Since lipomas are common soft-tissue neoplasms in other regions of the body, they are found only rarely in the parotid gland and are, therefore, often not considered in the initial differential diagnosis of parotid gland tumours. Even rarer are lipomas arising in the deep lobe of the parotid gland with only 6 cases presented in the literature. Lipomas originating in the parapharyngeal space are also extremely rare. When there is any suspicion, computed tomography and especially magnetic resonance imaging are of high diagnostic value. Fine-needle aspiration cytology seems not to contribute much to an accurate diagnosis. None of these preoperative examinations allows an absolute reliable distinction between a lipoma and a liposarcoma. The preferred treatment is complete surgical excision which will minimize the possibility of a recurrence and will also lead to a definitive diagnosis. We report 3 patients with a lipoma of the deep lobe of the parotid gland, extending into the parapharyngeal space, and discuss differential diagnosis and radiological features of lipomas in this rare location.
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