Parotid gland tuberculosis-presentation of 4 case variants

Samir Paruthy, Shivani B. Paruthy


Pulmonary tuberculosis is a necrotizing granulomatous disease with diverse presentation. Nevertheless, extra pulmonary involvement although rare even in endemic regions, is associated with diagnostic dilemma for confirmation and treatment modalities. Contextually, parotid gland tuberculosis is a rare surgical presentation because of nonspecific signs, symptoms and allegedly low incidence; it is often misdiagnosed as parotid neoplasm, and therefore remains a diagnostic paradox. However, clinical suspicion alongside pathological evidence and imaging helps in diagnosing indecisive questionable cases. We present 4 cases of parotid tuberculosis each with different clinical presentation along with clinical suspicion and pathological diagnosis. Parotid tuberculosis is a rare clinical entity and completely curable by category-I anti-tubercular therapy. It has no residual deformity if diagnosed timely followed by conservative treatment management.


Parotid gland, Tuberculosis, Revised National Tuberculosis Control Program, Acid fast bacilli, Purified protein derivative

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Prasad KC, Sreedharan S, Chakravarthy Y, Prasad SC. Tuberculosis in the head and neck: experience in India. J laryngol otol. 2007;121:979-85.

Sethi A, Sareen D, Sabherwal A, Malhotra V. Primary parotid tuberculosis: varied clinical presentations. Oral dis. 2006;12:213-5.

Janmeja AK, Das SK, Kochhar S, Handa U. Tuberculosis of the parotid gland. The Indian journal of chest dis allied sci. 2003;45:67-9.

Iseri M, Aydiner O, Celik L, Peker O. Tuberculosis of the parotid gland. J laryngol otol. 2005;119:311-3.

Birkent H, Karahatay S, Akcam T, Durmaz A, Ongoru O. Primary parotid tuberculosis mimicking parotid neoplasm: a case report. J med case rep. 2008;2:62.

Yu YH, Mo QG, Zhu X, Gao LQ, Liang C, Huang Z et al. Axillary fine needle aspiration cytology is a sensitive and highly specific technique for the detection of axillary lymph node metastasis: a meta-analysis and systematic review. Cytopathol J BriSociety Clin Cytol. 2016;27:59-69.

Kumagai S, Muta Y, Yazumi, S. Tuberculous abscess formation with liver invasion after endoscopic ultrasound-guided fine-needle aspiration for abdominal lymphadenopathy. Endoscopy. 2016;46(1)UCTN:E188-9.

Watanabe M, Nakayama T, Koduka Y, Katoh H, Hirokawa Y, Inoue R et al. Mycobacterium tuberculosis infection within Warthin's tumor: report of two cases. Pathology international. 2001;51:797-801.

Handa U, Kumar S, Punia RS, Mohan H, Abrol R, Saini V. Tuberculous parotitis: a series of five cases diagnosed on fine needle aspiration cytology. J laryngol otol. 2001;115:235-7.

Maurya MK, Kumar S, Singh HP, Verma A. Tuberculous parotitis: A series of eight cases and review of literature. National J maxillofacial surg. 2019;10:118-22.

Bhargava AK, Shenoy AM, Kumar RV, Nanjundappa, Rao CR. Parotid tuberculosis simulating malignancy. J laryngol otol. 1999;113:951-2.

Mastronikolis NS, Papadas TA, Marangos M, Karkoulias KP, Tsamandas AC, Goumas PD. Tuberculosis of the parotid gland. Tuberkuloz ve toraks. 2009;57:84-8.

Dixit R, Gokhroo A, Verma S, Panjabi M. Parotid gland tuberculosis. Int J mycobacteriol. 2017;6:318-20.

Thakur J, Thakur A, Mohindroo N, Mohindroo S, Sharma D. Bilateral parotid tuberculosis. J global infect dis. 2011;3:296-9.

Yang F, Wu M, Peng Y, Dong X, Ge Y. Do Not Ignore Tuberculosis of the Parotid Gland When Meeting Obvious Infiltration of Neutrophils in a Suspicious Swelling by FNAC. Ear, Nose, Throat J. 2020.