Ultrasound of the neck and right parotid gland demonstrated a mildly enlarged right parotid with a well-defined, solid, hypoechoic nodule measuring 32 × 20 × 16 mm, located at the mid to lower third of the gland and involving both the superficial and deep lobes. The lesion showed mild peripheral vascularity and was interpreted as a likely salivary gland tumor. Both lobes of the thyroid appeared normal with homogeneous echotexture and no focal lesions. Bilateral level I cervical lymph nodes were observed, the largest being a 39 × 8 mm node in the right submandibular region; all nodes demonstrated preserved hilum and were hypovascular with cortex <4 mm—features not concerning for malignancy. The submandibular glands were unremarkable bilaterally.

Fine needle aspiration (FNA) of the parotid lesion was performed, and cytological analysis revealed oncocytic features. According to the Milan System for Reporting Salivary Gland Cytopathology, the diagnosis fell under Category IVa — “Neoplasm: favoring benign.” The cytologic impression was consistent with an oncocytic neoplasm, most likely a Warthin tumor.

Routine preoperative blood tests were within acceptable limits, including a serum urea of 36.4 mg/dL, creatinine of 1.35 mg/dL, and serum glucose of 91.2 mg/dL. Viral screening tests were negative. The patient was scheduled for definitive surgical excision of the mass.