Primary submandibular tuberculosis: an unusual cause of submandibular salivary gland enlargement

A case report of very rare Primary Tuberculosis of Submandibular Gland. This is presented in view of its rarity and highlighting the importance of histopathological examination and Polymerase chain reaction (PCR) to reach the final and exact diagnosis of disease.     

Giant bilateral submandibular sialoliths and the role of salivary endoscopy

Sialolithiasis is the most common disease of the salivary glands. Sialoliths that exceed 15 mm in any dimension are considered as giant. We present the first case of simultaneous bilateral giant sialoliths reported in the literature and the role of salivary endoscopy in this scenario. Salivary endoscopy allows duct exploration and retrieval of smaller intra-ductal fragments during combined approaches (external and endoscopic).     

Primary extramedullary plasmacytoma of the salivary glands

Primary extramedullary plasmacytomas (PEMP) are uncommon plasma cell neoplasms that generally occur in the submucosal tissue of the upper airway. Salivary gland PEMP is an extremely rare condition. This report describes a unique case of PEMP in the parotid gland associated with pulmonary amyloidosis. A review of all salivary gland PEMP's suggests that they behave similarly to PEMP's in other locations. The treatment of choice for localized disease is radiotherapy which should include regional lymphatics. Local control can be achieved in the majority of cases. The minority of patients develop systemic metastases and die from their disease. Chemotherapy can control disseminated disease and may induce remission.     

Primary sarcomas of the major salivary glands

Sarcomas arising in the major salivary glands are rare. This article presents the clinicopathologic features of 11 patients with primary sarcomas of the parotid gland (eight men and three women aged 7 to 75 years; mean age, 42 years). The 11 sarcomas were histologically typified as follows: three malignant fibrous histiocytomas and two each of neurosarcomas, rhabdomyosarcomas, fibrosarcomas, and osteosarcomas. Four patients experienced disease recurrences, and seven patients developed metastases. Seven patients died of their sarcomas, with a mean survival time of 30 months. Four patients were alive from 5 to 12 years (one each with angiomatoid malignant fibrous histiocytoma, embryonal rhabdomyosarcoma, fibrosarcoma, and neurosarcoma). Prognosis correlated with size of the neoplasm, type of sarcoma, and histologic grade. In this respect, salivary gland sarcomas behaved in identical fashion to their soft-tissue counterparts.     

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.     

Primary squamous cell carcinoma of the submandibular salivary gland

Malignant tumors of the submandibular salivary glands are rare in occurrence, among which primary squamous cell carcinoma of the submandibular salivary gland is unusual and the documented evidence is 2 to 5% among malignant tumors A case of primary squamous cell carcinoma of submandibular salivary gland is being presented for its rarity     

Neuropeptides in human salivary (submandibular and parotid) glands.

The existence, distribution and density of various neuropeptides in human submandibular and parotid glands were investigated using immunocytochemistry and radioimmunoassay. Numerous nerve fibers containing vasoactive intestinal polypeptide (VIP) and peptide histidine methionine (PHM), or neuropeptide Y (NPY) and C-flanking peptide of NPY (CPON) immunoreactivities (ir) were found in close association to acini, ducts and blood vessels. Only few calcitonin gene-related peptide (CGRP)- and substance P (SP)-ir nerve fibers could be demonstrated, mainly localized around blood vessels and ducts. Galanin and the newly discovered peptides helospectin and pituitary adenylate cyclase activating peptide (PACAP) could not be detected in human salivary glands.     

Peptidergic innervation of human salivary glands (parotid gland and submandibular gland)]

Immunocytochemistry and a radioimmunoassay were used to investigate the existence and distributions of various regulatory peptide immunoreactivities (ir) in human submandibular and parotid glands. Numerous nerve fibers containing vasoactive intestinal polypeptide (VIP) and peptide histidine methionine (PHM), or neuropeptide tyrosine (NPY) and C-flanking peptide of NPY (CPON)-ir were found in close proximity to acini, ducts and blood vessels. Only a few calcitonin gene-related peptide (CGRP)- and substance P (SP)-ir nerve fibers could be demonstrated and were mainly localized around blood vessels and ducts. Galanin and the recently discovered peptides helospectin and pituitary adenylate cyclase activating peptide were unable to be detected in the salivary glands studied. Preliminary quantitative investigations of four human submandibular glands using radioimmunoassay showed that VIP-ir had the highest concentration, followed by NPY-ir and CGRP-ir; SP-concentrations were below the detection limit. The possible physiological significance of these peptides for salivary secretion is discussed.     

Hydatid cyst in submandibular salivary gland

This case of 52-year male with swelling in the left submandibular area for 1 year came to ENT OPD of Patna medical college, Patna. Clinical examination showed swelling to be multiple nontender cysts with enlarged submandibular salivary gland. CT-scan revealed large well-defined encapsulated multicystic lesions in the left submandibular gland. FNAC was suggestive of aspirate to be ectopic to that area. Excision biopsy was done. HPE showed features suggestive of parasitic infestation along with chronic sialadenitis. Gross picture and investigations were highly suggestive of parasitic infestation to be primary hydatid cyst of the gland. Scanning for other areas like liver and lungs done, no lesion was found.     

Arteriovenous hemangioma involving submandibular salivary gland

We present a case of an arteriovenous hemangioma involving the submandibular salivary gland in a 20 year old girl. Hemangiomas in this region are rare. Out of the reported cases most have been cavernous hemangiomas. The rarity of an arteriovenous malformation in the submandibular salivary gland prompted us to report this case.     

Hemangiomas of the salivary glands

Five salivary gland hemangiomas in adults are reported. The feasibility of preoperative diagnosis on clinical and radiologic grounds is emphasized. Adult hemangiomas are of the cavernous type and can be differentiated from infantile capillary hemangiomas clinically as well as histologically. Cavernous hemangiomas in the adult should be treated by surgical excision.     

Sialendoscopy of the salivary glands

INTRODUCTION: Sialoendoscopy is a simple efficient mode of treatment for major salivary gland sialoliths and strictures. METHODS: Sialendoscopy procedure requires specific devices, diagnostic and therapeutic sialendocopes, minigrasping forceps, wire baskets, lasers, balloons and stents. The sialendoscopy procedure is divided in three steps: the duct introduction step (through the papilla or through the duct wall); the diagnostic step (from main duct to third or fourth salivary division branches) and the therapeutic step (stone removal with a Dormia basket or miniforceps and stenosis balloon dilatation). The feasibility of stone removal depends on the size, the position, the mobility and the shape of the stone. The only contraindication is acute sialadenitis. DISCUSSION: Sialendoscopy complications are minor. Its success rate for stone removal is greater than 90%, and it has dramatically reduced the rate of sialadenectomy (to less than 5%).     

Undifferentiated carcinomas of salivary glands

Undifferentiated carcinomas of salivary glands are those epithelial malignancies whose light-optic histopathologic features are not sufficient to place them in other defined classes of carcinoma. They are ultrastructurally heterogeneous and can manifest neuroendocrine differentiation. With or without the latter, the carcinomas are biologically high-grade and rank with salivary duct and high-grade mucoepidermoid carcinomas in terms of morbidity and mortality.