Bilateral swelling of the parotid gland as the first clinical symptom of sarcoidosis

Introduction:

Sarcoidosis is a rare granulomatous systemic disease. In the ENT area may occur with unilateral or bilateral swelling of parotid gland, facial palsy, swollen lymph nodes, iridocyclitis and/or skin eruption.

Methods:

We report on a 44-year-old patient who came to our outpatient clinic as an emergency. He lamented a pressure-sensitive swelling of the parotid glands for 3 days. An antibiotic therapy with cefuroxime, which was started on an outpatient basis, did not improve the Symptoms. The examination on the day of admission in the hospital showed that both of Parotid Glands were significantly enlarged and sonomorphologically nodular indurated.

Results:

Firstly the serological evaluation excluded an acute mumps disease. An X-ray of the Thorax showed a lymphadenopathy of the Hilum Region. A CT-scan revealed also lymphomas of the Hilum with no intrapulmonary suspicious focus of neoplasia. Laboratory diagnostics revealed an increase in soluble IL2 receptor. We then opted for an open biopsy. The histological examination confirmed our suspected diagnosis.

Conclusions:

Swelling of the parotid gland as the first clinical manifestation of sarcoidosis is very rare. The prevalence is about 2 – 6%. A bilateral parotid participation is an extreme rarity. This is reported only in a few isolated cases in the literature. It is also important in terms of differential diagnosis to consider a sarcoidosis in such a clinical picture.

Publication History

Publication Date:
18 April 2018 (online)