A 37-year-old male had a painless right infra-auricular swelling that had gradually enlarged over three years. He had undergone surgery in the same region about 15 years earlier, raising concern for recurrent parotid neoplasm.

Ultrasound identified multiple adjacent mildly vascular hypoechoic nodules in the superficial and deep lobes of the right parotid, the largest 21 × 17 × 11 mm, with small subcutaneous extensions. MRI showed a 5.2 × 2.4 × 1.8 cm multiloculated superficial-lobe lesion with peripheral enhancement and internal cystic components. FNA was Milan category IVA benign and suggestive of pleomorphic adenoma.

A right total parotidectomy was undertaken to remove the multifocal nodules while preserving the facial nerve. Careful dissection was required because of scarring from the earlier operation; there were no intraoperative complications.

The specimen contained multiple pleomorphic adenomas (benign mixed tumours) in the right parotid. No malignant transformation was identified.

Recovery was uncomplicated, with no facial weakness or neuropraxia. The wound healed well and long-term surveillance was recommended because late recurrence remains possible.