Metastatic Melanoma to the Parotid Gland: A Case Report and Review of Current Diagnostic and Treatment Approaches.

Metastatic melanoma to the parotid gland is rare and represents a significant diagnostic challenge due to its atypical presentation, often resembling benign conditions, resulting in delays in diagnosis. Early and accurate detection is crucial for optimizing patient outcomes. We report the case of a 27-year-old woman who presented with a slowly growing, painless mass in her right parotid gland, which had been enlarging over the past three months. Her past medical history included the excision of an atypical blue nevus located on the scalp six years earlier. Imaging studies, including ultrasound and MRI, revealed an oval lesion in the right parotid gland's superficial lobe and ipsilateral intraparotid lymph nodes. Fine-needle aspiration cytology (FNAC) raised high suspicion of spindle cell melanoma, leading to an urgent total parotidectomy with selective neck dissection. Histopathological examination confirmed the diagnosis of metastatic melanoma. This case underscores the importance of considering melanoma metastasis in the differential diagnosis of parotid gland lesions, particularly in patients with a history of atypical pigmented skin lesions. A multimodal diagnostic approach, integrating FNAC, imaging, and histopathology, is essential for appropriate surgical planning. Long-term monitoring is essential to detect recurrence and metastasis, as melanoma is associated with locally aggressive behavior and a tendency for distant spread.