A 30-year-old man had a pleomorphic adenoma removed from his left parotid gland

A 30-year-old man had a pleomorphic adenoma removed from his left parotid gland

 

Question

A 30-year-old man had a pleomorphic adenoma removed from his left parotid gland. His postoperative course was uncomplicated. Two months later, he noted that his left cheek became wet while he was eating. Believing that saliva was being discharged from the parotidectomy scar, he went to the emergency department.

What diagnosis is suggested?

Parotitis
Otitis externa
Herpes zoster
Frey’s syndrome
Parotid adenoma

 

Show Correct.Answer

Correct Answer :  Frey’s syndrome

Explanation :

there were no signs of a fistula Sweating over the site of a resected parotid can indicate Frey’s syndrome

An examination revealed that the wound had healed well: there were no signs of a fistula (arrow, Panel A). Frey’s syndrome was suspected, and the lemon test was performed. As soon as the patient ate a lemon wedge, his left auricular and parotic regions became flushed and sweaty (arrow, Panel B), thus confirming the diagnosis. He opted for no treatment. Gustatory sweating, or Frey’s syndrome, can develop after a variety of insults to the autonomic nervous system, such as trauma or radiation therapy, but is most commonly encountered as a complication of parotidectomy. The most widely accepted mechanism is aberrant neuronal regeneration resulting in parasympathetic cholinergic innervation of cutaneous sympathetic receptors.

Created by USMLE PlAB MCQ

 

Created by USMLE PlAB MCQ

This is the optic fundal appearance of a patient with blurred vision.

This is the optic fundal appearance of a patient with blurred vision

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A 47-year-old white woman reports facial redness and flushing.

A 47-year-old white woman reports facial redness and flushing. Her eyes are itchy and irritated.,

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thick, reddish plaque on her right ear

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