sialocele

Sialoceles are cystic spaces (usually saliva containing) arising within a salivary gland.

Pathology

They tend to be post-traumatic or iatrogenic in nature. The proposed mechanisms include laceration of the salivary gland duct or ductal stenosis with subsequent dilatation.

Clinical presentation

Patients are often asymptomatic, but may present with mobile swelling involving the affected salivary gland.

Radiographic features

Ultrasound

Ultrasound may show a hypoechoic-anechoic cyst within the affected salivary gland.

MRI

Axial T2 weighted and CISS sequences have been shown to be useful to show the location (intra/extraparenchymal, superficial/deep lobe) of the cyst and its relation to muscles and vessels.

Treatment and prognosis

Management of sialoceles has been controversial and a range of surgical and non-surgical treatment modalities have been proposed.

Differential diagnosis

On imaging consider other cystic parotid lesions.

Bilateral cystic parotid lesions

• Warthin tumor
• benign lymphoepithelial lesions of HIV
• Sjögren syndrome

Unilateral cystic parotid lesion(s)

• Warthin tumor
• first branchial cleft cyst
• parotid lymphangioma
• benign lymphoepithelial cyst
• necrotic lymph node(s): especially from squamous cell carcinoma
• infected lymph node(s)