Complete agenesis of major salivary glands

An Unusual Asymptomatic Case of Unilateral Parotid Gland Agenesis

Congenital absence of the major salivary glands, especially of the parotid gland, is a very infrequent condition of poorly understood etiology. This condition may be unilateral or bilateral and may occur alone or in association with the absence of other salivary glands or with other developmental craniofacial deformities of maxillofacial first and second branchial arch. Only 24 cases are documented in the literature. The authors present a case of a 79-year-old female who was referred to the Neurosurgery Department for neurocognitive impairment. The brain computed tomography with contrast enhancement incidentally showed a complete absence of the left parotid gland. The medical history and physical and radiographic examinations were indicative of nonsyndromic and nonfamilial asymptomatic unilateral aplasia of the parotid gland.

Aplasia of the Major and Minor Salivary Glands: Report of a Rare Case

Background

Aplasia of the salivary glands, either partial or involving all the major and possibly the minor salivary glands, is a very rare cause of hyposalivation. The aim of this case report is to present a case of aplasia of the major and minor salivary glands and discuss the relevant literature.

Methods

A 23-year-old woman, with a non-contributory medical and family history was referred due to rampant caries, that could not be attributed to any obvious aetiology. No sicca symptoms, previous parotid gland swelling or general symptoms were reported. Clinically, oral mucosa dryness and extended dental erosions and caries were observed, while the orifices of the excretory ducts of the parotid and submandibular salivary glands were not evident. Unstimulated and stimulated saliva flow rates were severely diminished, while a diagnostic biopsy of the lower lip revealed absence of minor salivary glands. Detailed hematologic and immunological investigations to exclude systemic disorders were also within normal limits. Ultrasound and magnetic resonance imaging revealed the absence of all major salivary glands, confirming the clinical diagnosis of congenital aplasia of the salivary glands.

Results

Oral hygiene instructions and dietary advice were given while dental products with fluoride and saliva substitutes were administered and appropriate dental treatment was implemented. Regular dental follow-up was also advised.

Conclusions

Timely diagnosis of aplasia of the salivary glands is important, considering the detrimental effects of the absence of saliva on oral health. Management consists of the use of saliva substitutes, nutritional adaptation, maintenance of oral health and regular dental follow-ups.

Asymptomatic unilateral aplasia of the left parotid gland: an unusual entity and case report

Congenital agenesis of major salivary glands is considered a very infrequent condition and typically appears to be a coincidental finding. It can be present as sporadic case or may be combined with aplasia or hypoplasia of other salivary glands or the lacrimal glands, or as a part of syndromes. Only 23 cases documented in the literature to date, while the youngest patient was 50 days old. Plenty of radiographic useful techniques and treatment is closely related to the clinical manifestations; therefore. We present a case of 52 year old female who was referred to our radiology department for recurrent numbness of the left upper limb, experienced over the previous three months. Complete absence of the left parotid gland was incidentally demonstrated at the brain MRI scan. Based on the patient's past medical history, physical examination and demonstrated radiographic techniques it was an asymptomatic, no-syndromic and no-familious unilateral aplasia of the parotid gland. In the present report, we aimed to underline that this rare condition may be asymptomatic and co-exist with other medical conditions and syndromes.

Unusual Conditions Impairing Saliva Secretion: Developmental Anomalies of Salivary Glands

Salivary glands (SG) arise from ectodermal tissue between 6 and 12th weeks of intrauterine life through finely regulated epithelial-mesenchymal interactions. For this reason, different types of structural congenital anomalies, ranging from asymptomatic anatomical variants to alterations associated with syndromic conditions, have been described. Notable glandular parenchyma anomalies are the SG aplasia and the ectopic SG tissue. Major SG aplasia is a developmental anomaly, leading to variable degrees of xerostomia, and oral dryness. Ectopic SG tissue can occur as accessory gland tissue, salivary tissue associated with branchial cleft anomalies, or true heterotopic SG tissue. Among salivary ducts anomalies, congenital atresia is a rare developmental anomaly due to duct canalization failure in oral cavity, lead to salivary retention posterior to the imperforate orifice. Accessory ducts originate from the invagination of the developing duct in two places or from the premature ventral branching of the main duct. Heterotopic ducts may arise from glandular bud positioned in an anomalous site lateral to the stomodeum or from the failure of the intraoral groove development, hindering their proximal canalization. These anomalies require multidisciplinary approach to diagnosis and treatment. While ectopic or accessory SG tissue/ducts often do not require any treatment, patients with SG aplasia could benefit from strategies for restoring SG function. This article attempts to review the literature on SG parenchyma and ducts anomalies in head and neck region providing clinicians with a comprehensive range of clinical phenotypes and possible future applications of bioengineered therapies for next-generation of regenerative medicine.

Aplasia of the lacrimal and major salivary glands (ALSG). First case report in spanish population and review of the literature

Aplasia of the lacrimal and the major salivary glands (ALSG) is a rare disorder with scarce cases described in the recent literature. The pattern of genetic inheritance is autosomal dominant with variable expressivity. A 40 years male patient was referred to the Oral and Maxillofacial Service at the Hospital Universitario de A Coruña diagnosed with complete agenesis of all salivary glands. Our case it is the first of ALSG syndrome in the Spanish literature. Imaging tests are necessary to confirm the lack of formation of salivary glands and alteration of lacrimal system. A mutation of FGF10 has been proposed as the responsible of the syndrome. The management of the lacrimal alteration depends of the clinical findings. Clinical suspicion remains the principal tool to diagnose the syndrome.

Key words:ALSG, salivary glands aplasia.

New pathogenic variant in the FGF10 gene in the agenesis of lacrimal and salivary gland syndrome: Ophthalmological and genetic study

Aplasia/agenesis of lacrimal and salivary glands is a rare congenital defect that has been associated with disturbances in fibroblast growth factor 10 (FGF10). It can present with symptoms of congenital lacrimal obstruction, dry eye, and dry mouth. We report the ophthalmological and genetic study of a 19-year-old woman and her relatives suffering from this syndrome. A new probably pathogenic variant is described in the FGF10 gene.

Congenital Unilateral Agenesis of the Parotid Gland: A Case Report and Review of the Literature

Congenital unilateral agenesis of the parotid gland is a rare condition with only few cases reported in the literature. A review of 21 cases in the available literature is presented in this article. We report on a further case of a 34-year-old woman with agenesis of the left parotid gland and lipoma of the right cheek. Clinicopathological characteristics of described cases in the literature were discussed.

Sialolithiasis in an Accessory Submandibular Gland Identified by Magnetic Resonance Sialography

BACKGROUND

Accessory submandibular gland is a very rare anatomical variant. There have been only 6 reported cases of this entity in the English literature, only 1 of which was identified using magnetic resonance imaging.

METHODS

We report the case of a 39-year-old female with symptoms of left submandibular sialoadenitis who was diagnosed of sialolithiasis within the left accessory submandibular gland by magnetic resonance sialography (MR-Si).

RESULTS

The calculus was palpated near the submandibular papilla and was extracted by an intraoral approach. One-year follow-up revealed no evidence of recurrence.

CONCLUSIONS

This is the first case reported to date in the English literature of a patient with sialolithiasis within an accessory submandibular gland diagnosed by MR-Si.