sodium-pertechnetate-tc-99m and Submandibular-Gland-Diseases

Ectopic thyroid glands generally appear in the midline due to abnormal median migration; their presence lateral to the midline is rare. We report the case of a 42-year-old female who presented with symptoms of thyrotoxicosis and an expanding submandibular swelling. Tc-99m-sodium pertechnetate scanning showed thyroid tissue in the left submandibular region, while no thyroid tissue was seen in the normal site. The patient was treated with 10 mCi of 131I and subsequently became euthyroid. Literature review revealed seven cases of lateral aberrant thyroid tissue. The theories to explain lateral aberrant thyroid are presented.

Topics: Adult; Choristoma; Female; Humans; Iodine Radioisotopes; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Submandibular Gland Diseases; Thyroid Gland; Thyrotoxicosis

Ectopic thyroid tissue in the submandibular space with the thyroid gland in its normal location is an extremely rare phenomenon. We present a case of a 75-year-old woman who had painless swelling in the left submandibular space and was referred to our hospital with the suspicion of having a malignant tumor originating from the submandibular gland. Histologic examination showed normal follicular thyroid tissue without any sign of malignancy. In general there are 3 explanations for the presence of ectopic thyroid tissue found in the submandibular region: (1) displacement during the course of embryonal development, (2) spread of tissue during surgery on a normally located thyroid gland, and (3) metastasis of a highly differentiated papillary thyroid carcinoma. We reviewed the literature with respect to the embryological background and the clinical management of such cases.

Topics: Aged; Choristoma; Female; Humans; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Submandibular Gland Diseases; Thyroid Gland; Tomography, X-Ray Computed

Rosai-Dorfman disease (RDD) is an unusual clinical entity characterized by benign pseudolymphomatous proliferation with significant histiocytic infiltration. In the present paper, extranodal RDD of the major salivary glands causing salivary hypofunction and the results of salivary gland scintigraphy and ultrasound are presented in two siblings. Case 1: a 10-year-old boy with bilateral painless masses around the parotid and submandibular glands was referred. Ultrasound examination showed bilateral, well-defined, hypoechoic solid mass lesions within both parotid glands with minimal normal parenchyma in the upper poles. Both submandibular glands were markedly hypoechoic and heterogeneous. Mass lesions within the parotid glands appeared as cold lesions with regular contours on scintigraphy. Dynamic images showed normal uptake and normal response to secretion in the upper poles of the parotid glands, corresponding with ultrasonographically normal parenchyma. Both submandibular glands showed markedly diminished uptake and secretion. Case 2: a 9-year-old boy presented with mass lesions around the submandibular glands. Ultrasound examination showed normal parotid glands and markedly hypoechoic and heterogeneous submandibular glands. Salivary gland scintigraphy showed normal uptake and secretion of parotid glands with markedly diminished uptake and secretion in both submandibular glands. There were severe carious lesions in both patients due to salivary hypofunction. Treatments of the two patients' teeth were performed. Major salivary gland involvement of RDD is important for dentists as it may cause xerostomia and can mimic dental abscess. Functional evaluation of salivary glands with scintigraphy, besides radiological and pathological techniques, will help to explain whether salivary glands are affected or not and improve the diagnostic effectiveness.

Topics: Biopsy; Child; Dental Caries; Gingivitis; Histiocytosis, Sinus; Humans; Male; Parotid Diseases; Parotid Gland; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Submandibular Gland; Submandibular Gland Diseases; Tooth, Deciduous; Ultrasonography; Xerostomia

This study reviews the results of sialolithectomy performed with the CO2 laser.. Forty-nine patients were treated under local anesthesia at initial presentation in the outpatient clinic.. All patients had immediate relief after surgery. Clinical and scintographic follow-up of up to 28 months on 27 patients showed that all but 1 were asymptomatic. The single exception required excision of the submandibular gland because of two recurrences of sialoliths in Wharton's duct. Although some glands had no function clinically and scintigraphically, they were asymptomatic and needed no further treatment.. Salivary glands that are nonfunctioning clinically and scintigraphically should only be removed when there is a recurrence of symptoms.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures; Anesthesia, Local; Carbon Dioxide; Female; Follow-Up Studies; Humans; Laser Therapy; Male; Middle Aged; Parotid Diseases; Parotid Gland; Radionuclide Imaging; Recurrence; Salivary Duct Calculi; Salivary Gland Calculi; Sodium Pertechnetate Tc 99m; Submandibular Gland; Submandibular Gland Diseases

Topics: Choristoma; Female; Humans; Iodine Radioisotopes; Middle Aged; Radionuclide Imaging; Sodium Iodide; Sodium Pertechnetate Tc 99m; Submandibular Gland Diseases; Thyroid Gland

