Wk 9, Case 5 - Review

Patient History
Left neck mass.

Findings
Contrast-enhanced CT was performed from the skull base to the thoracic inlet. Study shows no evidence of aggressive lesions involving the nasopharynx, oral cavity, tongue base, tonsils, larynx or hypopharynx. No evidence of enlarged lymph nodes using standard size criteria.

There is an approximately 1.3 cm x 9 mm calcified mass at the junction of the expected location of Warthin's duct and the submandibular gland. These findings are consistent with a large sialolith. These findings are consistent with an enlarged and enhancing left submandibular gland which likely represents chronic obstructive sialadenitis. No evidence of dilatation of left Warthin's duct in the floor of mouth. There may be some mild dilatation of the intraglandular submandibular ducts. However, the majority of the abnormality involving the left submandibular duct is due to chronic sialadenitis which is also known as Kuttner tumor.

No evidence of calcified lesions is identified involving the course of the right submandibular duct within the floor of mouth.

Visualized portion of the brain is grossly within normal limits. However, dedicated brain imaging is necessary for complete diagnostic evaluation.

Visualized portion of the lungs is grossly within normal limits. However, dedicated chest CT is necessary for complete diagnostic evaluation.

Conclusions
Large sialolith at the junction of the left submandibular gland and Warthin's duct associated with chronic obstructive sialadenitis of the left submandibular gland which is also known as Kuttner tumor.