Lumps on the Side of the Head: Parotid Glands and Lymph Nodes

Common palpable structures on the lateral head/neck:

• Parotid glands: Largest salivary glands, located anterior to ears, overlying mandibular ramus. Produce serous saliva (amylase). Palpable as soft, non-tender masses. Pathology: sialadenitis, stones, tumors (80% benign — pleomorphic adenoma, Warthin's), Sjögren's.
• Cervical lymph nodes (levels I–V): Drain scalp, face, oral cavity, pharynx. Preauricular nodes (anterior to ear) drain eyelids, conjunctiva, temporal region. Postauricular nodes (behind ear) drain scalp, ear. Enlarged (>1 cm) nodes suggest infection (viral, bacterial), malignancy (lymphoma, metastasis), or autoimmune.

Evaluation: History, exam (mobility, tenderness, consistency), ultrasound ± FNA biopsy. Parotid masses: MRI with contrast, FNA.