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Rhinosporidiosis of the parotid duct.

Yadav SK, Shrestha S - Case Rep Dent (2014)

Bottom Line: The common sites of involvement are the nose and nasopharynx followed by ocular tissue.The case presented here is of 18-year-old male from the nonendemic zone of Nepal with a proliferative mass in the parotid duct.Thus clinicians should be flexible in the differential diagnosis of proliferative growth in the parotid duct, even in those cases which are from nonendemic areas.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Chitwan Medical College Pvt. Ltd, P.O. Box 42, Bharatpur 10, Nepal ; IAOMS Fellow Oral and Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Beijing 100081, China.

ABSTRACT
Rhinosporidiosis is a benign chronic granulomatous infection caused by Rhinosporidiosis seeberi (R. seeberi). Rhinosporidiosis is endemic in South Asia, notably in Southern India and Sri Lanka. The common sites of involvement are the nose and nasopharynx followed by ocular tissue. Rhinosporidiosis is also known to involve many rare sites and may become disseminated to ocular in generalized form. Rhinosporidiosis of parotid duct is extremely rare. The case presented here is of 18-year-old male from the nonendemic zone of Nepal with a proliferative mass in the parotid duct. Although rhinosporidiosis was not taken into consideration in the clinical differential diagnosis, eventual histopathological diagnosis confirmed rhinosporidiosis. Thus clinicians should be flexible in the differential diagnosis of proliferative growth in the parotid duct, even in those cases which are from nonendemic areas.

No MeSH data available.


Related in: MedlinePlus

Preoperative (front view).
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fig1: Preoperative (front view).

Mentions: On clinical examination, patient was moderately built with no signs of parlor, jaundice, or lymphadenopathy. Systemic examination also did not reveal any abnormalities. The nose, nasopharynx, oropharynx, and eyes appeared normal. On local examination, there was a single, soft to firm consistency, discrete extraoral swelling on the left side of the cheek measuring about 4 × 3 cm, extending anteriorly to masseter muscle (Figures 1 and 2). Overlying skin was normal in color and texture with no local rise of temperature. There was tenderness felt on palpation with no fixity to underlying skin or structure. The mouth opening was restricted to 30 mm. Intraoral examination showed serious discharge from the mouth at the opening of inflamed Stensen's duct on milking the gland. Routine laboratory investigation revealed eosinophilia (eosinophils, 40%). The fine needle aspiration cytology (FNAC) showed presence of neutrophils and lymphocytes in the fluid with increased level of Amylase (9,02,651 U/L). Ultrasonography (USG) showed a cystic lesion in the subcutaneous plane of cheek of size 3 × 1.6 cm, with echogenic debris and internal septations, without demonstrable communication with Stensen's duct. Sialography of the left parotid gland showed contrast flow in the distal part of Stensen's duct with pooling of contrast in the area of the lesion (Figure 3). No demonstrable connection to the proximal part of the parotid gland was present which led to focal ductal dilation. A provisional diagnosis based on the clinical presentation and the investigations done diagnosed it as sialocele of the parotid duct. Surgical excision of the cystic lesion was planned under general anesthesia.


Rhinosporidiosis of the parotid duct.

Yadav SK, Shrestha S - Case Rep Dent (2014)

Preoperative (front view).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3926341&req=5

fig1: Preoperative (front view).
Mentions: On clinical examination, patient was moderately built with no signs of parlor, jaundice, or lymphadenopathy. Systemic examination also did not reveal any abnormalities. The nose, nasopharynx, oropharynx, and eyes appeared normal. On local examination, there was a single, soft to firm consistency, discrete extraoral swelling on the left side of the cheek measuring about 4 × 3 cm, extending anteriorly to masseter muscle (Figures 1 and 2). Overlying skin was normal in color and texture with no local rise of temperature. There was tenderness felt on palpation with no fixity to underlying skin or structure. The mouth opening was restricted to 30 mm. Intraoral examination showed serious discharge from the mouth at the opening of inflamed Stensen's duct on milking the gland. Routine laboratory investigation revealed eosinophilia (eosinophils, 40%). The fine needle aspiration cytology (FNAC) showed presence of neutrophils and lymphocytes in the fluid with increased level of Amylase (9,02,651 U/L). Ultrasonography (USG) showed a cystic lesion in the subcutaneous plane of cheek of size 3 × 1.6 cm, with echogenic debris and internal septations, without demonstrable communication with Stensen's duct. Sialography of the left parotid gland showed contrast flow in the distal part of Stensen's duct with pooling of contrast in the area of the lesion (Figure 3). No demonstrable connection to the proximal part of the parotid gland was present which led to focal ductal dilation. A provisional diagnosis based on the clinical presentation and the investigations done diagnosed it as sialocele of the parotid duct. Surgical excision of the cystic lesion was planned under general anesthesia.

Bottom Line: The common sites of involvement are the nose and nasopharynx followed by ocular tissue.The case presented here is of 18-year-old male from the nonendemic zone of Nepal with a proliferative mass in the parotid duct.Thus clinicians should be flexible in the differential diagnosis of proliferative growth in the parotid duct, even in those cases which are from nonendemic areas.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Chitwan Medical College Pvt. Ltd, P.O. Box 42, Bharatpur 10, Nepal ; IAOMS Fellow Oral and Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, 22 Zhongguancun South Avenue, Beijing 100081, China.

ABSTRACT
Rhinosporidiosis is a benign chronic granulomatous infection caused by Rhinosporidiosis seeberi (R. seeberi). Rhinosporidiosis is endemic in South Asia, notably in Southern India and Sri Lanka. The common sites of involvement are the nose and nasopharynx followed by ocular tissue. Rhinosporidiosis is also known to involve many rare sites and may become disseminated to ocular in generalized form. Rhinosporidiosis of parotid duct is extremely rare. The case presented here is of 18-year-old male from the nonendemic zone of Nepal with a proliferative mass in the parotid duct. Although rhinosporidiosis was not taken into consideration in the clinical differential diagnosis, eventual histopathological diagnosis confirmed rhinosporidiosis. Thus clinicians should be flexible in the differential diagnosis of proliferative growth in the parotid duct, even in those cases which are from nonendemic areas.

No MeSH data available.


Related in: MedlinePlus