Cystic lesions of the parotid gland may be the presenting symptom in human immunodeficiency virus (HIV)-positive patients. The most common lesion is the benign lymphoepithelial cyst. Malignant lesions may also be associated with-or be hidden by-a cystic mass. We report a case of mucoepidermoid carcinoma in a 40-year-old HIV-positive woman who presented with a large cystic mass of the parotid that had been previously misdiagnosed as benign on several fine-needle aspiration biopsies. On our histologic examination, the true pathologic nature of the lesion was revealed. We suggest that an image-guided fine-needle aspiration biopsy of the thickened wall of cystic masses of the parotid may be more diagnostic than a random sampling of the contents.
In patients with human immunodeficiency virus (HIV) infection, it is not uncommon to see a cystic enlargement of the parotid glands as a presenting symptom. The presence of benign lymphoepithelial cysts in the parotid glands of some HIV-infected patients has been documented since the 1980s. However, during the clinical evaluation of such a patient, other causes of cystic enlargement of the parotid gland should be considered.