Parotid

Madelung disease

March 31, 2011     Silviu Albu, MD
article

Chronic parotitis: A challenging disease entity

March 1, 2011     John M. Harbison, MD, Benjamin D. Liess, MD, Jerry W. Templer, MD, Robert P. Zitsch III, MD, and Jessica A. Wieberg, MD
article

Abstract

Chronic parotitis is a troubling clinical condition characterized by repeated infection and inflammation of the parotid gland caused by decreased salivary flow or obstruction. Unilateral swelling, pain, and other associated symptoms occur during acute exacerbations of the disease. A variety of laboratory and radiographic tools are available to aid in the diagnosis. Multiple treatment options have been proposed, ranging from conservative medical management to surgical interventions. We present 2 patients with bilateral chronic parotitis who attempted prolonged medical management and ultimately required surgical parotidectomy for control of their disease.

Acute parotitis induced by trimethoprim/sulfamethoxazole

February 1, 2011     Jayna S. Patel, DO and Edward D. Scheiner, DO, FOCOO
article

Abstract

Adverse drug reactions to the sulfonamide antibiotics are uncommon. When they do occur, they usually manifest as a rash or urticaria. Our review of the recent literature found that while sialadenitis is listed as a possible side effect of sulfonamide use, no actual case has ever been reported until now. We describe a case of acute bilateral parotitis that arose as a side effect of sulfonamide antibiotic treatment. We also examine the relevance of such pathology to the proposed mechanisms of sialadenitis, and we briefly discuss sulfonamide-induced pancreatitis. Lastly, we review the controversy over the possibility that some adverse drug reactions may be caused by cross-reactivity among different classes of sulfonamides.

Solitary cysticercosis (tapeworm) of the parotid gland

October 31, 2010     Ashubhalla Seith, MD, Ankur Gadodia, MD, and Raju Sharma, MD
article

Neonatal suppurative parotitis

September 30, 2010     Alba Miranda, MD and Kevin D. Pereira, MD
article

Multifocal synchronous ipsilateral Warthin tumors: Case report and review of the literature

August 31, 2010     Joseph E. Hall, MD, Melissa McCarty Statham, MD, Rachel M. Sheridan, MD, and Keith M. Wilson, MD
article

Abstract

We report a case of a 73-year-old woman who presented with an enlarging superficial parotid mass, a concomitant ipsilateral deep-lobe parotid mass, and associated upper jugular lymphadenopathy. The clinical presentation and radiographic imaging were suggestive of malignancy, and the patient was treated with total parotidectomy with upper jugular lymph node sampling. Pathologic examination revealed two distinct masses, one in the superficial lobe and one in the deep lobe of the parotid gland, both consistent with synchronous Warthin tumors. Analysis of the upper jugular lymph nodes was consistent with reactive lymphoid hyperplasia. Although the true incidence of multicentricity in ipsilateral Warthin tumors may be underappreciated and underreported, this entity should remain in the differential diagnosis for unilateral parotid masses.

Sebaceous lymphadenoma: A case report and review of the literature

July 31, 2010     Benjamin While, MRCS, Olivia J.H. Whiteside, MRCS, Vijayadwaja Desai, MRCPath;, and Paul Gurr, FRCS
article

Abstract

An 80-year-old woman presented with a mass in her left parotid region. An ultrasound-guided core biopsy showed sebaceous glands with lymphoplasmacytic infiltration. Magnetic resonance imaging displayed a well-circumscribed lesion within the left parotid gland. The mass was completely excised, and the patient made a full recovery. Sebaceous lymphadenomas of the salivary glands are rare, benign tumors that are effectively treated by complete excision. The challenge that these tumors present lies in their accurate diagnosis. Because of their histologic similarity to related malignant tumors, such as mucoepidermoid carcinomas and sebaceous lymphadenocarcinomas, misdiagnosis could lead to unnecessarily radical treatment. We highlight the need for careful clinical and histologic diagnosis in tumors of the salivary glands.

