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Rheumatoid Nodule Simulating a Parotid Tumor.

Authors
  • Martins, Sara1
  • Fernandes, Bruno Miguel2
  • Bernardes, Miguel2, 3
  • Melo, Daniel4
  • Neto, Tiago5
  • 1 Maxillofacial Surgery Department, Centro Hospitalar São João, EPE, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. [email protected] , (Portugal)
  • 2 Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal. , (Portugal)
  • 3 Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal. , (Portugal)
  • 4 Pathology Department, Centro Hospitalar Universitário de São João, Porto, Portugal. , (Portugal)
  • 5 Maxillofacial Surgery Department, Centro Hospitalar São João, EPE, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. , (Portugal)
Type
Published Article
Journal
Head and neck pathology
Publication Date
Mar 01, 2021
Volume
15
Issue
1
Pages
334–340
Identifiers
DOI: 10.1007/s12105-020-01175-7
PMID: 32436170
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Rheumatoid nodules are an extra-articular manifestation of rheumatoid arthritis that are rarely found in the maxillofacial region. A 59-year-old woman with rheumatoid arthritis treated with methotrexate, leflunomide, and tocilizumab, presented with an enlarging mass in the left parotid region. Magnetic resonance imaging (MRI) displayed a lesion compatible with a neoplasm. However, an incisional biopsy showed features consistent with a rheumatoid nodule. The patient was managed conservatively, including cessation of methotrexate and initiation of treatment with hydroxychloroquine. At 15-month follow-up, the lesion had a significant reduction in size. To our knowledge, this is the first case report of a rheumatoid nodule in the parotid region. Although it is a rare manifestation, clinicians should consider this a possible differential diagnosis of parotid masses in patients with a history of rheumatoid arthritis or connective tissue disease.

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