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Sialosis — MFDS Part 1 MCQ

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ModerateOral PathologySialosisMFDS Part 1

A 29-year-old woman presents with slowly progressive, painless, bilateral and symmetrical parotid enlargement. The glands are soft, there is no erythema, saliva appears normal at the duct orifices, and the swelling is unrelated to meals. Which accompanying feature would most strongly support a diagnosis of sialosis (sialadenosis)?

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Correct answer: D — Recurrent self-induced vomiting due to bulimia nervosa

Sialosis is a non-inflammatory, non-neoplastic enlargement that most often produces painless, bilateral and symmetrical parotid swelling. It is associated with systemic metabolic and nutritional disturbances, including bulimia nervosa, malnutrition, diabetes mellitus and chronic alcohol-related disease. Recurrent self-induced vomiting therefore strongly supports the diagnosis. Acute fever and malaise suggest viral parotitis. Xerostomia with keratoconjunctivitis sicca suggests Sjögren disease, an autoimmune sialadenitis. Painful swelling during meals is characteristic of duct obstruction, commonly from a salivary calculus. A firm unilateral mass or facial nerve weakness raises concern for a salivary neoplasm rather than sialosis.

Reference: Downey MC, Cray JL, Dombrowski DS. A Patient Diagnosed with Bulimia Reports to the Dental Office Seeking Cosmetic Dental Work. Dental Clinics of North America. 2023. https://pubmed.ncbi.nlm.nih.gov/38905553/