinoma of the parotid gland: A rare case with diagnostic challenges

Primary squamous cell carcinoma of the parotid gland represents an exceedingly uncommon salivary malignancy, characterized by highly aggressive behavior and a generally poor prognosis. We report the case of a 52-year-old male with no significant medical or surgical history presented with a 7-month history of a progressively enlarging right parotid mass, recently complicated by ipsilateral facial nerve paralysis and masticatory dysfunction. Cross-sectional imaging revealed a large necrotic parotid-origin tumor with extension into the masticator, pharyngeal, and parapharyngeal spaces, associated with lytic erosion of the mandibular ramus and ipsilateral cervical lymphadenopathy. Histopathology confirmed a well-differentiated SCC staged as T4aN1M0. Given the unresectability of the lesion, the patient was referred for radiotherapy. This case highlights the extreme rarity and aggressive nature of primary SCC of the parotid gland, while emphasizing the pivotal role of advanced imaging in delineating tumor extent and osseous involvement. The unusual presentation of this case makes it worthy of sharing.