Primary Merkel cell carcinoma of the parotid gland

June 30, 2010     Mahmoud Ghaderi, DO, Jeffrey Coury, DO, Jacqueline Oxenberg, DO, and Harvey Spector, MD
article

Abstract

Primary Merkel cell carcinoma (MCC) is a neuroendocrine tumor that typically affects older whites. It usually originates in the dermis, but in rare instances it has arisen in other primary sites, including the oral mucosa and the parotid gland. Explanations for the presence of MCC in these atypical locations have included theories of malignant transformation and neuroendocrine migration. We describe the case of a 35-year-old white woman who had an MCC in the parotid gland and no evidence of any other primary cutaneous lesion. A left superficial parotidectomy with facial nerve preservation was performed, and a histologic diagnosis of MCC was made. Positron-emission tomography was negative for other lesions, and postoperative radiation therapy was administered for local control. To the best of our knowledge, this is only the sixth case of a primary MCC of the parotid gland to be reported in the English-language literature; of these 6 patients, ours was by far the youngest. Otolaryngologists should be familiar with this rare but potentially fatal neoplasm.

Hamartoma of the parotid gland: Report of a unique case

April 30, 2010     Yamileth Nicolau, MD, William C. Faquin, MD, PhD, and Daniel G. Deschler, MD, FACS
article

Abstract

Hamartomas of the parotid gland are very rare. We present the case of a parotid gland hamartoma with oncocytic and sebaceous metaplasia arising as a 3-cm mass in a 70-year-old man. To the best of our knowledge, there has been no previous report of a tumor with the same features. We present this case to create awareness of hamartomas as part of the differential diagnosis of parotid masses.

Primary parotid gland sarcoidosis: Case report and discussion of diagnosis and treatment

March 31, 2010     Nicole Longo, DO and Mahmoud Ghaderi, DO, FAOCO
article

Abstract

Sarcoidosis is a systemic disease of unknown origin that is characterized by noncaseating granulomatous lesions. Primary otolaryngologic manifestations of sarcoidosis are not commonly seen. The documented incidence of parotid gland involvement (either primary or secondary) is only 6%. Extrapulmonary involvement can be present in up to 30% of patients with sarcoidosis and can present at the same time as pulmonary sarcoidosis. We report a case involving a patient with primary unilateral parotid sarcoidosis who returned with bilateral recurrence approximately 4 years after a total unilateral parotidectomy. To the best of our knowledge, this is only the second reported case in the English-language literature of primary parotid sarcoidosis that is the sole manifestation of the disease. We also discuss methods of diagnosis and treatment of head and neck manifestations of sarcoidosis.

Dermoid cyst of the parotid gland

February 1, 2010     Behrad Aynehchi, MD, Jason G. Newman, MD, and John S. Brooks, MD
article

Abstract

A dermoid cyst is an ectodermally differentiated form of teratoma. Its occurrence in the parotid gland is very rare. Such a presentation must be properly evaluated in order to rule out malignancy. We describe the diagnostic evaluation and surgical management of a parotid dermoid cyst in an 18-year-old man. We also review the embryologic pathogenesis of the tumor and the usefulness of the physical examination, preoperative fine-needle aspiration cytology, magnetic resonance imaging, and computed tomography in evaluating the extent of the tumor, its histologic features, and its cystic characteristics. Finally, we discuss the role of surgical management in terms of preserving facial nerve integrity and preventing recurrence.

Acute suppurative neonatal parotitis: Case report

February 1, 2010     Sardar U. Khan, DLO, FCPS, Peter G. O'Sullivan, BSc, MPhil, and John McKiernan, FRCPI
article

Abstract

Neonatal suppurative parotitis is very rare. One review of the English-language literature spanning 35 years found only 32 cases. Most cases are managed conservatively with antibiotic therapy; early antibiotic treatment reduces the need for surgery. The predominant organism is Staphylococcus aureus. We report a new case of neonatal suppurative parotitis in a 3-week-old boy. The patient was diagnosed on the basis of parotid swelling, a purulent exudate from a Stensen duct, and the growth of pathogenic bacteria in culture. He responded well to 9 days of intravenous antibiotic therapy. We also discuss the microbiologic and clinical patterns of this disease.

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