Presentation
Clinically presenting with three days history of bilateral sub-mandibular lesion, swelling. Had bilateral parotid swelling one week ago. Ultrasound to rule out submandibular gland mumps.
Patient Data
Globularly enlarged, heterogeneous and hypervascular bilateral submandibular glands and the parotids however with patent, non-dilated Wharton's and the Stensen's ducts.
Multiple enlarged lymph nodes that maintain their central echogenic stromal fats are noted at the sub-mental region (levels IA & 1B), at the submandibular chains (levels IIA & IIB) and in the intra-parotid gland parenchyma, which are likely reactive. Two conspicuous rounded lesions (located at the left lateral neck; < 2cm in diameters each) with homogeneously echoic reflectivity but with mild eccentric foci shadowing are noted suggesting mature teratomatous nodules containing sebum and subtle hair plug compositions.
Case Discussion
Given the young adolescent age of this male patient, the sonographic features are more reflective of an acute parotitis and submandibular sialadenitis (mumps disease) likely the sequelae of direct contact with the infectious virus' droplets by the patient as no outbreak alerts were reported locally or regionally.
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