Swelling of the submandibular gland region: Cystic or neoplastic entity?

Saxena, Susmita; Kumar, Sanjeev; Kharbanda, Jitin

doi:10.4103/jomfp.jomfp_155_19

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…The article by Saxena et al describes a case of toxoplasmosis presenting as submandibular lymphadenitis in a 25‐year‐old male patient 1 . In contrast to our case, the patient did not have an oropharyngeal lesion and had only submandibular lymphadenopathy.…”

Section: Discussioncontrasting

confidence: 78%

“…Table I presents a comparative analysis drawn from various articles in the literature that discuss cases of lymphadenopathy induced by toxoplasmosis. The articles incorporated in the comparison are Saxena et al, Kale and Carlin, and our own case study 1,2 . This comparative exploration considers multiple aspects such as patient demographics (age and gender), clinical presentation and symptoms, diagnostic methodologies utilized, treatments administered, and the ultimate outcomes of each case.…”

Section: Discussionmentioning

confidence: 99%

“…Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii. In immunocompetent adults, toxoplasmosis is often asymptomatic, but can manifest as an acute febrile illness, with symptoms such as hepatosplenomegaly, myocarditis, uveitis, posterior cervical lymphadenopathy, and neurological abnormalities 1,2 . However, toxoplasmosis has not been previously reported as a cause of ulcerative oropharyngeal lesion with adenopathy.…”

Section: Introductionmentioning

confidence: 99%

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A Diagnostic Challenge: Toxoplasmosis Masquerading as Tonsillar Neoplasm

Hamud,

Brodsky,

Khnifes

2023

The Laryngoscope

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This case report elucidates an uncommon manifestation of toxoplasmosis characterized by an ulcerative oropharyngeal lesion and cervical lymphadenopathy, which intriguingly simulated a tonsillar neoplasm. The patient, a 28‐year‐old immunocompetent woman, reported symptoms such as a persistent sore throat, unilateral neck pain, and otalgia. Despite the initial clinical impressions, a diagnostic left subtotal tonsillectomy revealed no malignancy but marked acute and chronic inflammation. A comprehensive investigation subsequently indicated a recent primary infection with Toxoplasma gondii, as evidenced by the presence of high IgM antibodies and low IgG avidity. This unique case underlines the significance of incorporating toxoplasmosis into the differential diagnosis of oropharyngeal lesions, thereby necessitating a meticulous approach to laboratory testing. Laryngoscope, 2023

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Diagnostic Challenge: Toxoplasmosis Masquerading as Tonsillar Neoplasm

Hamud,

Brodsky,

Khnifes

2023

The Laryngoscope

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“…UC-MEC, a MEC variant first described by Raslan [21] in 1998, has been reported as a low-grade tumor with a favorable prognosis. A literature review revealed 20 cases of UC-MEC in the maxillofacial region [2][3][4][5][6][7][8][9]. The average age of these UC-MEC patients was 41.7 (range, 20-80) years.…”

Section: Discussionmentioning

confidence: 99%

“…Although the majority of MEC are typical in histology, unicystic MEC (UC-MEC), a rare variant of MEC, poses a great diagnostic and treatment challenge for clinicians and pathologists. To date, only 20 cases of UC-MEC have been reported in the English literature [2][3][4][5][6][7][8][9], which means that more cases are needed to study the clinicopathological features and appropriate treatment choices.…”

Section: Introductionmentioning

confidence: 99%

Unicystic Mucoepidermoid Carcinoma: A Pitfall for Clinical and Pathologic Diagnosis

Wang

Feng

et al. 2022

Journal of Oncology

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Unicystic mucoepidermoid carcinoma (UC-MEC) is a rare MEC variant, and its diagnosis is frequently problematic. This study is aimed at summarizing its clinicopathologic characteristics, treatment, and prognosis and proposing key points to avoid missed diagnosis and misdiagnosis in clinical and pathological conditions. This retrospective study included 30 UC-MEC cases, and the clinical findings were collected from the clinical medical records. Radiographic features, histologic behaviors, MAML2 rearrangement by fluorescence in situ hybridization (FISH), and follow-up data were analyzed. Moreover, glandular odontogenic cyst (GOC) and cytadenoma (CA) were used as controls. In the UC-MEC group, 19 patients were female (63%), and 11 were male (37%). The mean patient age was 39.5 (range, 7–72 years). The affected locations included the jaw (8 maxillary, 3 mandibular) and salivary glands (7 parotid, 11 palates, and 1 floor of the mouth). The chief complaint was swelling; the lesions were all cystic, among which 66.7% were well circumscribed and 33.3% poorly defined. Microscopic examination showed two UC-MEC histologic subtypes. Type A presented as a single cyst with mural thickening (8/30, 27%) lined predominantly by epidermoid cells with interspersed intermediate and mucinous cells, and type B (22/30, 73%) showed infiltrative tumor islands in the cystic wall or the surrounding tissue. FISH analysis suggested that approximately 66.7% of UC-MEC harbored a MAML2 rearrangement. During the median follow-up period of 42 months (range, 6–120 months), all type A patients and 68% of type B patients who underwent complete surgical resection lived without relapse. Seven cases with type B cancer that underwent curettage initially had local recurrence. Clinicians and pathologists hardly recognize UC-MEC owing to its cystic architecture. Specific epidermoid, mucous, and intermediate tumor cells, and MAML2 fusion testing, are essential to avoid potential diagnostic pitfalls. Prompting and completing resection surgery with negative margins would have a favorable prognosis.

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