Application of contrast-enhanced ultrasound and acoustic radiation force impulse imaging in a parotid gland lesion

Metastases of the parotid gland occur infrequently and usually originate from head and neck malignant melanoma or squamous cell carcinoma. We report on the extremely rare case of a late onset parotid metastasis 11 years after nephrectomy due to renal cell carcinoma. With the application of high-resolution B-mode ultrasound, colour-Doppler imaging and the new ultrasound techniques, contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) imaging, we were able to perform precise tumour description and modify treatment modalities. We suggest the evaluation of CEUS and ARFI imaging for an improved visualisation of parotid tumours and discuss the impact for the differential diagnosis of parotid masses.