Snap Shot Mrs. Jenson, a 58-year-old women presents with history of a painless lump in the region of the right parotid that has been there for 6 years. Recently, however, it started to grow in size. He husband says her speech has been changing slightly. Physical exam reveals a firm, non tender mass with early evidence of a peripheral facial nerve palsy. There is no lymphadenopathy in her neck. Introduction Most common tumor affecting the salivary glands, accounting for 70% of parotid tumors and 50% of salivary tumors. They are essetially benign. Malignancy can develop and is heralded by a sudden increases in size, pain, and infiltration of the facial nerve. High rate of recurrance post resection due to irregular borders which make clear excision difficult.