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Heerfordt-Waldenström syndrome is a rare subacute variant of sarcoidosis, characterized by enlargement of the parotid or salivary glands, facial nerve paralysis and anterior uveitis. Granulomas with a peripheral lymphocyte deficit are found in the anatomic pathology of affected organs. It is normally self-limiting, with cure achieved between 12 and 36 months, but some prolonged cases have been reported. Diagnosis of the syndrome is clinical, and treatment depends on the degree of systemic impairment. Oral corticosteroids represent the first line treatment option. The mortality rate ranges between 1 and 5% of cases.

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Abstract: Heerfordt-Waldenström syndrome is a rare subacute variant of sarcoidosis, characterized by enlargement of the parotid or salivary glands, facial nerve paralysis and anterior uveitis. Granulomas with a peripheral lymphocyte deficit are found in the anatomic pathology of affected organs. It is normally self-limiting, with cure achieved between 12 and 36 months, but some prolonged cases have been reported. Diagnosis of the syndrome is clinical, and treatment depends on the degree of systemic impairment. Oral corticosteroids represent the first line treatment option. The mortality rate ranges between 1 and 5% of cases.

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We present a patient with actinomycosis of the parotid, as confirmed by histology, and discuss the challenges involved when clinical and radiological findings are highly indicative of metastatic malignancy. Early treatment with antibiotics is indicated infungating or infected masses and exclusion of malignancy by histology is often needed.

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Sialocele is a subcutaneous cavity containing saliva, caused by trauma or infection in the parotid gland parenchyma, laceration of the parotid duct or ductal stenosis with subsequent dilatation. It is characterized by an asymptomatic soft and mobile swelling on the parotid region. Imaging studies are useful and help establishing the diagnosis, such as sialography, ultrasonography, computed tomography and magnetic resonance imaging. This paper describes a recurrent case of a parotid sialocele in a young female patient. She presented a 6 cm x 5 cm swelling on the left parotid region. The ultrasonographic scan of the area revealed a hypoechoic ovoid well defined image suggesting a cyst. A sialography of the left parotid showed a cavitary sialectasia in a panoramic and anteroposterior view. A conservative management was adopted by percutaneous needle aspiration of the swelling, which was useful to provide material for analysis and helped healing. Dentists should be aware of this pathology and the importance in adopting a conservative treatment whenever it is possible.

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Sialocele is a subcutaneous cavity containing saliva, caused by trauma or infection in the parotid gland parenchyma, laceration of the parotid duct or ductal stenosis with subsequent dilatation. It is characterized by an asymptomatic soft and mobile swelling on the parotid region. Imaging studies are useful and help establishing the diagnosis, such as sialography, ultrasonography, computed tomography and magnetic resonance imaging. This paper describes a recurrent case of a parotid sialocele in a young female patient. She presented a 6 cm x 5 cm swelling on the left parotid region. The ultrasonographic scan of the area revealed a hypoechoic ovoid well defined image suggesting a cyst. A sialography of the left parotid showed a cavitary sialectasia in a panoramic and anteroposterior view. A conservative management was adopted by percutaneous needle aspiration of the swelling, which was useful to provide material for analysis and helped healing. Dentists should be aware of this pathology and the importance in adopting a conservative treatment whenever it is possible.

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Childhood parotid swelling has a number of differential diagnosis mostly of inflammatory origin. Pneumoparotitis is an uncommon cause of parotid inflammation. It is caused by an excessive increase of intraoral pressure and secondary passage of air into the Stensen or Stenon duct and its glandular branches. Diagnostic clues can usually be obtained by a directed anamnesis. Ultrasonography (US) and computed tomography are essential diagnostic tools for this condition that has a benign course with spontaneous resolution in most cases. We present four cases of pneumoparotitis diagnosed by US in children 5 to 13 years of age. One of the cases occurred after the child chewed gum and made bubbles for a prolonged timeperiod and the other three after inflating baloons, making bubbles inside a pool and after playing the flute. All cases resolved spontaneously after two days. We suggest to consider pneumoparotitis in the differential diagnosis of parotid swellig in children.

