Küttner tumor

Last revised by Dr Daniel J Bell on 19 Jan 2022

Küttner tumor refers to a chronic sclerosing sialadenitis. Despite the term tumor, it is a non-neoplastic condition. It is classically described in relation to the submandibular gland but less commonly can also affect the other salivary glands 9 and occasionally also the lacrimal gland 6.

Although Herman Kuttner's published cohort of four patients all had submandibular disease 8, the term Kuttner tumor, where used, is also applied to chronic sclerosing sialadenitis of the parotid gland or other salivary (or even lacrimal) tissue. The use of the term "tumor" is an unhelpful epithet as the entity is not a neoplasm and is not associated with malignant progression 12.

  • sialolithiasis - thought to be associated in ~30 to 80% of cases although it is still unclear whether the sialolithiasis is the cause or result of the underlying inflammatory process 12

Clinically, it produces a firm swelling of the glands and may mimic neoplasia 2,3. Patients may experience recurrent pain and swelling that is often associated with food ingestion. Some patients may have an asymptomatic hard swelling of the submandibular gland.

It is sometimes considered as part of IgG4 related sclerosing disease 11,13.

These lesion are can be classified according to four histological stages 2,10 :

  • stage I - lymphocytic infiltration around the salivary ducts
  • stage II - diffuse lymphocytic infiltration and severe periductal fibrosis
  • stage III - prominent lymphocytic infiltration, parenchymal atrophy and periductal sclerosis
  • stage IV (end stage) - marked parenchymal loss and sclerosis (likened to that of liver cirrhosis).
  • T1: slightly hypointense
  • T2, STIR and DWI: slightly hyperintense 2

Many authors advocate excision of the lesion although there are also several reports of conservative management - e.g steroids.

It is named after Hermann Küttner, (1870-1932) 14, German surgeon, who described a series of patients with a unilateral, hard, tumor-like mass of the submandibular gland in 1896 8.

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