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Bilateral parotid voluminous masses: a case report.

Evaristo Belli1, Giancarlo Renzi, Filippo Marini Balestra

  • 1Maxillo-Facial Surgery Department, II Faculty of La Sapienza University at S. Andrea Hospital, Rome, Italy.

The Journal of Craniofacial Surgery
|January 6, 2004
PubMed
Summary
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Bilateral parotid gland masses in a 75-year-old woman were diagnosed as benign lymphoepithelial cysts. The likely cause was bilateral parotid duct obstruction from a mobile denture, not neoplastic or infectious agents.

Area of Science:

  • Otolaryngology
  • Pathology
  • Radiology

Background:

  • Bilateral parotid masses present a diagnostic challenge, requiring differentiation between neoplastic and nonneoplastic conditions.
  • Benign lymphoepithelial cysts are uncommon salivary gland tumors, often presenting as painless swellings.

Observation:

  • A 75-year-old woman presented with voluminous, bilateral, symmetrical parotid masses.
  • Initial evaluations excluded neoplastic and infectious causes, leading to surgical intervention for cosmetic and progressive enlargement concerns.

Findings:

  • Histopathology revealed benign lymphoepithelial cysts with polyclonal lymphoid infiltration.
  • Extensive serological and in situ hybridization testing ruled out active viral infections (CMV, HIV, EBV) and tuberculosis.
  • Bilateral parotid retention cysts were diagnosed, with a mobile denture causing parotid duct obstruction suspected as the primary pathogenic factor.

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Implications:

  • This case highlights the importance of considering dental factors in the pathogenesis of bilateral parotid cysts.
  • Retention cysts, secondary to ductal obstruction, should be included in the differential diagnosis of bilateral parotid masses.
  • Interdisciplinary collaboration between otolaryngologists and dentists is valuable for managing complex parotid gland pathologies.