|Year : 2015 | Volume
| Issue : 2 | Page : 79-81
Salivary Duct Cyst
Manu Gupta1, Aarti Mahajan2, Manish Gupta3
1 Department of Oral Pathology and Microbiology, Santosh Dental College, Ghaziabad, Uttar Pradesh, India
2 Department of Oral Pathology and Microbiology, MGV's Dental College, Nashik, Maharashtra, India
3 Department of Oral Medicine and Radiology, Santosh Dental College, Ghaziabad, Uttar Pradesh, India
|Date of Web Publication||17-Dec-2015|
48, Ashok Mohalla, Nangloi, Delhi - 110 041
Source of Support: None, Conflict of Interest: None
Salivary duct cyst is the rare nonneoplastic lesion of the salivary gland. Although most authors describe salivary duct cyst and mucocele as one entity, we are describing them separately because of different histopathological features. Unlike a mucocele, which is surrounded by granulation tissue, the salivary duct cyst is lined by epithelium. This article reports a case of salivary duct cyst in a 13-year-old male child in the parotid gland duct.
Keywords: Mucocele, parotid gland, salivary duct cyst
|How to cite this article:|
Gupta M, Mahajan A, Gupta M. Salivary Duct Cyst. Indian J Oral Health Res 2015;1:79-81
| Introduction|| |
Salivary duct cyst may be acquired or congenital.  The majority, however, are acquired, and most of these are probably secondary to obstruction.  Some authors, therefore, prefer the term retention cyst to designate these lesions.  Still others prefer the term simple cyst.  Ours is a rare case of congenital salivary duct cyst where the lesion was present since birth. The lesion was completely asymptomatic, and the patient was only bothered about his facial appearance.
Though salivary duct cysts primarily involve the parotid glands, most of them are of acquired variety. The Armed Forces Institute of Pathology registry reports consist of 166 cases of salivary duct cysts occurring in the major salivary glands out of which 152 cases involves the parotid gland, 13 cases involves the submandibular gland, and only 1 case involves the sublingual gland, but there is no clear documentation about the prevalence of congenital salivary duct cysts.
Clinically, salivary duct cysts of the parotid gland are similar to lymphoepithelial cysts. Typically, they are unilateral painless swellings with no involvement of the facial nerve and no fixation to the overlying skin. The majority of affected patients are over 40 years of age. 
| Case report|| |
A 13-year-old male patient came with the chief complaint of swelling in the parotid region. The patient gave the history of the presence of a small swelling at birth that was noticed by his family members and had gradually increased in size since then. No associated symptoms were present. On clinical examination, a well-defined swelling was seen on the left lower third of the face below the ear lobule overlying the angle of mandible, was oval in shape and measured approximately 3 cm × 2 cm in size [Figure 1] and [Figure 2]. On palpation, the swelling was freely movable and soft in consistency.
Sialography of the parotid gland revealed that the main duct was of even diameter and ductal structure within the gland branched regularly and tapered gradually toward the periphery of the gland, giving it a tree in winter appearance [Figure 3] and [Figure 4]. Superficial parotidectomy was performed based on sialographic findings. On histopathological examination, the lesional tissue composed of a cystic cavity lined by single layered columnar cells [Figure 5] and [Figure 6]. At places, ciliated and mucous cells were observed, and microscopic diagnosis of salivary duct cyst was made. On follow-up, after 6 months, no residual symptoms were noticed, and there was no evidence of recurrence.
|Figure 3: Sialography of the parotid gland showing no ductal obstruction|
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|Figure 4: Sialography of the parotid gland showing normal glandular structure|
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| Discussion|| |
Salivary duct cysts are uncommon lesions with a predilection for parotid gland and are often found in the superficial lobe of the parotid.  Apart from acquired (occur following obstruction in the duct) or congenital, Eversole had separated the third type of retention cysts known as reactive oncocytoid cysts. The pathogenesis of oncocytic metaplasia is related to aging of cells in the seromucinous gland and ducts. There is no gender predilection for salivary duct cyst. Salivary duct cyst of the parotid gland mostly presents as an asymptomatic, unilateral swelling. In most of the cases of the parotid duct cyst, the facial nerve is uninvolved, and fixation to overlying skin is absent. The cysts range from 0.8 cm to 10 cm in size, but majority reach 1-3 cm in size. All types of salivary duct cysts have similar histopathological features except for oncocytosis. 
Salivary duct cyst can be easily diagnosed based on certain criteria; these include- unilocular appearance on the radiograph, cavity distended by mucous, epithelial lined by flattened to cuboidal single layered cells, the presence of mucous or oncocytoid cells, papillary epithelial projections, and minimal lymphocytic infiltrate.  Treatment requires either partial or complete surgical removal of the gland. Whenever, possible the cyst and its associated lobules of salivary gland should be removed.
Salivary gland cysts could be an early manifestation of a salivary gland tumor. The presence of epithelial alterations, such as metaplasias and focal papillary proliferations observed, are comparable to similar changes seen in odontogenic cysts and may be an early marker of tumor manifestation. There have been rare instances of development of benign and malignant neoplasms such as adenocarcinoma and mucoepidermoid carcinoma from the lining of a salivary duct cyst. 
| References|| |
Richardson GS, Clairmont AA, Erickson ER. Cystic lesions of the parotid gland. Plast Reconstr Surg 1978;61:364-70.
Seifert G, Thomsen S, Donath K. Bilateral dysgenetic polycystic parotid glands. Morphological analysis and differential diagnosis of a rare disease of the salivary glands. Virchows Arch A Pathol Anat Histol 1981;390:273-88.
Cohen MN, Rao U, Shedd DP. Benign cysts of the parotid gland. J Surg Oncol 1984;27:85-8.
Jensen JL. Idiopathic diseases. In: Ellis GL, Auclair PL, Gnepp DR, editors. Surgical Pathology of the Salivary Glands. Philadelphia: WB Saunders Company; 1991. p. 66-82.
Koudelka BM. Obstructive disorders. In: Ellis GL, Auclair PL, Gnepp DR, editors. Surgical Pathology of the Salivary Glands. Philadelphia: WB Saunders Company; 1991. p. 26-38.
Eversole LR. Oral sialocysts. Arch Otolaryngol Head Neck Surg 1987;113:51-6.
Dardick I. Color Atlas/Text of Salivary Gland Tumor Pathology. New York: Igaku Shoin Medical Publishers; 1996. p. 131-41.
Takeda Y, Yamamoto H. Salivary duct cyst: Its frequency in a certain Japanese population group (Tohoku districts), with special reference to adenomatous proliferation of the epithelial lining. J Oral Sci 2001;43:9-13.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]