WFUMB position paper. Incidental findings of the salivary glands

Abstract

A salivary incidentaloma (SI) stands for any focal salivary lesion, independent of size, discovered by any imaging method including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), multimodal positron emis-sion tomography (PET) combined with CT or MRI, or X-ray imaging, performed for another reason, in the absence of known salivary glands’ disease. The article presents a detailed analysis of salivary gland diseases with the emphasis on neoplasms. It describes frequency of SIs found on imaging, their prevalence, epidemiology and clinical significance. The probability of malignancy or malignant transformation of a SI, its imaging features, recommended treatment, management and follow-up, as well as ethical issues, psychological burden, informed decision making, economical consequences and costs are discussed. The general prevalence of SIs is low, but is dramatically increasing over time, and may rise significantly in selected groups of oncologic patients. SIs most frequently turn out to be benign primary neoplasms or pseudotumors, including intraparenchymal lymph nodes. SIs detected by other imaging methods should be subsequently assessed with US. Solid SIs demand ultrasound guided fine-needle aspiration cytology (US-FNAC). Neoplasms should undergo surgery. Post-operative US follow-up is man-datory for malignant tumors and recommended for benign neoplasms.

Incidental Findings in Pediatric Patients: How to Manage Liver Incidentaloma in Pediatric Patients

“…IFs on imaging studies are asymptomatic and unexpected pathologies, unrelated to the presenting illness. They often necessitate further imaging or diagnostic work-ups which entail both a psychological and an economic burden for the patient and the healthcare system [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

“…The following issues are almost identical for the evaluation of IF in all organs and will be briefly summarized [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 219 ].…”

“…The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications titled “Incidental imaging findings—the role of ultrasound” [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. Each WFUMB position paper on IFs will follow the same template and, accordingly, will be uniformly structured to help readers interpret the key messages [ 7 ], will discuss the prevalence and imaging features of hepatic incidental finding in pediatric patients and will discuss strategies for work- and follow-up.…”

Managing Incidental Findings Reported by Medical, Sonography and Other Students Performing Educational Ultrasound Examinations

“…Comprehensive reviews of IF in different organs and systems are being published in a series of position papers by the World Federation for Ultrasound in Medicine and Biology (Bialek, et al 2021, Lewicki, et al 2021, Trenker, et al 2021 to give recommendations on how to handle particular IF.…”