Citation, DOI & article data
Citation:
Weerakkody, Y., Bell, D. Küttner tumor. Reference article, Radiopaedia.org. (accessed on 20 May 2022) https://doi.org/10.53347/rID-20010
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.
Associations
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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.
Histological classification
These lesion are can be classified according to four histological stages 2,10 :
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stage I - lymphocytic infiltration around the salivary ducts
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stage II - diffuse lymphocytic infiltration and severe periductal fibrosis
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stage III - prominent lymphocytic infiltration, parenchymal atrophy and periductal sclerosis
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stage IV (end stage) - marked parenchymal loss and sclerosis (likened to that of liver cirrhosis).
MRI
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T1: slightly hypointense
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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 management - e.g steroids.
History and etymology
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.
- 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
- 5. Yousem DM, Kraut MA, Chalian AA. Major salivary gland imaging. Radiology. 2000;216 (1): 19-29. Radiology (citation) - 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
- 14. Duncker & Humblot. Neue Deutsche Biographie. (1982) ISBN: 9783428001941 - Google Books
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