Right Submandibular Mass – Oncocytic Cyst

Case Presentation:
A 75-year-old male presented with a gradually enlarging right submandibular mass, which had been present for the past two years. The patient denied any associated symptoms such as pain, difficulty swallowing (dysphagia), or voice changes (dysphonia). There were no specific factors that exacerbated or alleviated the swelling. His past medical and surgical history was unremarkable, and there was no known family history of similar conditions. The patient was not on any long-term medications.

Clinical Examination:
On general examination, the patient appeared well, with stable vital signs. Local examination of the neck revealed a well-defined, firm, non-tender mass in the right submandibular region. The mass was fixed to the underlying structures but showed no signs of inflammation, skin discoloration, or overlying skin changes. No palpable cervical lymphadenopathy was detected.

Imaging Findings:
A neck ultrasound was performed, revealing a large, well-defined cystic structure measuring 72x46x27 mm, originating from the lower third of the right parotid gland. The cyst exhibited thin walls (<1 mm) and was hypoechoic, without internal septations or solid components. No other significant abnormalities were noted in the neck region.

Management and Surgical Intervention:
Given the persistent and enlarging nature of the mass, the patient underwent a right superficial parotidectomy for complete excision of the cystic lesion. The surgery was performed without complications, and the patient recovered well postoperatively.

Histopathological Examination:
Histopathology of the excised specimen confirmed the diagnosis of a simple oncocytic cyst with benign reactive lymph nodes. No evidence of malignancy was found.

Conclusion:
Oncocytic cysts are rare benign cystic lesions that may arise in the salivary glands. While often asymptomatic, they can gradually enlarge over time, warranting surgical excision, particularly when malignancy cannot be excluded preoperatively. In this case, the right superficial parotidectomy was curative, and the patient had an uneventful recovery. Regular follow-up was recommended to monitor for any recurrence

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