Sialadenosis Alcohol Clinical — ORE Part 1 MCQ

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ModerateOral MedicineSialadenosis Alcohol ClinicalORE Part 1

A 45-year-old woman has gradually developed painless bilateral parotid enlargement. She has no xerostomia, fever or respiratory symptoms. Serum amylase is raised and liver enzymes are mildly elevated. She drinks 28 units of alcohol each week. What is the most likely diagnosis?

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Correct answer: E — Alcohol-related sialadenosis

The diagnosis is **alcohol-related sialadenosis**. Sialadenosis is a non-inflammatory, non-neoplastic disorder producing chronic, painless, symmetrical enlargement of the parotid glands, and chronic alcohol excess is a recognised association. The absence of xerostomia makes Sjögren syndrome less likely, as sicca symptoms are a central clinical feature. Mumps causes an acute, painful or tender parotitis, often with fever and systemic symptoms. Bilateral parotid neoplasia is much less likely with diffuse symmetrical enlargement rather than focal masses. Sarcoidosis can involve salivary glands, but would ordinarily require supporting systemic features or investigations. Mild liver-enzyme elevation supports alcohol-related systemic disease; the raised amylase is compatible with salivary gland enlargement but is not diagnostic in isolation.

Reference: Mandel L, Hamele-Bena D. Alcoholic parotid sialadenosis. Journal of the American Dental Association. 1997. https://pubmed.ncbi.nlm.nih.gov/9332142/