Salivary Gland Enlargement

Aka: Salivary Gland Enlargement, Salivary Hypertrophy, Sialadenosis, Salivary Gland Disorder

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II. Definitions

  1. Sialoadenitis
    1. Inflammation or infection of Salivary Gland or duct
  2. Sialadenosis
    1. Autoimmune Neuropathy induced Salivary Gland localized hypertrophy of the acinar component
    2. Chronic, bilateral, asymptomatic Salivary Gland hypertrophy
    3. Associated with Alcoholism, Diabetes Mellitus, Bulimia Nervosa, Malnutrition
  3. Sialolithiasis
    1. Calculus within Salivary Gland duct and secondary obstruction

III. Causes: Acute versus Chronic Salivary Enlargement

  1. Acute
    1. Unilateral Acute Salivary Swelling
      1. Acute Sialolithiasis (50% of cases)
      2. Bacterial Sialadenitis (fever)
    2. Bilateral Acute Salivary Swelling
      1. Viral Sialadenitis
  2. Chronic
    1. Unilateral Chronic Salivary Swelling
      1. Salivary Gland Tumor
        1. Palpable mass evaluated with CT or Ultrasound, ENT referral and FNA
      2. Salivary Gland Duct Stricture (constant symptoms)
        1. Evaluated with CT, ENT referral and sialography
      3. Chronic Sialolithiasis (recurrent) with Obstructive Sialoadenitis
        1. Stone may be palpable
        2. Evaluate with CT or US and ENT referral
      4. Chronic Bacterial Sialoadenitis (recurrent)
        1. Evaluate with CT, ENT referral and sialography
        2. Treat with oral Antibiotics
      5. Posttreatment Sialadenitis
        1. Follows post-radiation, Radioactive Iodine or Anesthesia
    2. Bilateral Chronic Salivary Swelling in Children
      1. Juvenile Recurrent Parotitis (age 3 to 6 years)
    3. Bilateral Chronic Salivary Swelling in Adults
      1. Systemic Autoimmune Conditions
        1. See Xerostomia
        2. Sjogren Syndrome
        3. Immunoglobulin G4 Related Disease
      2. Chronic infection, inflammation and other febrile causes (eval with labs, u/s, ent referral, FNA)
        1. HIV Infection (associated with bilateral, parotid benign lymphoepithelial cysts)
        2. Fungal Infection
        3. Viral Sialadenitis
        4. Lymphoma
        5. Chronic Granulomatous Disease
          1. Sarcoidosis
          2. Mycobacterial infection (Tuberculosis, Leprosy)
      3. Sialadenosis (asymptomatic, chronic bilateral parotid enlargement)
        1. Eating Disorder (Anorexia, Bulimia Nervosa) or Malnutrition
        2. Alcoholism
        3. Cirrhosis
        4. Chronic Pancreatitis
        5. Endocrine Disorder
          1. Acromegaly
          2. Diabetes Mellitus
          3. Gonadal hypofunction

IV. References

  1. Daniels in Goldman (2000) Cecil Medicine, p. 2245
  2. Kim (2024) Am Fam Physician 109(6): 550-9 [PubMed]

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