Metastatic malignant disease to the parotid gland.

A survey of over 250 consecutive parotidectomies performed at The Mason Clinic indicates a surprising incidence of metastatic malignant disease to the parotid gland. Four percent of all parotidectomies performed indicated a metastatic focus of malignancy from an ;unsuspected primary outside areas of the head and neck usually implicated in parotid disease. Twenty-five percent of all cancer discovered at parotidectomy was metastatic malignant disease to the parotid gland. The most common site was the lung. A high index of suspicion, evaluation of pathologic specimens by electron microscopy, and detailed metastatic work-up for patients with malignant disease in parotid lymph nodes are recommendations which should be considered by the surgeon performing parotid procedures.