Retromandibular vein ectasia : A parotid mass mimicker

Abstract Retromandibular venous ectasia is a rare lesion that may imitate a parotid gland mass. Accurate radiological diagnosis prevents unnecessary invasive procedures. We present the case of a 69-year-old male patient presenting a right-sided, painless, compressible parotid region mass, fluctuating in size with head position and Valsalva maneuver. No thrill was palpable on physical examination. Doppler ultrasound demonstrated an anechoic compressible intra-parotid lesion, with luminal color filling, and venous spectral waveform. Contrast-enhanced computed tomography and Magnetic resonance angiography of the neck revealed an ectatic retromandibular vein. The patient was conservatively managed and regularly followed up. No complications occurred. Cervical region venous ectasias are rare and commonly misdiagnosed. They should be considered in the soft neck masses differential diagnosis. Imaging plays a key diagnostic role.