BENIGN DISEASES OF THE SALIVARY GLANDS Flashcards
female 6yo child px presents 2 days ago: bilateral swelling of parotid glands(Inchadas) + pain, erytema + tenderness(Sensibilidad), malasie(Malestar) + fever & sometimes trismus (Sin mover la mandibula)
Dx tx agent & complications
Son contagiosas (de 14 a 21 de incubación- sintomas)
Dx: Viral Parotitis (A. Inflamatory D).
Tx: Sintomatics or Mumps Vaccine
Complications: Meningitis, Hearing loss orchitis, pancreatitis/nefritis.
FP: Obstruction of gl. salivary
80 yo male px with DM and a traumatic punch face evolution of 4 days presents fever, painfull sweling with tenderness & PURULENT salivary secretions| pain + erytema
Dx & tx or Complication
#Agents: S. Aureus. S. Neumonie. E. Coli |
Dx: Supurative Sialadenitis (Parotitis) by bactirias
tx: Rehidratation, hygiene + IV antibiotics peniciline resistense (Usar Cefalosporinas)
If not get better at 48 h….
Complications: Abscess (Make do a USG or CT-Scan, draining)
#Cronic: Kliebsella, Enterobacter, Pseudomonas or candida
40 yo px presents painless BILATERAL enlarged parotid glands (parecen bolas) Xerostomia (Dry mouth-Resequedad bucal) at exploration you see: Cervical Lymphadenopaty cyst (Tipo quistico)
You make USG or CT-Sacn and see Multiple Cyst (bilateral)
Serch Seroloc + VIH
Dx? & Tx?
Dx: VIH infection Parotid Glands
Tx: Non ()Scleroterapy | Gland excision or
AMILASA en los quistes <– Patognomonico
Px Unilateral/Bilateral salivary gland Swelling (Hinchadas)+ minimal pain +
Dx etiology depens of other factors
A) Cat Scrash - Afects Peri/intraparotis lymph nodels
B) Parotid Enlargement + facial palsy + Uveitis (O)j(°)[Xerostomia + Xerospthalmia].
C) Asintomatic + Trismus (Mandibula “Trabada”)
D)Granulomatosis + Polyanglitis (Unilateral + pain)
Dx: Chronic Granulomatosis Sialadenitis.
A)Bartonella H.
B) Sarcoidosis (Sx Heerfrdt)
C)Antinomicosis (Use penicilin)
D)Wegener Granulomatosis (GPA) Use Cyclophosphamide + Sistemic Steroid+ Azathioprine/methotrexate.
B (Se cura solito en meses o años)
MAle px coments that recurently after eating (1 h) he feels painfull swelling gland (under toung) at exploration you see and touch “Stone” in the floor of mouth. «Occasionally gritty Sandlike foreign bodies in the oral cavity».
Px coments that he dont hydrated and has dry mouth (boca seca).
A) What gland is the 80% afected?
Dx & Dx help Imagen
Tx A-D
Los px suelen tener DM o gota
Dx: Sialolithiasis
A) Submanibular Gland (Stone made by Alkaline [Ca+ P+]Hydroxypatite).
Imagen: X-ray + Sialo Endoscopy
Tx: Extration or Excision
la Dra dijo que siempre CT
Inflamatory D.
old smoker man 76 yo px after 3 months persisting with intermitent bilateral pain swelling gland, while eating.
has a infection before and same symtoms.
#Recently trauma or old infection (a la larga puede generar inflamacion y obstruccion)
You make a ct scan to serch any malignancy (Negative)
Dx? & tx Antibiotics + Excision + hygienic
Dx: Chronic Sialadenitis
Tx: Superficial Parotidectomy.
60 yo female (postmenopausic) px present after 3/6 mounts dry eye & mouth (Ojo seco y boca), articular pain, sometimes painfull swelling glands with a history of rematoid artritis dx 5 y. ago.
At exploration: No genera lagrimas, red eye, artritis and mialgia.
You make serological test: anti-Ro/SSA y/o anti-La/SSB.
Tx: Syntomatic (R.ED. S)
Dx: Sx Sjögren (Autoinmune)
CC: Parotid enlargment + Xerostomia + Keratoconjuntivitis.
Tx: Steorids + Topical Steroids + Eye drops + Rituximab
55 yo female px with history of VIH-Multicystic disease.
Presents: Unilateral cystic swelling on parotid gland (Pain/less).
CC: Solo tiene una masa, pero no tiene sintomas asociados más que el dolor.
Dx + Tx: Sintomatic unless…too much higher parotid ? Es un tumor si o si, la cara en especial la zona de las parotidas y ocular se ve agrandada a lo bestia.
#Complication: Neoplasic Carcinoma.
Dx: Benign LYMPHOEPITELIAL lesions (IgG4).
A.ke: Gowmin Tumor/ Sx Mikulicz
Tx: Excision, radiation or draining. Superficial Parotidectomy.
25 yo Asian man -.-
present slowly growing painless mass in the major dalivay gland. at exploration neck and head salivary glands are growth. swelling.
Dx + Tx?
Makes serological test: Eosinophilia + IgE
Dx: Kimura Disease
Tx: Parotidectomy (Quitarlo)
Spontaneus appearing painfull ULCERATION over hard palate (Unilateral), asociated with radiation therapy. (Patology isquemia)
Make a biopsy
#Asociate with Squemous Cell Carcinoma (SCC)
Necrotizing Salometaplasia
Male 30 yo px presents Uni/bilateral diffuse enlargergement of parotid gland with/out pain. factors associated of endocrin disorder and drugs.
Make Bipsy: Acinar enlargement.
isn´t Sialoadenitis not itis
Dx: Sialadenosis
Tx:Resection
Px
Dx: Parotid Cysts
Most Common Benign Neoplasic
Tipos de celulas encontradas: Epitelial. Mioepitelial & stroma
PLEOMORPHIC ADENOMA
90% de Submandibular B. Tumors [Son muchas celulas/diferentes]
Benign Neoplasic Tx
Non Radiothepapy
Cx excision
Parotidectomy (preservar el VII)
Complet Submandibular Excision (Sin dañar el margen mandibular)
Buen pronostico :)
Mass Parapharyngeal.
whats the tumor preaority at CHILDREN?
Specially Female
HEMANGIOMA
Endotelial Cell Origin