Salivary gland scintigraphy using 99Tcm sodium pertechnetate and a 20-min dynamic data acquisition with a sialogogue at 10 min was employed as the primary imaging modality in sialadenitis in 32 patients. Paired asymptomatic glands within the study group were used to establish control values for a number of computer-derived functional parameters. The shape of the activity-time curve was described as: H = hyperactive, N = normal, M = median, S = sloped, F = flat, O = obstructed. Of seven patients who had ductal stones on plain films, two passed stones prior to sialography and had normal curves, whole the remaining five patients had Type O curves. Parametric evidence of gland dysfunction was identified in an additional seven symptomatic glands, six being hyperactive; histology identified an acute inflammatory infiltrate in the only excised gland in this group. Glandular hypofunction was identified in one case, in which histology revealed extensive fibrosis and glandular atrophy. Type M and S curves were found in 28 glands, 75% of which were asymptomatic. Only one gland was indicated as hypoactive by calculated parameters, and this showed a Type S curve. Scintigraphy and plain films represent the least invasive and, we feel, the most suitable primary method of investigating sialadenitis. Conventional contrast sialography may be reserved for cases with no identifiable stone but an obstructed curve. The use of functional parameters and curve morphology to determine gland dysfunction other than obstruction is non-specific, probably insensitive and is unlikely to alter clinical management. We propose an algorithm for the investigation of sialadenitis.

Topics: Adolescent; Adult; Aged; Algorithms; Female; Humans; Male; Middle Aged; Parotitis; Radionuclide Imaging; Salivary Gland Calculi; Sialadenitis; Sodium Pertechnetate Tc 99m; Submandibular Gland Diseases

Unilateral radionuclide accumulation in salivary glands is an uncommon finding on gallium scintigraphy. The differential diagnosis includes malignant tumors and inflammatory processes of these organs. Two cases of unilateral gallium uptake of the parotid and submandibular gland respectively, verified as solitary tuberculosis, are presented, together with the correlative findings of Tc-99m pertechnetate scintigraphy, sialography, and sonography. None of these imaging modalities is specific enough to provide pathognomonic signs for tuberculosis. When assessing unilateral gallium uptake of the salivary glands, one should be aware of the possibility of tuberculosis.

Topics: Adult; Female; Gallium Radioisotopes; Humans; Parotid Diseases; Radionuclide Imaging; Salivary Gland Diseases; Sialography; Sodium Pertechnetate Tc 99m; Submandibular Gland Diseases; Tuberculosis; Tuberculosis, Oral

Submandibular gland function following transoral sialolithectomy was examined by 99mTc-pertechnetate sialo-scintigraphy in 10 cases. An intraindividual comparison between the function of the treated gland and that of the contralateral normal gland was made using a time-activity curve. Although glandular recovery was not affected by the duration of symptoms or the existence of the symptom at mealtimes, it was inversely proportional to the size of the calculus. Furthermore, the prognosis was more favorable in patients when the anatomically normal orifice of the submandibular duct was preserved.

Topics: Adolescent; Adult; Aged; Child; Dilatation, Pathologic; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Salivary Duct Calculi; Salivary Gland Diseases; Secretory Rate; Sodium Pertechnetate Tc 99m; Submandibular Gland; Submandibular Gland Diseases; Time Factors

In recent years salivary gland scintigraphy has gained widespread acceptance as a useful means for evaluating salivary gland disorders. An absolute indication for this procedure exists when the ductal orifice of one or several major salivary glands cannot be found or cannot be cannulated. Clinical conditions in which this problem occurs include technical failure to probe and cannulate the duct, developmental anomalies, obstructive disorders, traumatic lesions and fistulae and the need of postsurgical information after glandular excision or after ligation or repositioning of a major excretory duct. The clinical value of scintigraphy in these conditions is demonstrated by means of case presentations.

Topics: Adult; Aged; Constriction, Pathologic; Female; Humans; Male; Middle Aged; Parotid Gland; Radionuclide Imaging; Salivary Duct Calculi; Salivary Gland Diseases; Salivary Gland Fistula; Salivary Glands; Sodium Pertechnetate Tc 99m; Submandibular Gland Diseases

Salivary gland imaging with 99mTc as pertechnetate provides functional information concerning trapping and excretion of the parotid and submandibular glands. Anatomic information gained often adds little to clinical evaluation. On the other hand, functional information may detect subclinical involvement, which correlates well with biopsy of the minor labial salivary glands. Salivary gland abnormalities in systemic disease such as sarcoidosis, rheumatoid arthritis, lupus erythematosus, and other collagenvascular disorders may be detected before they result in the clinical manifestaions of Sjögren's syndrome. Such glands, after initially demonstrating increased trapping in the acute phase, tend to have decreased trapping and failure to discharge pertechnetate in response to an appropriate physiologic stimulus. Increased uptake of gallium-67 citrate often accompanies these findings. Inflammatory parotitis can be suspected when increased perfusion is evident on radionuclide angiography with any agent. The ability of the salivary gland image to detect and categorize mass lesions, which result in focal areas of diminished activity such as tumors, cysts, and most other masses, is disappointing, while its ability to detect and categorize Warthin's tumor, which concentrates pertechnetate, is much more valuable, although not specific.

Topics: Adenolymphoma; Humans; Lymphangioma; Parotid Diseases; Parotid Neoplasms; Radionuclide Imaging; Salivary Gland Diseases; Sjogren's Syndrome; Sodium Pertechnetate Tc 99m; Submandibular Gland Diseases; Submandibular Gland Neoplasms; Technetium