Sialoadenitis secondary to ¹³¹I therapy for well-differentiated thyroid cancer

Radioiodine (¹³¹I) is an important therapy for patients who have well-differentiated thyroid cancer. However, ¹³¹I may also result in side effects in multiple organs and glands. The glands that are frequently affected are the salivary glands with the major untoward effects including sialoadenitis and increased risk of second primary malignancy. This report will review sialoadenitis secondary to ¹³¹I therapy including (1) proposed mechanisms, (2) incidence and clinical presentations, (3) possible approaches to improve prevention, (4) management, and (5) sequelae of sialoadenitis (e.g. xerostomia and salivary duct obstruction). A discussion of second primary malignancies is beyond the scope of this review. With a better understanding of the above, dentists, oral surgeons, otolaryngologists, endocrinologists, nuclear medicine physicians, and nuclear radiologists will be more likely to implement more effective preventive measures to reduce the incidence and severity of ¹³¹I-induced sialoadenitis, and if it does occur, to identify and treat sialoadenitis sooner, thereby potentially reducing not only the severity of the initial symptoms, but also the severity of subsequent sequelae.