Unilateral submandibular gland aplasia masquerading as cancer nodal metastasis

A Case of Sublingual Gland Hypertrophy in the Setting of Submandibular Gland Aplasia Presenting as a Neck Mass

Background

Absence or aplasia of the major salivary glands is an uncommon diagnosis and is often associated with other congenital abnormalities. Agenesis of a single submandibular gland, however, is an even more rare phenomenon and can be associated with hypertrophy of other salivary glands.

Methods

A 48-year-old female presented to the clinic with a left-sided neck mass below her mandible. Workup including a CT scan showed an absent left-sided submandibular gland and an enlarged sublingual gland protruding through the mylohyoid muscle.

Results

The patient underwent a transoral resection of the mass with subsequent resolution of the mass. The pathology returned as normal salivary gland tissue.

Conclusions

Sublingual gland hypertrophy is a very uncommon presentation for a patient with a neck mass. This situation can arise in the setting of submandibular gland aplasia and compensatory hypertrophy of other salivary glands.

Rare condition of unilateral submandibular gland aplasia and its diagnostic significance in oral cavity carcinoma

Background

The unilateral submandibular gland aplasia (agenesis) is a rare, asymptomatic condition usually discovered incidentally on imaging. This is associated commonly with either compensatory hypertrophy of contralateral submandibular gland or sublingual glands.

Case presentation

We report the case of a 34-year-old male with incidentally detected unilateral submandibular gland aplasia associated with hypertrophy of ipsilateral sublingual gland, demonstrated by imaging modalities, where we have highlighted the diagnostic significance of such rare findings in oncology, particularly in oral cavity carcinoma cases with metastatic submandibular lymph nodes (level IB) mimicking as submandibular gland. Hence, lymphadenopathy can be missed preoperatively which is an important part of staging and treatment planning.

Conclusions

Aim of the present report is to create awareness about such rare entity in both clinicians/radiologists and highlight the imaging features for correct identification and to avoid any diagnostic dilemmas.

Unilateral Submandibular Gland Aplasia with Ipsilateral Sublingual Ranula - A Case Report

Background:

Congenital aplasia of major salivary glands is a very rare entity, especially if it concerns an ipsilateral aplasia in a nonsyndromic patient.

Key points from the case:

The aim of this report is to present a case of an aplasia of the left submandibular gland, which was incidentally diagnosed during presurgical imaging for an ipsilateral sublingual ranula. Histopathological evidence of the lack of sublingual gland tissue in the excised specimen of the ranula is discussed.

Main lessons to be learned from this case report:

Unilateral submandibular aplasia has unknown etiology. Clinicians should be aware of this condition mainly to be able to differentially diagnose a hypertrophy/dysplasia of the contralateral or other major salivary glands, or when xerostomia is the main patient's symptom.

Unilateral Submandibular Gland Aplasia Mimicking Nodal Metastasis

Aplasia of salivary glands is rare and usually involves several major salivary glands. Isolated unilateral submandibular gland aplasia or aplasia accompanied by hypertrophy of contralateral submandibular gland or sublingual glands is a rare entity. The majority of cases are incidentally detected findings in asymptomatic patients; however, imaging findings may mimic mass-like lesions, posing diagnostic challenges in cancer patients. We presented 2 cases, a case with melanoma and an asymptomatic case, who had asymmetric lesion at left submandibular space, demonstrated to represent left submandibular gland accompanied by right submandibular gland aplasia. We aimed to highlight the imaging features for correct identification of these mass-like lesions as normal contralateral salivary gland accompanied by unilateral submandibular gland aplasia.

Agenesis of submandibular glands: a report of two cases with review of literature

Background. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG. Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMG aplasia, demonstrated by computerized tomography (CT) and magnetic resonance imaging (MRI). Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family.

Isolated unilateral aplasia of submandibular gland: a rare anomaly detected incidentally on computerized tomography

Aplasia of the major salivary glands is a very uncommon anomaly, with isolated aplasia of only 1 submandibular gland being even rarer. We report a case of a 60-year-old woman in whom unilateral aplasia of the left submandibular gland was detected incidentally on computerized tomography with no other associated congenital abnormalities.

Normal fetal salivary glands at 14-16 weeks of gestation as observed by transvaginal ultrasound imaging

OBJECTIVES

Absence or congenital anomalies of the parotid glands are associated with significant long-term morbidity. To date there are no published data on ultrasonographic detection of these defects in early pregnancy. We set out to demonstrate and measure the fetal parotid and submandibular salivary glands at 14-16 weeks using transvaginal ultrasound imaging.

METHODS

During a routine fetal anomaly detection scan in 30 consecutive patients, an attempt was made to examine the fetal parotid and submandibular glands. The fetal head was scanned in transverse sections just below the fetal ears, and the area of the parotid and submandibular glands was inspected. The examination time was not prolonged for the purpose of measuring the salivary glands. The fetal biparietal diameter and the femur length were also documented.

RESULTS

The median gestational age was 15.4 (range, 14.4-16.5) weeks. In all 30 patients examined, at least one pair of parotid and submandibular glands was clearly visualized and measured. In seven patients the parotid and submandibular glands were visualized on both sides. The median length of the parotid gland was 7.5 (range, 5.5-11.5) mm and that of the submandibular gland was 5.4 (range, 3.7-8.5) mm.

CONCLUSIONS

The fetal salivary glands can be demonstrated by transvaginal ultrasound imaging at 14-16 weeks of gestation. This is the first reported study presenting the normal values of salivary gland measurements, which may be important in detecting fetuses with congenital absence or other malformations of the glands.

PET/CT-MR Imaging in Head and Neck Cancer Including Pitfalls and Physiologic Variations

This article emphasizes the strengths and potential pitfalls of functional and anatomic imaging in patients who have head and neck cancer with an emphasis on the treated neck, including patients who have undergone surgery and/or radiation therapy. Anatomic and molecular imaging together allow optimal evaluation and interpretation of a patient who has cancer. Effective assessment of patients who have head and neck cancer can be achieved through a careful review of pertinent anatomy, with awareness of the physiologic variations (especially those in the treated head and neck) seen in PET imaging, and analysis of both the PET and cross-sectional images.