Imaging diagnosis: CT findings in bilateral necrotising sialometaplasia of the mandibular salivary glands in a Tibetan Terrier

Abstract

A 7-year-old female neutered Tibetan Terrier presented with a 2-week history of bilateral mandibular swelling, lethargy, reduced appetite, pyrexia and right sided exophthalmos. Computed tomography (CT) identified severe bilateral enlargement and heterogenicity of the mandibular salivary glands, which contained multiple cavitary lesions. Cytology of both mandibular salivary glands confirmed necrotising sialometaplasia. The treatment with phenobarbitone, omeprazole and paracetamol was initiated. The patient made a dramatic improvement upon 3-week follow up, with marked reduction in size of the mandibular salivary glands and resolution of clinical signs. To the authors' knowledge, this is the first reported case describing the CT imaging features of necrotising sialometaplasia. K E Y WO R D S cavitations, necrotising sialometaplasia, phenobarbitone, salivary gland disease BACKGROUNDThis case describes previously unreported computed tomography (CT) features of canine necrotising sialometaplasia, a distinct clinical entity that to date has only been described in histopathological or clinical reports in veterinary patients. [1][2][3][4][5][6][7] This condition is characterised by painful lobular necrosis, fibrosis and squamous metaplasia of the affected salivary glands. 2,8,9 Both spontaneous resolution and response to phenobarbitone treatment have been reported in veterinary patients. 10,11 This case describes the imaging features of a condition that should be a differential diagnosis for aggressive salivary disease.