Simultaneous bilateral parotid and submandibular gland calculi

A recent review of the medical literature revealed no recorded cases of simultaneous bilateral parotid and submandibular calculi. We present such a case with roentgenographic documentation.     

A case of Kuttner tumor of the submandibular gland

Kuttner tumor (known as chronic sclerosing sialadenitis) is a totally benign inflammatory lesion and to date there has been no report of malignancy. However, because of its clinical features, the clinical diagnosis is often that of a salivary gland neoplasm. We report a case of Kuttner tumor and discuss its differential diagnosis, especially the pathological diagnosis. Kuttner tumor may be mainly due to T lymphocyte immune reaction and of itself is a benign lesion, but it may provide a state in which a malignant lesion arises.     

A case of giant sialolith of the submandibular salivary gland

Sialolithiasis is the most common disease of the salivary glands. This report describes the case of a patient who had an unusually large submandibular gland sialolith that was completely encased in the glandular substance. The author describes the management of this patient and reviews the literature.     

Metachronous bilateral submandibular gland metastases from carcinoma of the breast

Metastases to the salivary glands from distant neoplasms are unusual, with most reported cases involving the parotid gland. Metastatic deposits in the submandibular gland are extremely rare with bilateral involvement not previously reported. We present the case of a patient with advanced breast carcinoma who has had metachronous involvement of both submandibular glands and review the literature on this subject.     

A case of bilateral aplasia of the submandibular glands associated with a unilateral submandibular hemangioma

Congenital aplasia of the major salivary gland is a rare condition. We report on a case of bilateral aplasia of the submandibular glands associated with a left submandibular hemangioma. A 62-year-old woman came to our department complaining of a 3-year history of left submandibular swelling. She had no notable family or personal medical history. On physical examination of the head and neck region, a 30 mm, non-tender mass was palpated in the left submandibular area. On imaging examinations including ultrasonography and CT, lack of the right submandibular gland and a left submandibular mass with calcification were demonstrated. Fine needle aspiration cytology resulted in blood elements only. Functioning tissue could not be observed in the bilateral submandibular glands on technetium pertechnetate scintigraphy. We performed a left submandibular tumor extirpation. Intraoperatively, the left submandibular gland and duct were missing. On pathologic examination, the tumor was found to be a hemangioma. The parotid and sublingual glands were recognized bilaterally on postoperative MRI. Her postoperative condition was satisfactory. This condition may be due to the dysfunction of several factors, such as fibroblast growth factors, related to gland differentiation.     

Malignant schwannoma of the submandibular gland. A case report

The first case of malignant schwannoma of the submandibular gland in a 23-year-old man with neurofibromatosis is reported. Light microscopy showed typical features of neurogenic sarcoma and an immunocytochemical study confirmed the schwannian differentiation of the neoplasm. The patient is still well without evidence of metastases or local recurrence of the tumor 80 months after the excision of the neoplasm.     

A mucocele of the submandibular gland

We encountered an unusual case of a mucocele arising from the submandibular gland. Among the limited number of cystic salivary gland neoplasms reported in the literature, there have been no reports, to our knowledge, of a similar cystic lesion. The unique characteristics of this mass permitted definitive diagnosis by computed tomographic scanning.     

Carcinosarcoma of the submandibular gland: an autopsy case

Malignant mixed tumors of salivary glands are classified as three types: carcinoma arising in a pleomorphic adenoma, the most common; benign metastasizing pleomorphic adenoma; and carcinosarcoma (true malignant mixed tumor), which is very rare [Ann. Otol. Rhinol. Laryngol. (1982) 91 342]. In carcinoma, both epithelial and soft tissue elements are malignant. In the context of previous reports, we discuss a case of carcinosarcoma of the submandibular gland including the results of postmortem examination.     

Tuberculosis of the submandibular gland: a case report

INTRODUCTION: Tuberculosis remains an important public health problem in France. After a certain decline, its incidence has remained unchanged since 1990. 30% of tuberculosis cases are extra-pulmonary form, most of them concern nodes especially in cervical areas. CASE REPORT: This case of submandibular tuberculosis illustrates diagnostic and therapeutic difficulties. DISCUSSION: There are few clinical signs or laboratory clues suggestive of tuberculosis, however a surgery cannot be avoided and must be performed in combination with antituberculosis chemotherapy.     

An unusual sequel of submandibular gland calculus—A case report

Sialolithiasis in sub-mandibular gland is a common condition. Sub-mandibular fistula as a sequel of sub-mandibular sialolithiasis is a rare entity. We report a case of an unusually large sub-mandibular gland calculus causing a cutaneous fistula.     

A rare case of asymptomatic bilateral submandibular gland sialolithiasis: a giant, fistulized calculus on the right and multiple calculi on the left

Sialolithiasis is the most common disease of the submandibular gland; sialoliths account for at least 80% of all salivary duct calculi. We present a rare case of asymptomatic bilateral submandibular gland sialoliths. On the right, the patient had a giant (35 × 35 mm) sialolith that had fistulized into the oral cavity. In the left submandibular gland, he had 30 differently sized sialoliths.     

