The parotid lump—don't biopsy it!

All lumps in the parotid region must be assumed to originate in the parotid gland. A mobile, superficial-appearing lesion cannot be assumed to be located just beneath the skin. Open incisional biopsy should never be used in approaching lumps in this region because of the danger of tumor seeding or damage to the facial nerve. The presence of a parotid lump is a definite indication for referral. Treatment by a head and neck surgeon is always done with the patient under general anesthesia. If these basic principles are followed, recurrence of mixed tumors often can be prevented.