Hodgkin Lymphoma of the Parotid Gland: An Unusual Presentation in a Paediatric Patient

ABSTRACT Background Malignancy involving the salivary glands is a rare occurrence; of these malignancies occurring in the salivary glands, the majority are associated with the parotid glands. Lymphoma is a rare occurrence in the parotid glands and salivary glands in general, and the majority of these are non‐Hodgkin lymphoma (NHL). Hodgkin lymphoma (HL) is exceptionally rarely encountered in the parotid gland in the paediatric population and consequently can often be overlooked when considering differential diagnoses. Method 12‐year‐old patient was referred to the local oral and maxillofacial surgery department with a 1‐month history of left‐sided facial swelling affecting the pre‐auricular region. A CT scan and ultrasound were completed, which showed a large mass affecting the left parotid gland, and an ultrasound‐guided biopsy established a diagnosis of nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) of the left parotid gland. Results The patient subsequently underwent treatment with chemotherapy only, receiving 3 cycles of CVP—cyclophosphamide, vincristine, and prednisolone—over a 1‐month period. Repeat imaging demonstrated an incomplete response to CVP. As a result of this, the patient received 4 cycles of R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) over a 2‐month period. The patient showed a complete response to this and, following 36 months of follow‐up, has experienced no recurrence of disease. Conclusion Hodgkin lymphoma—and particularly NLPHL—of the parotid gland is a rare occurrence, but it is vital that this remains part of the differential diagnosis when confronted with a swelling in the pre‐auricular region.