Pleomorphic Adenoma — ORE Part 1 MCQ

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EasyOral PathologyPleomorphic AdenomaORE Part 1

A 50-year-old woman presents with a slowly enlarging painless swelling in the right parotid region. On examination, it is firm, mobile, and non-tender with no facial nerve involvement. What is the most likely diagnosis?

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Correct answer: C — Pleomorphic adenoma

The correct answer is C: Pleomorphic adenoma. This diagnosis is supported by the classic presentation: slow growth over time, painless, firm, mobile swelling without facial nerve involvement. Pleomorphic adenoma is the most common benign tumour of the parotid gland and typically presents with these benign features. Option B (Warthin tumour) is a plausible distractor as it is also benign, but it is less common and may have more acute inflammatory symptoms. Option A (mucoepidermoid carcinoma) and Option E (adenoid cystic carcinoma) are malignant tumours that would typically present with pain, facial nerve involvement, or rapid growth—features absent here. Option D (parotid abscess) is tender and acute, not a slowly enlarging painless mass.

Reference: Ellis GL, Auclair PL. AFIP atlas of tumor pathology series 4: tumors of the salivary glands. ARP Press, Washington DC, 2008; cited in 'A Review of the Current Literature on Pleomorphic Adenoma', PubMed indexed literature (2023). https://pubmed.ncbi.nlm.nih.gov/37614271/