Question

A patient presents with a firm, tender, slow-growing mass below the ear as shown in the image below. What could be the diagnosis?

• A. Bezold abscess
• B. Parotid abscess
• C. Upper cervical lymphadenopathy
• D. Osteoma of the mandible

Answer 1

The Correct Option is B

The patient presents with a firm, tender, slow-growing mass below the ear. To diagnose, we consider the characteristics of the mass and its location:

1. Location: The mass is located below the ear, which suggests an issue with structures around or within the parotid gland.
2. Characteristics: It is firm, tender, and slow-growing. These characteristics are consistent with an inflammatory or infectious process, such as an abscess.

Let's evaluate the options:

1. Bezold abscess: This is a rare complication of mastoiditis, typically located in the neck beneath the sternocleidomastoid muscle, less likely to present directly below the ear.
2. Parotid abscess: Fits the symptoms of a firm, tender mass below the ear, originating from infection of the parotid gland.
3. Upper cervical lymphadenopathy: While it can cause a similar presentation, it is usually associated with systemic or regional infection or malignancy and might not be as tender.
4. Osteoma of the mandible: Typically a bony mass, represents as a firm and hard growth, rather than tender, since it is a bone tumor.

Given the location (below the ear) and characteristics (firm, tender), the most suitable diagnosis, considering all information and common etiologies, is a Parotid abscess.