Submandibular gland enlargement

Submandibular gland enlargement refers to an increase in the volume of the submandibular gland, exceeding "normal" values of 7.4 ± 1.8 mL ¹.

Pathology

Causes

Obstruction

• sialolithiasis

• submandibular duct stenosis (e.g. tumor, granulomatous disease)

Infection

• acute sialadenitis: following sialolithiasis

• acute suppurative sialadenitis (submandibular abscess) 

  • from odontogenic infection

  • from hematogenous spread

  • immunodeficiency

• acute viral sialadenitis

  • mumps

Inflammatory

• chronic sialadenitis

  • Mikulicz syndrome

  • Sjögren syndrome

  • chronic sclerosing sialadenitis (Küttner tumor)

• IgG4-related disease: diffuse submandibular gland enlargement, with a homogeneous density ²

• granulomatosis with polyangiitis ³

• submandibular gland sarcoidosis ⁴ - rare 

Neoplastic

All salivary gland tumors are to be considered

• benign

  • pleomorphic adenoma

  • intraductal papilloma of salivary glands

  • oncocytoma of salivary glands

  • submandibular gland hemangioma

  • submandibular gland lymphangioma

  • lipoma

• malignant

  • mucoepidermoid carcinoma

  • adenoid cystic carcinoma

  • myoepithelioma

  • adenocarcinoma

  • acinic cell carcinoma of salivary glands

  • squamous cell carcinoma of salivary glands

  • malignant mixed tumors of the salivary glands

  • carcinosarcoma

  • carcinoma ex pleomorphic adenoma

  • salivary duct carcinoma

  • submandibular gland metastases

  • cutaneous squamous cell carcinoma

  • malignant melanoma

  • submandibular gland lymphoma

Miscellaneous

• bulimia nervosa: painless diffuse swelling of major salivary glands ¹

• acromegaly ⁵

• pneumosialodenitis of the submandibular gland: gas in the submandibular gland ⁷

• compensatory hypertrophy in the setting of contralateral congenital absence or atrophy/disease ⁶