Ectopic salivary gland tissue in the anterior mandible: a case report

Abstract

Ectopic salivary gland inclusions in the mandible are a rare phenomenon. Classically as described by Stafne 1 they have been found in the posterior mandibular region. Cases affecting the anterior mandible are even more unusual. We report a case of ectopic salivary gland tissue in the anterior mandible. In our discussion we emphasise the need for a thorough history, examination and relevant investigations. Mandibular radiolucencies can prove a pitfall for the unwary.

Stafne Bone Cavity in the Anterior Mandible

“…16,28Y32,60 In most cases, the radiolucency was located either entirely beneath the root apices 1,6,9,10,17,20,27,32,34,37,42,47Y50,62 or partially superimposed over the apices. 4,5,8,19,28,29,31,38,39 In few cases, it appeared between the roots of the adjacent teeth 8,16,21,27,39,60 or in edentulous areas. 3,7,14,15,21,27 Occasionally, the displacement of the roots of the teeth can also be seen in the radiograph.…”

“…28,29 The size of the lesions was noted in 20 cases, ranging from 0.5 to 2 cm, with a median size of 1.2 cm. 8,27,32,34,42,48,49 In 1 case, the lesion was multilocular and extremely large (9 Â 20 cm 2 ), extending from the right molar to the left second molar. 12 Recently, Smith et al 28 documented a bilateral case with 45 Â 14 mm 2 on the left side and 38 Â 17 mm 2 on the right side.…”

“…28Y32,42,47,49,85Y87 However, in the literature review, it was reported that these cavities also have contents other than glandular tissue such as fibrous connective tissue, 9 adipose tissue, 32 muscle, nerve, lymph nodes, and blood vessels. 8,19,97,98 Thus, surgical exploration and biopsy should be reserved for patients in whom symptoms referable to the region are present or the findings are not consistent with the cavities or exceptional when an additional pathologic lesion is suspected to develop in the entrapped salivary tissue. 42,65,98 …”

The Embryology of the Salivary Glands: An Update

“…In addition to the common presence of salivary tissue within the parotid and periparotid lymph nodes, heterotopic salivary gland tissue can rarely be found in the middle ear, 42 in a remnant of Rathke pouch, 43 the cerebellopontine angle, 44,45 the posterior mandible as Stafne inclusions or in the anterior mandible, 46,47 in the palatine and lingual tonsils, 48 parathyroid and thyroid glands, 49,50 the soft tissues of the neck, and medial to the sternocleidomastoid mus-cle. 51 There is even a report of such heterotopic salivary tissue in the rectum.…”

Heterotopic parathyroid gland tissue in the parotid gland adjacent to a pleomorphic adenoma

“…This anomalous migration of tissue could be similar to when thyroid tissue appears in the parotid area (Mysorekar et al, 2004), or parotid tissue in the anterior mandibular area (Dorman and Pierse, 2002), masseter muscle or mandible (Kahn et al, 2002). Heterotopic parathyroid gland tissue would develop in the presence of an ectopic inductive influence from the parotid ectomesenchyme.…”