1. R Theo Gregor

2. Clinical appearance Right sided parotid tumour in young woman, present for few years

3. CT Scan Axial view showing mass deep to the superficial lobe on the right; appears to be a deep lobe tumour, but not a true parapharyngeal extension. Position of the facial nerve is not seen. See arrows showing the lateral extent of the tumour.

4. CT Coronal view. Lesion is seen between superficial lobe and the great vessels medially. See arrows

5. CT Coronal view showing the mastoid process. Note how closely the tumour is applied.

6. Surgery Shows the flaps raised. Note the great auricular nerve passing upwards across SCM muscle

7. Surgery Tumour can be seen deep to the raised superficial lobe closely applied to the mastoid process. See red arrows

8. Surgery The mastoid tip is drilled away in order to expose the facial nerve, which is deep to the mass. The main trunk was found to be elongated by the mass, and entirely deep to it.

9. Closure The incision is hidden in hair line, and the superior portion is hidden behind the tragus, because this is young patient, with no obvious skin creases.