OBJECTIVE: Sclerosing polycystic adenosis (SPA) is a rare lesion of the major salivary glands that can simulate a slow growing tumor. The histological appearance of the lesion is similar to that of fibrocystic disease of the breast. The multifocal nature of the lesion makes management difficult. There are no pathognomonic signs and symptoms of the condition. CASE REPORT: We report the case of a 25-year-old, white man who presented with a tender parotid nodule that had been growing slowly over a year and a half. Magnetic resonance imaging showed a lesion in the right parotid gland having features consistent with those of a neoplasm. The patient underwent superficial parotidectomy. Histopathologic examination showed sclerosing polycystic adenosis. The patient continues to be under our follow up; the clinical course has been uneventful with no local recurrence till date. CONCLUSION: SPA is considered amenable to conservative surgical excision with tumor-free margins. Facial nerve preservation is recommended for parotid lesions. Recurrence is rare and is most likely due to incomplete surgical excision or occult multifocal disease rather than true recurrence. Although invasive carcinoma has not been described in these lesions so far, it is advisable to keep these patients under long-term follow-up care.
