Unmasking salivary stone masqueraders: A case series and discussion on salivary gland pathologies mimicking sialadenitis with sialolithiasis

Objective

Sialadenitis with sialolithiasis is a common pathology affecting the salivary glands which may present with classic peri-prandial symptoms. However, other calcific pathologies can similarly obstruct the salivary ducts or mimic the imaging characteristics of sialolithiasis. These impersonators may cause the initial diagnosis or the subsequent therapeutic offerings more difficult. This case series will walk through an exhaustive, case-based review of overlapping disease presentations that similarly present with calcifications within the major salivary glands. In compiling this diverse case series concerning salivary stone mimickers, we hope to provide the comprehensive otolaryngologist with a better understanding of the subtle differences in the signs and symptoms of sialolithiasis mimickers and improve their differential diagnosis formation when non-classic calcifications are seen.

Methods

A multi-institution retrospective review.

Results

Five cases initially concerning for sialadenitis with imaging confirming presence of calcification were initially worked up for sialolithiasis due to presentation. Further workup in each case diagnosed a variety of calcification-producing salivary gland pathologies unrelated to obstructive sialolithiasis.

Conclusions

While sialadenitis secondary to sialolithiasis is a common diagnosis with distinct symptoms, it is still important for the comprehensive otolaryngologist to distinguish nuances in the patient's symptoms and imaging characteristics of non-sialolithiasis calcifications.