The most common malignant tumour (70%) of the parotid gland in Australia is spread of skin cancer involving intra-parotid lymph nodes. These tend to be aggressive tumours that may also spread to lymph nodes in the neck. There is usually a history of removal of a skin cancer or melanoma on the scalp, ear, facial or temple skin in the preceding two years. Occasionally a patient will present with a lump that originates in the parotid. These also tend to be hard and irregular and can be fixed to deep structures or to the overlying skin causing discolouration or ulceration. They can be multiple and there can be palpable lymph nodes in the neck most frequently in the upper deep cervical region.
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