Differential diagnosis of submandibular gland swellings

Year 2018, Volume: 8 Issue: 1, 56 - 61, 05.04.2018

Demet Yazıcı , Mehmet Yalçın Çöktü Zekiye Güney Sanem Okşan Erkan Orhan Görgülü İlhami Yıldırım Osman Kürşat Arıkan

Abstract

Objective: The differential diagnosis of
submandibular triangle swellings can be challenging to the clinician. In
this study, we retrospectively analyzed clinical and histopathological
characteristics of these swellings referred to our clinic and integrated
our results with current literature in terms of various diagnostic
aspects.




Methods: A
total number of 64 transcervical submandibular gland extirpations were
reviewed and evaluated regarding age, gender, fine-needle aspiration
biopsy and specimen reports




Results:
This study comprised 34 male (53.1%) and 30 female (46.9%) patients. We
classified submandibular triangle swellings clinicopathologically as
tumoral and non-tumoral lesions for better evaluation. We had 15
patients with primary epithelial submandibular gland neoplasm, 10
(66.7%) of them were benign cases, all of the benign cases were
pleomorphic adenoma with a male to female ratio of 1:2.33 and a mean age
of 30.8 years, 5 (33.3%) of them were malignant with a mean age of 55
years. There were also 37(57.8%) patients with chronic sialadenitis
associated with sialolithasis, 1 (1.6%) had acute sialedenitis, 2 (3.1%)
had granulomatous sialadenitis, 2 (3.1%) had reactive cervical
lymphadenopathy and 5 (7.8%) were treated for cystic lesion removal.
Ultrasonography and fine needle aspiration cytology were our major
diagnostic tools for differential diagnosis. Our institution's
sensitivity of fine-needle aspiration cytology for identifying
malignancy was 60% and the specificity was 100%.




Conclusion:
Submandibular gland excision for primary lesions has relatively low
incidence compared with other surgical implications. Although chronic
sialadenitis caused by symptomatic sialolithiasisis the most frequent
indication for surgery, diverse clinical entities should be ruled out
for differential diagnosis of swellings of this region.

Keywords

Submandibular gland, submaxillary gland, salivary gland calculi, submandibular gland neoplasm, pleomorphic adenoma, biopsy, fine-needle

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