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Published in: Head and Neck Pathology 4/2017

01-12-2017 | Original Paper

Intraoral Salivary Duct Cyst: Clinical and Histopathologic Features of 177 Cases

Authors: Ivan J. Stojanov, Umer A. Malik, Sook-Bin Woo

Published in: Head and Neck Pathology | Issue 4/2017

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Abstract

The salivary duct cyst (SDC) is a reactive ductal ectasia most frequently seen in major salivary glands, and likely caused by obstruction. The aim of this study is to define the clinical and histopathologic spectrum of intraoral SDCs. Cases were retrieved from the archives of Harvard School of Dental Medicine/StrataDx, Inc. from January 2012 to August 2014. There were 177 cases of which 103 (58.2%) occurred in females, with a median age of 56 (range 2–95). Approximately half of cases (45.8%) presented in the area of the buccal mucosa, lower lip mucosa, or mandibular vestibule, and 23.2% presented in the floor of mouth. SDCs were lined at least focally by 1–2 layers of cuboidal/columnar epithelium in 85.3% of cases and showed varying degrees of metaplasia (oncocytic, mucous cell, squamous, ciliated, apocrine-like) in 68.4% of cases. Intraluminal mucous stasis was present in 41.8% of SDCs, incipient calcification was present within 4.5% of SDCs, and chronic obstructive sialadenitis was seen in 90.2% of cases. No cysts showed adenomatous ductal proliferations or true papillary structures with fibrovascular cores, although 41.2% exhibited reactive undulation of cyst lining. Thirty-nine ‘papillary oncocytic cystadenoma-like’ SDCs (22.0%) demonstrated complete oncocytic metaplasia and marked undulation. An additional seven such cysts (4.0%) had a ‘Warthin tumor-like’ lymphoplasmacytic infiltrate. Intraoral SDCs occur most commonly in the sixth decade of life in locations distinct from extravasation mucoceles, likely secondary to intraluminal obstruction. SDCs show diverse histopathology and certain phenotypic variants may be mistaken for papillary oncocytic cystadenoma or Warthin tumor.
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Metadata
Title
Intraoral Salivary Duct Cyst: Clinical and Histopathologic Features of 177 Cases
Authors
Ivan J. Stojanov
Umer A. Malik
Sook-Bin Woo
Publication date
01-12-2017
Publisher
Springer US
Published in
Head and Neck Pathology / Issue 4/2017
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-017-0810-5

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