This elderly patient who was on anticoagulants fell down and hit his left face on the edge of a table. Immediately, he developed a rapid swelling of the left parotid gland and ecchymosis of the surrounding skin. The ecchymotic spot behind the ear mimicked Battle's sign, however there was no evidence of temporal bone fracture by otoscopy. The ear canals and tympanic membranes were normal. There were also some ecchymotic spots around the pore of Stensen's duct in the left cheek mucosa.
There were no fractures on CT, but a heterogenous swelling of the left parotid gland was evident (adjacent picture).