A distinct radiologic perspective on parotid pleomorphic adenoma: sialo-CBCT case report

Pleomorphic adenoma (PA) is the most prevalent benign salivary gland tumor, manifesting predominantly in the parotid gland. The imaging techniques most frequently employed for diagnosis include ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI). Sialography is an interventional imaging technique that utilizes a positive contrast medium to illustrate the ductal anatomy of the parotid and submandibular glands. While there are studies in the literature demonstrating the sialography combined with cone beam computed tomography (CBCT) in the diagnosis of non-tumoral pathologies of salivary glands, there is a paucity of literature evaluating tumors with sialo-CBCT. The objective of this case report was to present the diagnostic and treatment processes of a pleomorphic adenoma of the parotid gland diagnosed by sialo-CBCT and to review the literature. To the best of our knowledge, no other case of PA has been reported in the literature that has been radiologically visualized and characterized with sialo-CBCT.

A 61-year-old female patient exhibited swelling in the left cheek and was initially diagnosed with parotid PA on USG examination. Subsequently, a sialo-CBCT was performed to visualize the lesion and parenchymal structure. Post-contrast CBCT images revealed a focal lesion area in the left parotid superficial lobe, partially surrounded by contrast-enhanced parenchymal tissue with regular borders. Subsequently, surgical excision of the lesion was performed, and the presence of PA was confirmed as the definitive diagnosis.

Although sialo-CBCT is not the primary diagnostic tool for diagnosing PA, it allows simultaneous assessment of salivary gland tumors, parenchymal architecture, and the ductal system without superimposition, offering precise and comprehensive three-dimensional visualization.