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Swollen parotid gland. No lesion in MRI. Is it a blocked duct? What is the cure?

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ENT Specialist
Practicing since : 1992
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I have had a swollen parotid gland for at least two years. The latest MRI (April 2012) showed no defined mass or lesion. The specialist said that was good news and I agree. However, he said no further evaluation required. Does that mean I have to walk around with a swollen gland? It is bigger sometimes more than others. If it is a blocked duct, can't I get that fixed? I look like I'm just beginning to get the "mumps." I can't believe I have to live with this.
Posted Tue, 19 Jun 2012 in Ear, Nose and Throat Problems
Answered by Dr. Ravinder Sharma 15 hours later
Dear Moss
Thanks for writing in.
As you have told that your MRI done in April 2012 shows that there is no lesion. The specialist opinion that you are not suffering from anything serious is to assure you that there is nothing that is life threatening. Possibly he is telling you that there is no tumour in your parotid gland. Whenever we suspect a diagnosis our first concern is to find what is more concerning. With the help of MRI we are sure that this is not a parotid tumour. Parotid tumours can be benign or cancerous and they require extensive surgery and radiotherapy and recurrence is quite common. I think you will feel relieved to find that there is no evidence of such a disturbing diagnosis.

The images sent with the query do not have a similar opinion - The MRI report suggests that there is no evidence of tumour while the letter states it as a pleomorphic adenoma. Plromorphic adenoma of parotid gland is a benign tumour and can be treated by superficial parotidectomy. This tumour is known for recurrence. On the basis of the info provided it is difficult to point to a diagnosis but i can suggest for fine needle aspiration biopsy from this swelling. This will help us in reaching a diagnosis,

I would first like to tell you about the probable causes of enlarged parotid glands.
Mumps - is not a possibility as here the duration of symptoms lasts for a week to ten days and is associated with fever.
Calculi - Calculi is a possibility but it is very rare to find bilateral parotid enlargement because of calculi. Usually they are unilateral.

Parotid enlargement can be seen in
Endocrine disorders including Diabetes mellitus, cushing syndrome , hypothyroidism, autoimmune disorders like Sjogren syndroma, Mixed connective tissue disorder , Chronic renal failure, Cirrhosis of liver , Anorexia nervosa , Sarcoidosis may also have bilateral parotid enlargement, uveitis and hilar lymphadenopathy, Acquired immunodeficiency syndrome .
If I look at your medical history it is suggestive of history of diabetes, renal insufficiency and thyromegaly
I feel you will need a work up by an ENT surgeon and a physician plus fine needle aspiration biopsy and some blood tests (for autoimmune diseases and other infections) to come to the diagnosis. Once we get to the cause, we can control the disease.
I hope this answers your concern
Do let me know if anything else is required from my side

with warm regards
Ravinder Sharma
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