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We describe an 86-year-old woman with a large parotid tumor. Ten years previously, she had first noticed a tumor about the size of the tip of the little finger in the right parotid region.The tumor had become very large. Her Hematological examination showed a pattern of severe anemia and undernourishment. Excision of the tumor was carried out, and the excised tumor measured 200×180×150mm and weighed 900g. Histological examination revealed that the tumor was a carcinoma in pleomorphic adenoma. There has been no evidence of recurrence after 3.5 years of follow up.

Ten cases which were suspected of tumor in the major salivary area were assesed comparing the results of pre-operative diagnostic examinations (present history, physical examination, sialography, Technetium-99 and Gallium-67 imagings, ultrasonography and computed tomography) with surgically and pathologically confirmed diagnosis.The aim of this study is to obtain information concerning differential diagnosis between salivary tumor and inflammatory lesion, and between benign and malignant salivary tumors.It seems that differential diagnosis between tumor and inflammatory lesion seems to be possible with pre-operative examinations, however discrimination between benign and malignant tumors is difficult.It is very important to make a provisional diagnosis of the lesion in major salivary gland area putting all kinds of information from individual examinations together.In the case of suspicious malignant tumor, we must establish a total cure system including an open biopsy and following therapies.