Küttner tumour (KT) refers to a chronic sclerosing sialadenitis of the salivary glands. Despite the term tumour, it is a non neoplastic condition. It is classically described in relation the submandibular gland but less commonly can also affect other salivary glands 9 and occassionally as well as the lacrimal gland 6.
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).
- sialolithiasis - thought to be associated in ~30 to 80% of cases although it is still unclear whether the sialolithiais is the cause or result of the underlying inflammatory process 12.
- T1: slightly hypointense
- T2, STIR and DWI: slightly hyperintense 2
Treatment and prognosis
Many authors advocate excision of the lesion although there are also several reports of conservative managment - e.g with steroids.
History and etymology
It is named after H. Küttner, German physician, who described a series of patients with a unilateral, hard, tumour-like mass of submandibular gland in 1896 8.
- 5. Yousem DM, Kraut MA, Chalian AA. Major salivary gland imaging. Radiology. 2000;216 (1): 19-29. Radiology (citation) - Pubmed citation
- 1. Ahuja AT, Richards PS, Wong KT et-al. Kuttner tumour (chronic sclerosing sialadenitis) of the submandibular gland: sonographic appearances. Ultrasound Med Biol. 2003;29 (7): 913-9. Ultrasound Med Biol (link) - Pubmed citation
- 2. Abu A, Motoori K, Yamamoto S et-al. MRI of chronic sclerosing sialoadenitis. Br J Radiol. 2008;81 (967): 531-6. doi:10.1259/bjr/38960620 - Pubmed citation
- 3. Huang C, Damrose E, Bhuta S et-al. Kuttner tumor (chronic sclerosing sialadenitis). Am J Otolaryngol. 23 (6): 394-7. Am J Otolaryngol (link) - Pubmed citation
- 4. Chow TL, Chan TT, Choi CY et-al. Kuttner's tumour (chronic sclerosing sialadenitis) of the submandibular gland: a clinical perspective. Hong Kong Med J. 2008;14 (1): 46-9. Hong Kong Med J (link) - Pubmed citation
- 6. Ho HW, Lim Z, T lim KH et-al. Bilateral Kuttner tumours of the lacrimal glands. Orbit. 2011;30 (2): 96-7. doi:10.3109/01676830.2011.556305 - Pubmed citation
- 7. Unal M, Karabacak T. Küttner's tumour of the submandibular gland. B-ENT. 2006;2 (4): 197-9. - Pubmed citation
- 8. Küttner H. Über entzundiche Tumoren der Submanxillar-speicheldruse. Bruns Bietr Klin Chir. 1896;15:815–834
- 9. Chou YH, Tiu CM, Li WY et-al. Chronic sclerosing sialadenitis of the parotid gland: diagnosis using color Doppler sonography and sonographically guided needle biopsy. J Ultrasound Med. 2005;24 (4): 551-5. J Ultrasound Med (citation) - Pubmed citation
- 10. Mukherji SK, Chong V. Atlas of head and neck imaging, the extracranial head and neck. Thieme Medical Publishers. (2004) ISBN:3131360712. Read it at Google Books - Find it at Amazon
- 11. Geyer JT, Ferry JA, Harris NL et-al. Chronic sclerosing sialadenitis (Küttner tumor) is an IgG4-associated disease. Am. J. Surg. Pathol. 2010;34 (2): 202-10. doi:10.1097/PAS.0b013e3181c811ad - Pubmed citation
- 12. Beriat GK, Akmansu SH, Kocatürk S et-al. Chronic Sclerosing Sialadenitis (Küttner's tumour) of the Parotid Gland. Malays J Med Sci. 2010;17 (4): 57-61. - Free text at pubmed - Pubmed citation
- 13. Laco J, Ryska A, Celakovsky P et-al. Chronic sclerosing sialadenitis as one of the immunoglobulin G4-related diseases: a clinicopathological study of six cases from Central Europe. Histopathology. 2011;58 (7): 1157-63. doi:10.1111/j.1365-2559.2011.03833.x - Pubmed citation