Parotid Gland Enlargement in Acromegaly: A Case Report of This Rare Finding.

We report a case that shows the pathognomonic orofacial features identified with acromegaly. Unilateral parotid gland enlargement was also present. Our investigation showed that the parotid gland swelling was non-neoplastic and part of the organomegaly complex associated with acromegaly. Parotidomegaly represents a very rare finding in acromegaly.

Lingual (Not Palatine) Tonsillolith: Case Report.

The lingual tonsil (LT), located at the base of the tongue posterior to the circumvallate papillae, consists of aggregates of lymphoid tissue separated by a median glossoepiglottic ligament that splits the LT into right and left halves. Tonsillar tissue on either side of the ligament exhibits discrete round nodules that project upward. Each prominence is covered by nonkeratinized epithelium and has a central crypt formed by an invagination of the overlying epithelium. Ducts of adjacent mucous glands empty into the crypt, serving as a flushing mechanism to cleanse the crypt. A thin fibrous connective tissue capsule isolates the LT from the underlying tongue musculature. Lingual tonsillar tissue tends to regress with aging. Hypertrophy and pathologic changes of the LT can develop and cause subjective symptomatology. Patient complaints include sore throats, dysphagia, globus sensation, dyspnea, obstructive sleep apnea, dysgeusia, halitosis, and otalgia. Tonsilloliths in the palatine tonsil are often reported, but the LT also can develop a tonsillolith. Only 1 report of LT tonsilloliths was found in the English-language dental literature. Because of its literary rarity, this report presents a case of an incidental finding of a lingual tonsillolith. Diagnostic skills are sharpened when such cases are brought to the attention of the profession.

Radioactive Iodine-Induced Hyposalivation: Case Report.

Radioactive iodine (131I) is used in the treatment of differentiated thyroid cancers. Collateral damage to the salivary glands (SGs) can be anticipated. Standard therapeutic doses of 131I often cause SG obstructive symptomatology and hyposalivation can develop with the higher 131I doses used for aggressive thyroid malignancies with or without metastases.

Simultaneous Bilateral Hypertrophies of the Parotid Gland and Masseter Muscle: Case Report.

Increased salivary demand can lead to enlarged parotid salivary glands, and increased activity of the masseter muscles can cause masseter hypertrophy. This report describes a most unusual case of simultaneous bilateral hypertrophies of the parotid gland and masseter muscle originating from the very extensive habit of chewing gum. An extensive literature review uncovered many cases of the independent existence of masseteric or parotid hypertrophy, but no example of the simultaneous occurrence of these 2 conditions.

Sialosis, Gout Induced or Idiopathic? Case Report.

Sialosis is observed in relation to diabetes, alcoholism, and malnutrition. An assumed relation between gout and sialosis is probably based on confusion that originated from the therapeutic use of phenylbutazone for gout and the sialadenitis that the medication caused. This report describes a case of sialosis in a patient with a longstanding history of gout that was idiopathic in origin.

Rare Submandibular Presentation of Pediatric Castleman Disease: Case Report.

Castleman disease (CD), a benign lymphoproliferative disorder that affects lymph nodes, is uncommon in children, with only approximately 100 cases published. Although 23% of pediatric CD cases are found in the neck, there is no substantial reported percentage found in the salivary glands, especially the submandibular salivary gland (SMSG). A pediatric case of CD involving the SMSG is reported because of its extreme rarity.

Differentiating 131I Radiation Sialadenitis From Autoimmune (Sjögren Syndrome) Sialadenitis: Case Report.

Radioactive iodine (131I) is used effectively for the treatment of differentiated thyroid cancers. Because it is actively secreted by the salivary glands, radiation damage to these glands can occur. Obstructive swellings after mealtime salivary stimulation are common occurrences. Dry mouth is not usually seen if low doses of 131I are used. A subjective complaint of xerostomia in a patient treated with 131I 75.8 mCi proved to be related to the simultaneous presence of Sjögren syndrome (SS). Serologic, histologic, scintigraphic, and salivary volume findings and the patient's subjective complaints served to establish the pre-existence of SS.

Mandibular Bisphosphonate Osteonecrosis: A Cautionary Tale.

The authors examined a 55-year-old female who had received eight intravenous infusions of a potent bisphosphonate (BP) for metastatic bone disease. A mandibular extraction was subsequently performed. At presentation, infection with suppuration and sequestrum formation were observed in the area of extraction. Both the oncologist and dental practitioner must be made aware that when BPs are going to be administered, dental care should be performed in a timely fashion. Prophylactic measures must be taken by the dentist if dental surgery is required for a patient who has received BP.

Wine and Dental Destruction: Case Report.