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La indicación de la PAAF como método diagnóstico en glándulas salivales no es considerada esencial por todos los autores, debido a los buenos resultados obtenidos por la clínica, los estudios con imágenes y la posibilidad de arribar a un diangóstico en el acto quirúrgico con la anatomía patológica por congelación. Pese a ello, la mayoría de los profesionales considera que la PAAF de glándulas salivales permite evitar cirugías innecesarias en un importante número de casos, al establecer el diagnóstico diferencial entre patologías inflamatorias y neoplásicas y arribar a la cirugía, cuando es necesario, con un adecuado diagnóstico prequirúrgico y el conocimiento de la patología por parte del paciente. Se analizan los resultados de 785 PAAF de glándulas salivales, realizadas por palpación y bajo ecografía. Se exponen las concordancias y discordancias citológicas y anatomopatológicos, la sensibilidad y especificidad, las dificultades diagnósticas y las ventajas del método.(AU)

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La indicación de la PAAF como método diagnóstico en glándulas salivales no es considerada esencial por todos los autores, debido a los buenos resultados obtenidos por la clínica, los estudios con imágenes y la posibilidad de arribar a un diangóstico en el acto quirúrgico con la anatomía patológica por congelación. Pese a ello, la mayoría de los profesionales considera que la PAAF de glándulas salivales permite evitar cirugías innecesarias en un importante número de casos, al establecer el diagnóstico diferencial entre patologías inflamatorias y neoplásicas y arribar a la cirugía, cuando es necesario, con un adecuado diagnóstico prequirúrgico y el conocimiento de la patología por parte del paciente. Se analizan los resultados de 785 PAAF de glándulas salivales, realizadas por palpación y bajo ecografía. Se exponen las concordancias y discordancias citológicas y anatomopatológicos, la sensibilidad y especificidad, las dificultades diagnósticas y las ventajas del método.

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La adenosis poliquística esclerosante de la parótida (APEP) es una enfermedad infrecuente, caracterizada por elementos histológicos inflamatorios reactivos de las glándulas salivales, pero la presencia de displasia y atiplas hace también posible pensar se trate de un pseudotumor o una neoplasia. La APEP posee además semejanzas histopatológicas con la enfermedad fibroquística de la mama y comparten receptores de progesterona y estrógenos en las células ductales. La edad promedio de ocurrencia de esta patología es de 44,5 años y generalmente afecta las glándulas salivares mayores. Presentamos aquí el caso clínico de una mujer de 25 años de edad que el año 2002 consultó por un aumento de volumen de la parótida derecha, de larga data. Después de estudios diagnósticos y tratamientos fue intervenida quirúrgicamente y el análisis histopatológico sugirió el diagnóstico APEP.

Sclerosing polycystic adenosis (SPA) of the parotid gland is a rare disease characterized histologically by a reactive inflammation of the salivary glands, although the presence of displasia and atypia raise the possibility that SPA might represent a neoplastic lesion. SPA bears histopathological resemblance to fibrocystic disease of the breast, and both glands show progesterone and oestrogen receptors in the ductal cells. The mean age of occurrence is 44.5 year-old, and it mostly affects major salivary glands. We report the case of a 25-years-old woman, who in 2002 presented with increased volume in the right parotid gland. After medical studies and several surgical treatments, the histopathological study revealed it to be SPA.

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Childhood parotid swelling has a number of differential diagnosis mostly of inflammatory origin. Pneumoparotitis is an uncommon cause of parotid inflammation. It is caused by an excessive increase of intraoral pressure and secondary passage of air into the Stensen or Stenon duct and its glandular branches. Diagnostic clues can usually be obtained by a directed anamnesis. Ultrasonography (US) and computed tomography are essential diagnostic tools for this condition that has a benign course with spontaneous resolution in most cases. We present four cases of pneumoparotitis diagnosed by US in children 5 to 13 years of age. One of the cases occurred after the child chewed gum and made bubbles for a prolonged time-period and the other three after inflating baloons, making bubbles inside a pool and after playing the flute. All cases resolved spontaneously after two days. We suggest to consider pneumoparotitis in the differential diagnosis of parotid swelling in children.

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Para diferenciar parotiditis aguda viral de parotiditis recurrente infantil y bacteriana, se dispone de ecógrafos con transductores de alta frecuencia. En este estudio se efectuaron ecografías en 15 niños entre 16 meses y 16 años que consultaron por tumoración parotídea, y luego la evolución clínica y el resultado confirmaron el diagnóstico.(AU)

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