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15 pages, 2815 KiB

Open AccessArticle

High Field MRI in Parotid Gland Tumors: A Diagnostic Algorithm

by Chiara Gaudino, Andrea Cassoni, Martina Lucia Pisciotti, Resi Pucci, Chiara Veneroso, Cira Rosaria Tiziana Di Gioia, Francesca De Felice, Patrizia Pantano and Valentino Valentini

Cancers 2025, 17(1), 71; https://doi.org/10.3390/cancers17010071 - 29 Dec 2024

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Abstract

Backgrounds: Imaging of parotid tumors is crucial for surgery planning, but it cannot distinguish malignant from benign lesions with absolute reliability. The aim of the study was to establish a diagnostic MRI algorithm to differentiate parotid tumors. Methods: A retrospective study was conducted including all patients with parotid tumors, who underwent 3T-MRI and surgery. Morphological characteristics and normalized T2 and late postcontrast T1 signal intensities (SI) were assessed. “Ghosting sign” on late postcontrast T1 sequence was defined as indistinguishability of the tumor except for a thin peripheral enhancement. Patients were divided according to histology and imaging data were compared. A diagnostic MRI algorithm was established. Results: Thirty-six patients were included. The combination of normalized late T1 postcontrast SI, normalized T2 SI and “ghosting sign” allowed for the distinguishing of malignant from benign parotid tumors with high sensitivity (100%), specificity (93%), positive predictive value (80%), negative predictive value, (100%) and accuracy (94%). Moreover, pleomorphic adenomas often showed a homogeneous T2 signal and a complete capsule (p < 0.01), Warthin tumors protein-rich cysts and calcifications (p < 0.005 and p < 0.05), and malignant tumors an inhomogeneous contrast enhancement (p < 0.01). Conclusions: High field MRI represents a promising tool in parotid tumors, allowing for an accurate differentiation of malignant and benign lesions. Full article

(This article belongs to the Special Issue Advances in Radiotherapy for Head and Neck Cancer)

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16 pages, 3073 KiB

Open AccessArticle

Three Signs to Help Detect Sjögren’s Syndrome: Incidental Findings on Magnetic Resonance Imaging and Computed Tomography

by Yukinori Takagi, Ikuo Katayama, Sato Eida, Miho Sasaki, Toshimasa Shimizu, Shuntaro Sato, Kunio Hashimoto, Hiroki Mori, Mitsunobu Otsuru, Masahiro Umeda, Yoshihiko Kumai, Ryo Toya, Atsushi Kawakami and Misa Sumi

J. Clin. Med. 2023, 12(20), 6487; https://doi.org/10.3390/jcm12206487 - 12 Oct 2023

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Abstract

This study aimed to retrospectively investigate the prevalence of Sjögren’s syndrome (SS) among patients with ranulas, parotid cysts, or parotid calcifications; identify the characteristic magnetic resonance imaging (MRI) or computed tomography (CT) findings of the lesions associated with SS; and compare the SS disease stages among SS patients with the three lesion types. A total of 228 patients with the lesions were classified into SS, possible SS, and non-SS groups. The prevalence of SS among patients with ranulas, parotid cysts, or parotid calcifications was 16%, 24%, and 40%, and the rates of either SS or possible SS were 25%, 41%, and 64%, respectively. SS was associated with (i) ranulas: ≤17 mm; (ii) parotid cysts: bilateral and multiple; and (iii) parotid calcifications: in females, bilateral, multiple, parenchymal, and no coexisting calcifications in other tissues. SS patients with ranulas were significantly younger and had lower submandibular gland stage scores on MRI/CT than those with other lesions. Additionally, in 58% and 15% of SS patients with ranulas and parotid calcifications, respectively, detection of the lesions led to the diagnosis of primary SS. Therefore, recognizing the prevalence of SS among patients with these lesions and the findings associated with SS can help detect undiagnosed SS. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Sjogren’s Syndrome)

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8 pages, 1409 KiB

Open AccessCase Report

Chondroma Arising from the Temporomandibular Joint: A Case Report

by Masayoshi Hijiya, Masamitsu Kono, Katsuya Okuda, Shunji Tamagawa, Takuro Iyo, Tetsuya Kinoshita, Hideki Sakatani, Masanobu Hiraoka, Fumiyoshi Kojima, Shin-Ichi Murata and Muneki Hotomi

Medicina 2023, 59(5), 842; https://doi.org/10.3390/medicina59050842 - 26 Apr 2023

Cited by 2 | Viewed by 3209

Abstract

Periarticular chondromas are common in the humerus and femur but rarely occur in the temporomandibular joint. We report a case of a chondroma in the anterior part of the ear. One year prior to his visit, a 53-year-old man became aware of swelling in the right cheek region which gradually increased in size. In the anterior part of the right ear, there was a palpable 25 mm tumor, elastic and hard, with poor mobility and without tenderness. A contrast-enhanced computed tomography CT showed a mass lesion with diffuse calcification or ossification in the upper pole of the parotid gland and areas of poor contrast within. A magnetic resonance imaging showed a low-signal mass lesion at the parotid gland with some high signals in both T1 and T2. Fine-needle aspiration cytology did not lead to diagnosis. Using a nerve monitoring system, the tumor was resected with normal tissue of the upper pole of the parotid gland in the same way as for a benign parotid tumor. Distinguishing between pleomorphic adenoma, including diffuse microcalcification of the parotid gland and cartilaginous tumors of the temporomandibular joint, may be sometimes difficult. In such cases, surgical resection may be a beneficial treatment option. Full article

(This article belongs to the Section Oncology)

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7 pages, 2091 KiB

Open AccessCase Report

Calcification in Salivary Gland Cancer Mimicking Sialolithiasis—A Diagnostic Pitfall on Imaging: Report of Two Cases and Brief Review of the Literature

by Vivian Thimsen, Vanessa Fauck, Marco Wiesmüller, Abbas Agaimy, Mirco Schapher, Heinrich Iro, Michael Koch and Konstantinos Mantsopoulos

J. Clin. Med. 2022, 11(12), 3329; https://doi.org/10.3390/jcm11123329 - 10 Jun 2022

Cited by 2 | Viewed by 4070

Abstract

Objectives: Sialolithiasis is the most common cause of calcifications detected with ultrasound in patients with chronic inflammatory symptoms and swellings of the salivary glands. Other differential diagnoses of calcifications are extremely rare and mostly benign. Methods: Case report and literature review. Results: Two rare cases of malignant parotid gland tumors with calcifications in a localization typical for sialolithiasis, which were mistaken for salivary calculi based on image findings, are presented. Conclusions: This report intends to highlight the pitfalls in the imaging of parotid gland diseases. Even if malignant tumors of the parotid gland with calcifications are extremely rare, in ambiguous cases, differential diagnoses should be considered carefully. A high suspicion index of the need for further diagnostics in cases with calcifications is practical and could include missing periprandial symptoms, no obstruction signs in the proximal duct, and missing evidence of sialolithiasis in sialendoscopy. Full article

(This article belongs to the Special Issue New Perspectives in Diseases of the Salivary Glands: Diagnostic Approach and Treatment Strategies)

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