A case of a giant submandibular gland calculus perforating the floor of the mouth

Sialolithiasis is characterized by the obstruction of salivary gland secretion by a calculus. It is associated with swelling, pain, and infection of the affected gland. More than 80% of all salivary calculi occur in the submandibular gland. One reason for this is the makeup of the saliva in the submandibular gland, which includes a higher mucus content, a greater degree of alkalinity, and greater concentrations of calcium and phosphate salts compared with the saliva of the parotid and sublingual glands. Other factors are that its duct is longer and its saliva flows against gravity. Sialoliths that reach several centimeters in diameter (megaliths, or giant calculi) are rare. Perforation of the floor of the mouth by a giant calculus is extremely rare. We report such a case in a 56-year-old man who presented with a 2-day history of severe pain in the left sublingual area and painful swelling in the left submandibular area. Removal of the stone and the left submandibular gland was performed via an extraoral incision. On gross examination, the sialolith measured 5.6 cm.     

Myoepithelial neoplasia of the submandibular gland: case report and therapeutic considerations

Tumors of the submandibular gland typically arise from the seromucinous acini, which make up the majority of the gland. The most common benign tumor of this structure is the pleomorphic adenoma, whereas the most common malignancy of the submandibular gland is adenoid cystic carcinoma. We describe an unusual case of a neoplastic process of the myoepithelial cells of the submandibular gland in a middle-aged woman. This rare tumor is most commonly diagnosed in the parotid gland and in the minor salivary glands of the hard palate; a review of the literature uncovered only 5 previous reports of myoepithelioma of the submandibular gland. Distinguishing myoepithelioma from benign pleomorphic adenoma and malignant myoepithelial carcinomas can be challenging. Immunohistochemical staining can help to distinguish between the benign neoplasms, but histologic features remain the "gold standard" for diagnosing the malignant tumors. Increasing use of immunohistochemistry panels to assess parotid neoplasms also suggests that myoepithelioma may be underrecognized.     

内镜辅助耳后发际入路颌下腺切除术与传统术式的对照研究

目的 与传统经颈入路比较,评价内镜辅助耳后发际入路颌下腺切除术的可行性及其利弊.方法 2009年1月至2010年1月,前瞻性对照研究28例颌下腺良性病变患者分别行两种术式的治疗结果.其中13例接受内镜辅助耳后发际入路手术,15例接受传统经颈入路手术.术前所有病例均行CT或MRI检查评估病损大小、位置、毗邻,并行细针穿刺活检明确病理.秩和检验比较两组患者的切口长度、手术时间、术中出血量、术后并发症及切口美容效果.结果 28例患者颌下腺均顺利完整切除.内镜组切口长度、手术时间与传统组比较,差异有统计学意义(Z值分别为-4.516和-3.263,P值均＜0.01);术后3个月,内镜组切口美容效果好于传统组,差异有统计学意义(Z=-4.472,P＜0.01).术后内镜组2例患者(15.4%)出现暂时性耳垂麻木、1例(7.7%)出现暂时性面神经下颌缘支麻痹,均在术后1个月缓解.所有病例随访10～24个月,中位随访18个月,未见复发.结论 对于颌下腺良性疾病,内镜辅助耳后发际入路颌下腺切除术安全、可行.与传统经颈入路比较,切口隐蔽,美容效果确切.

Abstract：

Objective To assess the feasibility,the risks and the advantages of endoscope-assisted submandibular gland resection using a retroauricular hairline incision ( RAHI) by comparing it with the conventional submandibular gland resection.Methods Twenty eight patients with benign lesions of the submandibular gland were included in the prospective clinically controlled study.Thirteen patients had endoscope-assisted resection using the RAHI approach and 15 cases had conventional transcervical approach resection.The size,location and adjacency of all lesions were evaluated by CT or MRI before surgery.The pathologic diagnoses of all cases were identified as benign diseases using fine needle aspiration biopsy.The two groups were compared for incision length,operation time,bleeding,incision cosmetic result,and complications.Results All 28 operations were successfully performed.Incision length in the endoscopic group was significantly longer than that in the trancervical group (Z =-4.516,P＜0.01),and the surgical time was longer in the endoscopic group( Z =-3.263 ,P ＜0.01) .After three months the mean subjective satisfaction score for the incision scar in the endoscopic group was significantly higher than that in the trancervical group(Z=-4.472,P＜0.01).In the endoscopic group,2 cases (15.4%) with temporary numbness of the earlobe and 1 case (7.7% ) with a temporary marginal mandibular nerve paralysis were found postoperatively.However,they recovered within 1 month.All 28 patients were disease free with a follow-up of 10 to 24 months (median of 18 months).Conclusions Endoscope-assisted submandibular gland resection via RAHI is feasible and safe for the treatment of benign submandibular gland lesions.In comparison with the transcervical approach,this method can provide better cosmetic results without significant complications.     

Tumors of the submandibular gland

Primary neoplasms of the submandibular gland do not hold a statistically impressive position when compared to other tumors in the head and neck. Due in part to their relative rarity, incorrect preoperative diagnosis is not uncommon, but perhaps of more significance is the lack of an adequately prepared management program of these lesions. This presentation reviews tumors of the submandibular gland at the Charity Hospital in New Orleans, La., for the 24-year period 1948-1971.