Head and Neck Imaging

Sialocele

collection of saliva; also called salivary mucocele or salivary retention cyst. CT or MRI show a smoothly bordered cystic mass in or near a salivary gland. It appears that two mechanisms exist in the formation of sialoceles:

  • Partial obstruction (usually caused by inflammation, sialolithiasis or a tumour) of the distal end of a duct will produce dilatation of the duct resulting in an epithelial-lined retention cyst.

  • Disruption of the duct (usually caused by trauma or surgery) will cause extrusion of saliva into the adjacent tissue; this incites an inflammatory reaction and is eventually walled off by granulation tissue (Fig.1). It is a pseudocyst without a distinct epithelial lining. The mechanism of injury responsible for the extravasation is often minor and not always recalled by the patient.

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    Fig.1

    Axial T1-weighted spin echo image through the submandibular region. A low signal intensity mass lesion with peripheral enhancement, as well as enhancing septa within the lesion, is seen. The lesion is lying just anteriorly to the submandibular gland (asterisk). Pathological examination revealed a granulation tissue-lined pseudocyst, consistent with a mucocele of the extravasation type; the adjacent submandibular gland parenchyma appeared normal (from: Van der Goten A., Hermans R., Smet M.H., Baert A.L.: Submandibular gland mucocele of the extravasation type: report of two cases. Pediatr Radiol 1995, 25: 366-368, with permission).
    Sialocele, Fig.1