Parotid Gland Tuberculosis: A Clinical Rarity

Case Report

Austin J Dent. 2016; 3(4): 1044.

Parotid Gland Tuberculosis: A Clinical Rarity

Rahman T*, Ahmed SS, Hashmi GS and Zainab S

Department of Oral and Maxillofacial Surgery, Aligarh Muslim University, India

*Corresponding author: Tabishur Rahman, Department of Oral and Maxillofacial Surgery, Dr. Ziauddin Ahmed Dental College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

Received: July 16, 2016; Accepted: September 10, 2016; Published: September 12, 2016


We describe a case of Parotid gland tuberculosis which is a rarely encountered clinical entity. The condition is often misdiagnosed as a neoplasm or other inflammatory diseases of salivary gland and leads to unnecessary surgery. The paper highlights the importance of considering this condition in the differential diagnosis especially in the countries where tuberculosis is endemic.

Keywords: Parotid; Tuberculosis; Infection; Swelling


Tuberculosis of the parotid gland is a rare clinical entity which causes some difficulties in diagnosis because of the similarities in presentation to that of a neoplasm. Extrathoracic tuberculosis is seen in approximately 20% of overall active tuberculosis [1]. However, parotid gland involvement is a clinical rarity, even in countries in which tuberculosis is endemic [2].

Case Presentation

A 15-year-old female presented with an enlarging asymptomatic mass in the left parotid region of one year duration with accompanied history of fever. The medical history was non-revealing for any systemic disease. Physical examination revealed a mobile, non-tender mass of 5X5 cm occupying the superficial lobe of the left parotid gland extending from mandibular angle to ear lobe with no overlying skin changes. There was no sinus or discharge from swelling (Figure 1). Cervical lymphadenopathy was noticed on involved side. Facial nerve function was normal. The complete blood count, erythrocyte sedimentation rate, other biochemical investigations and chest X-ray were normal. Monteux test was positive and sputum smear examination was negative for acid fast bacilli (AFB). Ultrasonography (USG) of the parotid region showed enlarged left parotid gland with hypo echoic rounded solid mass like lesions within the architecture of the gland without any calcification and cystic degeneration (Figure 2). USG guided fine needle aspiration cytology of the swelling showed granulomatous epithelioid cell clusters, macrophages and caseation necrosis, suggestive of tubercular parotid lymphadenitis (Figure 3). AFB smear prepared from fine needle aspiration cytology (FNAC) sample positively confirmed our diagnosis of tubercular parotitis. The patient was treated with four drugs (Isoniazid, Rifampicin, Ethambutol and Pyrazinamide) anti-TB regimen for 2 months, followed by two drugs (Isoniazid, Rifampicin) for 4 months and showed a complete resolution of swelling.