Salivary Duct Cyst

Rnad Issa Foudah

Group 1 stomatology
 Salivary duct cyst:-
• Is a relative lesion to salivary gland duct obstruction and build up of trapped mucin with
in
is a true cyst as it is lined by epithelium, found in oral mucosa sites with minor salivary
glands or parotid glands

Its caused by mucus trapped with in lumen secondary to salivary gland obstruction
Severe obstruction can lead to squamous or oncocytic metaplasia of duct epithelial
bilayer
 may become secondarily infected around sialolith, which acts as nidus .
ETIOPATHOGENESIS
It caused by obstruction of minor salivary gland duct which causes
the back up of saliva
This continuous pressure dilates the duct and forms a cyst like lesion.
May associated with sialoliths, mucus plugs, post operative or post
inflammatory stricture.
Clinical Features
• AGE&SEX
Occur most often in older patients
No sex predilection

SITE:
Most common in parotid gland
Intraorally, it is common on the floor of the mouth
( Buccal mucosa + lips ).
Appearance:-
Dome shaped sessile , slow growing but asymptomatic nodule.

1 to 3cm but have been reported to grow up to 10cm

Symptoms:-
• Fluctuant to palpation but usually painless
• Some may feel firmer especially if a sialolith is present
• Mucos or pus may be expressed from digital ductal orifices when
palpated when secondarily infected
• Numbness in part of your face.
• Muscle weakness on one side of your face.
• Persistent pain in the area of a salivary gland.
• Difficulty swallowing.
• Trouble opening your mouth widely.
Histopathology:-
• Mucoid secretion surrounded by a bilayer of cuboidal or columnar
stratified salivary duct epithelium. Cyst lining may have papillary folds
into the lumen
• May have squamous or oncocytic metaplasia of cyst lining, especially
with more severe obstruction.
• Sialolith and bacteria causing secondary infection may be present
among the submitted tissue
• Feeding salivary gland, if included has obstructive changes with
variable ductal dilation, lymphocytic infiltrate with periductal patern
and fibrosis
 Diagnosis:
• Based on patient reported history and clinical examination, definitive
diagnosis made by histopathologic evaluation under light microscopy

Laboratory diagnosis:
Biopsy shows lining of epithelium which consists of cuboidal, columnar
or atrophic squamous epithelium surrounding thin or mucoid secretion
in the lumen.
Warthin tumor ( papillary cystadenoma lymphomatosum )
Lymphoid stroma in the cyst wall and multiple papillary infoldings with a bilayer of
columnar and oncocytic epithelial lining

Papillary cystadenoma:
The lining epithelium has an adenomatous proliferation forming multi-layerd plaques of
columnar or oncocytic salivary duct lining with papillary infolding.
Treatment
Surgical excision:
It is treated by conservative surgical excision

Antibiotics
Erythromycin
Chlorhexidine mouth wash ( relieving the pain of patient )