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Enigmatic Formations Found in Routine Orthopantomography (OPG) Examinations: A Case Report

Authors :
Riccardo Nocini
Luca Sacchetto
Morris Zarantonello
Alessia Pardo
Michele Bonioli
Daniele De Santis
Source :
Diagnostics, Vol 13, Iss 5, p 840 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

We describe two clinical cases of occasional radiographic findings on orthopantomography (OPG) that were performed routinely, for which the definitive diagnosis may be uncertain. After an accurate remote and recent anamnesis, for reasons of exclusion, we hypothesize a rare case of the retention of a contrast medium in the parenchyma of the major salivary glands (parotid, submandibular, and sublingual) and their excretory ducts as a consequence of sialography examination. In the first case we analyzed, we found it difficult to classify the radiographic signs on the sublingual glands, left parotid, and submandibular, while in the second case, only the right parotid was involved. Using CBCT, the spherical findings were highlighted, with multiple having different dimensions, as well as radiopaque in their peripheral portion and more radiolucent inside them. We could immediately exclude salivary calculi, which usually have a more elongated/ovoid shape and appear homogeneously radiopaque without radiolucency areas. These two cases (of hypothetic medium contrast retention with unusual and atypical clinical-radiographic presentation) have very rarely been comprehensively and correctly documented in the literature. No papers have a follow-up longer than 5 years. We conducted a review of the literature on the PubMed database, finding only six articles reporting similar cases. Most of them were old articles, demonstrating the low frequency of this phenomenon. The research was performed using the following keywords: “sialography”, “contrast medium”, “retention” (six papers) and “sialography”, and “retention” (13 papers). Some articles were present in both searches, and the really significant ones (defined after a careful reading of the entire article and not only of the abstract) resulted only in six occurrences in a time span from 1976 to 2022.

Details

Language :
English
ISSN :
20754418
Volume :
13
Issue :
5
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.bf4ac022a351461b9d9b25733d2cbb45
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics13050840