PP104: A rare case of Sjogren’s syndrome presented as bilateral multifocal cystic major salivary gland disease

Abstract

Purpose We present a rare case of a Sjogren’s syndrome presented as bilateral multifocal cystic major salivary gland disease. Material and methods A 38 year-old woman presented to the Oral & Maxillofacial dpt for examination of a progressing enlargement of her right preauricular area during the last six mounts period. A non painful, smooth discrete mass was obvious and palpated superficially of the right parotid. Regarding her medical history she reported recurrent, moderate episodes of dry keratoconjuctivitis and hypothyroidism due to Hasimmoto disease, well controlled by her endocrinologist. An USS examination of major salivary glands followed by an MRI scan were ordered. An FNA biopsy of the right parotid mass was suggested, followed by a sublabial glad biopsy. Results Both USS and MRI scan revealed multiple cystic lesions different in size within the major salivary glands, especially in parotids and diffuse enlargement of the parotid glands. Reports of FNA biopsy of the right parotid mass plus sublabial glad biopsy described diffuse lymphocyte infiltration of the glands with benign lymphoepithilial lesions. Conclusions Based mostly on the clinical and histological findings the diagnosis of Sjogren’s syndrome was carried out. Regarding the radiological findings we have to conclude that beyond the expected findings of dilated ducts, punctuate or globular collections and cavitary lesions, which characterize the disease, an appearance of multifocal cystic lesions bilaterally in major salivary gland, even rarely should be expected. Such findings should be under consideration for the differential diagnosis of diseases with benign lymphoepithilial lesions.