Hong Kong Med J 2008;14:46-9 | Number 1, February 2008
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.
Key words: Autoimmune diseases; Sclerosis; Sialadenitis; Submandibular gland
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