Solitary parotid duct sialolith in a patient with Sjörgren’s syndrome: Report of a case

Wan Ahmad Kamil Wn,Kadir K,Burhanuddin Na,Goh Yc,Hassan S,Siar Ch,Rahman Fa

doi:10.22452/adum.vol23no2.4

Abstract

Sjorgren’s syndrome is an uncommon chronic autoimmune disorder that affects exocrine glands. Sialolithiasis is an obstructive salivary gland disease which is also uncommon in the parotid salivary gland. The existing literature has documented the occurrence of multiple calcifications within the parenchyma of the parotid glands in patients with Sjorgren’s syndrome. This report describes the first case of right parotid duct solitary sialolith formation in a 64 year old female patient with Sjorgren’s syndrome. Whether the salivary stone encountered in this case represents an oral manifestation of Sjorgren’s syndrome or is just a co-incidental finding was discussed.

Highlights

Sjörgren’s syndrome is a chronic autoimmune disease due to progressive lymphocytic infiltration and subsequent destruction of exocrine glands [1]
Sialolithiasis, termed salivary calculi or salivary stone formation, is due to deposition of calcium salts around a central nidus which may consist of altered salivary mucins, desquamated epithelial cells, bacteria, foreign bodies, or products of bacterial decomposition [4,5,6]
Sialolithiasis is rare in the parotid duct (Stensen’s duct) with occurrence rate of 5% to 15% compared to the submandibular gland where the prevalence is considerably higher (85% to 95%)

Summary

Introduction

Sjörgren’s syndrome is a chronic autoimmune disease due to progressive lymphocytic infiltration and subsequent destruction of exocrine glands [1]. The clinical presentation in both forms of Sjörgren’s syndrome typically consists of dry mouth (xerostomia) and dry eyes (kerato-conjunctivitis sicca). Sialolithiasis, termed salivary calculi or salivary stone formation, is due to deposition of calcium salts around a central nidus which may consist of altered salivary mucins, desquamated epithelial cells, bacteria, foreign bodies, or products of bacterial decomposition [4,5,6] It is the most common cause of salivary gland obstruction. 28 Solitary parotid duct sialolith in a patient with Sjörgren’s syndrome the right Stensen duct in order to document this rare occurrence. Case Report A 64-year-old female patient presented to the Oral Medicine Clinic, Faculty of Dentistry, University of Malaya with a one month history of recurrent swelling and associated pain in the area of her right parotid salivary gland. Patient was reviewed after a week, the surgical area had healed well (Figure 2B) and she was advised to continue eating sour food to stimulate salivary flow

Discussion

Conclusion