Parotid tumor presenting with hemifacial spasm.

A 47-year-old man presented with right parotid swelling and a history of frequent attacks of hemifacial spasm. MRI of the brain and neck showed a mass in the right parotid gland. Fine needle aspiration biopsy of the mass revealed a pleomorphic adenoma of the parotid gland, which was confirmed after total right parotidectomy. His attacks of hemifacial spasm did not improve after surgery and 8 months postoperatively, he received botulinum toxin-A injections, which improved his symptoms. Clinicians need to be aware that patients with occult parotid tumors can present like patients with classic hemifacial spasm.