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Kuttner's tumour (chronic sclerosing sialadenitis) of
the submandibular gland: a clinical perspective
TL Chow,
Tony TF Chan,
CY Choi,
SH Lam
Division of Head and Neck Surgery,
Department of Surgery, United Christian
Hospital, Kwun Tong, Kowloon, Hong
Kong
OBJECTIVE. To study clinical perspectives pertaining to chronic sclerosing
sialadenitis, which is also known as Kuttner’s tumour.
DESIGN. Retrospective medical chart review.
SETTING. Regional hospital, Hong Kong.
PATIENTS. From February 2005 to February 2007, nine cases with Kuttner’s
tumour were identified from our hospital electronic database.
INTERVENTIONS. They underwent submandibular sialadenectomy under either
local (n=6) or general (n=3) anaesthesia.
MAIN OUTCOME MEASURES. The results of preoperative ultrasonography, fine-needle
aspiration cytology, and intra-operative frozen section
examination were correlated with the final diagnosis. Operative
morbidity was also evaluated.
RESULTS. The mean age of the patients at diagnosis was 61 years; three
were females. Three had bilateral submandibular swellings.
Following preoperative ultrasonography in six of the patients,
tumours were suspected in two, an enlarged lymph node in one,
and diffuse enlargement was visualised in the other three. Six
patients had preoperative fine-needle aspiration cytology; five
yielded scanty acini with normal-looking ductal cells, variable
degrees of infiltration by chronic inflammatory cells without
granuloma admixing fibrosis. In the sixth patient, only bland-looking
epithelial cells, indicative of ductal differentiation
suspicious of neoplasm were noted. Intra-operative frozen
section examination was conducted in three patients: chronic
inflammation without evidence of carcinoma was visualised in
each. Operations performed under local anaesthesia were well
tolerated; only one patient endured a transient, marginal facial
nerve palsy.
CONCLUSIONS. Kuttner’s tumour is by no means rare. When supported by
ultrasonography and fine-needle aspiration cytology, an accurate
diagnosis can be made preoperatively and surgery can be
reserved for symptomatic cases. Submandibular sialadenectomy
is a safe and effective means of treating Kuttner’s tumour, and
can be accomplished under local anaesthesia.
Hong Kong Med J 2008;14:46-9
Key words: Autoimmune diseases; Sclerosis;
Sialadenitis; Submandibular gland
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