Author: Natasha Kim Berg, MD. Fellow in Cytopathology, Northwestern University, Chicago

Reviewer: Ajit Singh Paintal, MD. Assistant Professor of Pathology, Northwestern university, Chicago

A 70 year old male with history of coronary arterial disease, hypertension, arthritis, and gastrointestinal reflux disease presented with a left submandibular mass. He reported that the mass had been present for 3-4 years.  Initially, it was approximately the size of a marble, but recently it had increased to the size of a golf ball and become painful.  He had also noted some fluctuation in the size of the mass, associated mostly with meals. He denied dyspnea, odynophagia, hoarseness, dysphagia, ear pain, severe headaches or visual changes.  A neck CT demonstrated 3.6 x 3.3 x 2.9 cm, heterogeneously enhancing, partially cystic and partially solid mass arising anteriorly from the left submandibular gland.  FNA and subsequent resection were performed.

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What is the most likely diagnosis?