The acidity of wine can cause dental erosion. Furthermore, its constituents may lead to excessive staining of teeth. The authors report the case of a patient whose amount, manner and timing of wine consumption caused these dental problems.

Bilateral Parotid Swelling in Polycystic Ovarian Syndrome.

Polycystic ovarian syndrome (PCOS) is recognized by the presence of polycystic ovaries, irregular menstruation, and increased androgen levels. Many patients have insulin resistance or impaired glucose tolerance and an associated development of type 2 diabetes mellitus. A patient with PCOS is presented whose cosmetic concerns centered on the prolonged existence of substantial bilateral parotid swelling. The pathophysiology, diagnosis, and therapy of sialosis are discussed.

Eagle Syndrome: Case Report.

Eagle syndrome (ES) is now defined as both an elongation of the styloid process (SP) and ossification of the stylohyoid ligament (SHL). Because subjective symptomatology is varied or can be absent, imaging is the best approach to diagnosis.

Diagnosing Juvenile Recurrent Parotitis. Case Reports.

Diagnosis of juvenile recurrent parotitis is based upon clinical symptomatology, because no positive serologic signs have been identified. Objective confirmation is best obtained from sialographic or ultrasound studies.

Facial angioedema and systemic lupus erythematosus: case report.

Non-medication-related acquired deficiencies of C1 esterase inhibitor (C1-INH) can cause the facial acquired angioedema (AAE) seen in systemic lupus erythematosus (SLE). The defect can originate from a lymphoproliferative disease (LPD) that catabolizes C1-INH or from circulating antibodies that inactivate C1-INH. This report describes a third and rare variety of facial AAE originating in SLE in which there was no LPD or circulating antibodies to impede C1-INH activity.

Diagnosing the Parotid Lipoma. Case Report.

The clinical features of the rarely reported and diagnostically challenging parotid gland lipoma are described. Presurgical diagnosis is aided by CT scan imaging.

First bite syndrome after deep lobe parotidectomy: case report.

First bite syndrome (FBS) has recently been recognized in published medical studies; however, only 2 cases have been reported in dental studies. The syndrome was defined by Netterville and Civantos and Netterville et al as originating from a postoperative complication after parapharyngeal space (PPS) surgery. The most frequent reason for PPS surgery is the presence of a deep lobe parotid gland (PG) neoplasm, with cervical schwannoma the second most common lesion mandating surgery in this space. Surgical therapeutic procedures in the PPS for these tumors can inadvertently ablate the sympathetic nerve supply to the PG. Subsequently, with the first introduction of food into the mouth, severe intense and debilitating pain will develop and radiate through the upper neck, PG, and auricular regions on the ipsilateral surgical side. The intense pain will last approximately 5 seconds.With continued mastication, the pain will subside, but not totally abate. After the meal, the pain will gradually disappear, only to return with the next masticatory period. The pain is initiated by salivation, whether by food or the thought of food and will be accentuated by acidic sialogogic foods. Usually, with the passage of time, some gradual improvement in the intensity and frequency of the pain episodes can be anticipated.

Masseteric intramuscular hemangioma: case report.

Securing a clinical diagnosis for the masseteric intramuscular hemangioma is difficult. However, making a diagnosis can be facilitated with imaging, particularly magnetic resonance imaging, which serves as a key element in preoperative diagnosis.

Identifying primary Sjögren syndrome in children: case report.

Primary Sjögren syndrome (PSS) rarely occurs in children. In addition, because the objective and subjective diagnostic criteria for juvenile PSS differ from those seen in adults, identification of its presence can be difficult to establish. This case report illustrates the accepted benchmarks for diagnosing pediatric PSS.

Rigo-Fede disease: case report.

Riga-Fede disease results when an infant's instinctive tongue thrusting and raking motion over recently erupted primary mandibular incisors causes a traumatic ulceration of the tongue and/or mouth floor. The symptoms and therapeutic approach to the condition are highlighted in this case report.

Granular cell tumor. A case report.

The granular cell tumor, a non-specific, slow growing nodule usually affecting the tongue, is best regarded as having a reactive/metabolic origin rather than a neoplastic one. Histogenetically, it is thought to develop from neural cells. Definitive diagnosis is only obtained after histologic examination of a tissue specimen.

The botryoid cyst: case report.

The clinical and radiographic features of the botryoid odontogenic cyst (BOC) are non-specific; and significant overlap exists with other lesions. Here we report a case of an asymptomatic BOC in the anterior mandible. The purpose of this report is to call attention to the manifestations of the BOC, to review the differential diagnosis and to outline the histologic criteria required to establish a definitive diagnosis. This report highlights the importance of careful histologic examination of unilocular or multilocular radiolucencies lying lateral to the roots of vital teeth. Following diagnosis of a BOC, long-term follow-up to monitor for recurrence is indicated.