Quartz 4

W6 Cases

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Salivary Gland Diseases12

Case 1

A 48-year-old male patient came to a dental clinic to treat a slightly painful and unhealed lesion at the left posterior hard palate for over two weeks. His medical history is significant to cardiovascular disease with implementation of two stents in the coronary arteries before. He uses aspirin regularly to prevent blood vessel thrombosis.

Activity:

Identify the pathosis and describe the clinical and histopathological features

Clinically

  • Ulcerated Surface
  • 1.5 cm
  • Located in left posterior hard palate

Microscopically

  • Pseudoepitheliomatous hyperplasia
  • Preservation of lobular architecture
  • Lobular infarction with or without mucin spillage
  • inflammation secondary to extravasation of mucin

Differential Diagnosis

  • Mucoepidermoid carcinoma
  • postradiation changes
  • squamous cell carcinoma

Relevant Clinical Investiagations

  • positive stains
  • focal to absent p53, MI81
  • Myoepithelial cells are p63/calponin positive

Diagnosis

  • necrotizing sialo-metaplasia

Case 2

Case description:

A 60-year-old male patient presented with pain and swelling in the lower right side of the floor of the mouth for the past week. The history of pain was sudden in onset with moderate intensity and was continuous in nature. Medical history is insignificant.

**Identify the pathosis and describe the clinical, radiological and histopathological features

  • Clinically
    • intraoral photograph showing sialolith on the floor of the mouth on right side causing sialo-oral fistula
  • Radiologically
    • Mandibular occlusal view revealing homogenous radiopacity in the floor of the mouth on the right side
    • OPG showing well-defined radiopacity about lower right of second premolar
  • Differential Diagnosis
    • Sialadenitis due to microbial infection
    • Sialadenitis due to salivary stone
    • Salivary neoplasms
  • Diagnosis
    • Sialolithiasis (salivary stone )

Describe the aetiology of this condition

  • Exact aetiology unknown. However, salivary stagnation, increased alkalinity of saliva, infection, inflammation or physical trauma to salivary duct or gland may predispose to calculus formation

Footnotes

  1. Original PDF page 1: W6 Cases, p.1 ↩

  2. Original PDF page 2: W6 Cases, p.2 ↩

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