Clinical Entities that Mimic Salivary Inflammatory Disease
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SALIVARY GLAND DISORDERS (HT HOFFMAN, SECTION EDITOR)
Clinical Entities that Mimic Salivary Inflammatory Disease Daniel E. Palmieri 1 & Barry M. Schaitkin 2 & Jolie L. Chang 3 Published online: 18 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Sialadenitis due to salivary obstruction is associated with characteristic intermittent pain and swelling of the affected gland. Common etiologies of adult salivary obstruction include salivary duct stones or duct stenosis. However, various pathologic processes can mimic obstructive salivary gland symptoms. This is a case-based review of pathologies that may present similar to the signs and symptoms of salivary obstruction with gland inflammation. Recent Findings Multiple cases with pathologies mimicking inflammatory salivary gland disease have been reported and described. This review uses a case-based approach to highlight the clinical presentation, exam, and imaging findings of disorders that imitate sialadenitis in order to describe approaches for achieving accurate diagnoses. Summary Cases involving nonobstructive salivary pathology are presented to demonstrate a broad differential diagnosis for facial and salivary gland swelling. Keywords Salivary swelling . Imitators of salivary disease
Introduction Recurrent swelling of the salivary glands is most often caused by salivary duct obstruction from sialolithiasis or duct stenosis. At times, certain pathologies within or near the salivary glands can present similarly to recurrent sialadenitis. Even imaging features can misdiagnose salivary obstruction. For example, most calcifications within or near a salivary gland are classified immediately and possibly incorrectly as salivary stones. We will use the following example cases to demonstrate how certain disorders can mimic salivary gland obstruction and mask a
This article is part of the Topical collection on Salivary Gland Disorders * Jolie L. Chang [email protected] Daniel E. Palmieri [email protected] Barry M. Schaitkin [email protected] 1
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
2
University of Pittsburgh Medical Center, Pittsburgh, PA, USA
3
Department of Otolaryngology, Head and Neck Surgery, University of California, San Francisco, CA, USA
separate underlying condition. Key features in the clinical history, physical exam, and imaging findings can help determine the diagnosis.
Case 1: Granulomatosis with Polyangiitis History: 39 year-old female presented with 2 months of fluctuating floor of mouth swelling that had been progressive over 2 weeks. She was initially seen by her primary care physician and given antibiotics. She did not have improvement of her symptoms and was subsequently seen by two separate otolaryngologists and prescribed oral steroids for presumed sialadenitis. She stated that her symptoms have fluctuated but overall have progressed. Her pain has become so significant that swallowing was very difficult. The patient does report a history of dry eyes and dry mo
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