SALIVARY DUCT CYST: A CASE REPORT

Abstract

　We report a case of a salivary duct cyst that was diagnosed definitively by histopathological examination after surgery performed for a cyst of the parotid gland. A 27-year-old male patient presented to us with a one-week history of swelling and tenderness in the lower part of the left ear. On physical examination, we found an easily movable mass near the lower part of the left ear. An ultrasound and MRI examination of the neck revealed a subdermal cystic lesion in front of the parotid gland overlying the left masseter muscle. The cytologic examination findings were classified as Class II, malignancy was not admitted. We scheduled an operation for diagnosis and complete removal of the cyst. An S-shaped incision was made in front of the left ear. A subdermal cystic lesion was observed in front of the parotid gland overlying the left masseter muscle. The cyst wall was adherent, with particularly strong adhesion to the hypodermis, and because the cyst wall burst during detachment, it was removed to the extent possible. Histopathological examination revealed the diagnosis of a salivary duct cyst. After the patient had been commenced on solid food 2 days after the operation, an increase in clear fluid from the drain was observed, which was suspected to be caused by leakage of saliva. Pressure was applied with gauze to the wound site and going without food, the symptoms reduced gradually, with complete recovery achieved within 2 months. Diagnosis of salivary duct cyst before surgery is difficult, and care must be taken during the operation to avoid- salivary leakage and facial nerve paralysis. When the wall is adherent, especially if it is strongly adherent to the hypodermis, the cyst should be resected with extra care.