A 17-year-old boy presented with the complaints of insidious onset of bilateral postauricular painless swelling since 1 year, which gradually increased in size and was associated with bluish discolouration of the skin above the swelling and not associated with fever, pain, itching, night sweats or ear discharge or weight loss. No history of chronic cough suggestive of pulmonary tuberculosis. No history of similar complaints elsewhere in the body. No family history of similar complaints. On general examination, he was haemodynamically stable with no evidence of pallor or icterus or pedal oedema. On local examination, the swelling behind left ear was rubbery in consistency, non-tender, mobile, ovoid shape of size 3 x 2 cms with smooth surface and well-defined margins. Skin over the swelling showed bluish discolouration. The swelling behind the right ear was rubbery in consistency, non-tender with smooth surface and well-defined margins, round in shape 2x2 cm with normal skin over it. No axillary/ inguinal lymphadenopathy. No hepatosplenomegaly. Other systemic examination was unremarkable.