A 26 year-old woman with no medical history of personal or family tuberculosis was admitted for a left sub-mandibular swelling which had appeared 12 months earlier. It began small then gradually increased in volume without alteration of the general condition. Many broad-spectrum antibiotics were attempted without any improvement. Examination showed a 5 cm painless, elastic left parotid mass, adherent to the skin and deeper layers, with mild inflammation of the overlying skin but without fistula or facial paralysis (Figure 1). Moreover, we found ipsilateral sub-mandibular lymphadenopathies. The contralateral parotid region was unremarkable. Otoscopy was normal and oral cavity examination showed neither left tonsillar deviation nor purulent secretions from the left Stensen's duct. The MRI showed a 4.6 cm, irregular and heterogeneous tumoral process of the deep lobe of the left parotid gland with a T1 hyposignal and a T2 hypersignal, and heterogeneous enhancement after gadolinium injection (Figure 2). Fine needle aspiration cytology (FNAC) of the mass was inconclusive. We, therefore, decided an exploratory extrafacial parotidectomy. In preoperative, parotid tissue appeared necrotic and purulent by places (Figure 3). Frozen section showed tuberculous lesions in both parotid and sub-mandibular lymph nodes. We, therefore, restricted surgery to a left lower pole parotidectomy. A check-up looking for second location tuberculosis (clinical examination, chest X ray, sputum analysis) was negative. The tuberculin skin test was positive at 12 mm. A prolonged (9 months) four drug antituberculous regimen (H: isoniazid, E: ethambutol, R: rifampicin and Z: pyrazinamid) was then started according to our usual protocol: 2 RHZE/7 RH. The evolution was satisfactory with no relapse after six years.