Neonatal isolated submandibular suppurative sialadenitis (NISSS) is a rare condition. We present a case of NISSS caused by Staphylococcus aureus (S. aureus) in premature triplet girls born at 28 + 1 weeks of gestation. Mother's milk culture tested positive for S. aureus, which is presumed to be the potential contributing factor of the infection. The first symptoms appeared in one of the girls at 31 days of age, followed by her sisters at 34 and 36 days of age, respectively. A search of the PubMed/Medline, ScienceDirect and Web of Science databases revealed that this is the first reported case of NISSS in triplets. We defined risk factors like an immature immune system, prolonged orogastric feeding and antidiuretic therapy for developing NISSS in neonates.

Standard of care RPT may result in dose-limiting side effects of the salivary glands include sialadenitis and xerostomia that are inconsistent with outcomes from external beam for equivalent ADs. This work develops a parametrizable 'Macro-to-Micro' (M2μ) model that demonstrates the consideration of small-scale dosimetry in comparison to conventional methods that typically assume uniform voxel or organ-level uptake. Anatomical features of the salivary gland are represented by annular structures (a centralized branching network of ducts, including excretory, lobar, interlobular) and small-scale voxels (intralobular ducts and acinar cells) with dimensions set to reproduce ex-vivo murine histopathology measurements and scaled up in size for extrapolation to humans. Simulations were performed by scoring and recording S-value histograms to the target ductal and acinar cells, for two beta emitters (177Lu, 131I) and one alpha emitter (225Ac). Four idealized activity distributions were created to assign activity to surface and volumes of the annuli, and GEANT4 v11 was used for radiation transport calculations. Comparisons against whole gland uniform spherical self-dose S-value calculations were conducted to validate the radiation transport and to highlight differences between M2μ and conventional dosimetry approaches. Analyses for both models showed greater S-value variation in comparison to the homogeneously distributed activity S-value calculation. The most notable result was that the calculated S-values differed between different branches, depending on the geometric size of the annuli. For the surrounding acinar cells, S-values from ductal cells decreased as a function of distance from the branching structures. High variability of S-values, depending on ductal cell dimensions as well as within the acinar cell distribution of the salivary gland highlights the potential clinical utility of small-scale approaches to RPT salivary gland dosimetry, contingent on clinical translation and validation. To this end, future work should further refine the model and incorporate small-scale activity distributions from pre-clinical and translational studies.

Salivary gland (SG) fibrosis represents a critical pathological feature of exocrine hypofunction driven by the persistent activation of myofibroblasts (MFs). However, the translational gap between the convoluted in vivo regulatory networks governing these cells and the deployment of precise, disease-modifying interventions remains a formidable challenge. This review systematically examines current mechanistic evidence undergirding MF activation, survival, and its phenotypic reversal, focusing on restoring glandular function. We synthesize recent literature mapping in vivo canonical profibrotic signaling cascades, noncanonical crosstalks, and cellular heterogeneity within the injured exocrine stroma. Evidence underscores that the pathological tilt between profibrotic Smad3 and inhibitory Smad7 acts as a critical rheostat for MF differentiation across diverse etiologies. Beyond classical pathways, emerging mechanisms-such as mitochondrial metabolic reprogramming, store-operated calcium entry (SOCE) collapse, and persistent cGAS-STING innate immune sensing-are mechanically reinforced by extracellular matrix rigidity via a YAP/TAZ mechanotransduction loop. These events, coupled with aberrant epigenetic imprinting, structurally lock the persistent MF phenotype and restrict cellular plasticity. Consequently, we evaluate targetable interventions-ranging from small-molecule inhibitors (SB431542, decitabine) and biologics (rituximab) to traditional botanical formulations (Shengmai San) and stem cell-derived extracellular vesicles-that effectively attenuate scar formation and improve salivary flow rates in preclinical or clinical models. Ultimately, this review establishes a novel, etiology-driven "etiology-origin-pathway-target" matrix that shifts the paradigm from empirical anti-inflammatory management toward origin-specific precision therapeutics capable of reversing established salivary gland fibrosis.

Background: Lymphoepithelial sialadenitis (LESA) is a chronic lymphoid-rich inflammatory disorder of the salivary glands that is strongly associated with Sjögren's disease and may overlap clinically, radiologically, and histopathologically with IgG4-related sialadenitis, HIV-associated lymphoepithelial lesions, chronic sialadenitis, salivary gland tumors, and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). Objective: This scoping review mapped current evidence on diagnostic challenges, differential diagnostic criteria, management strategies, and surveillance considerations for LESA. Eligibility criteria: Sources were selected using the Population-Concept-Context framework and included the literature addressing salivary gland lymphoepithelial lesions, LESA, Sjögren's disease-associated salivary gland involvement, or related lymphoid-rich salivary gland disorders published from 2010 onward. Sources of evidence and charting methods: Google Scholar was searched, records were screened in sequential stages, and relevant data were charted narratively across clinical, serological, imaging, histopathological, immunophenotypic, molecular, therapeutic, and follow-up domains. Results: Thirty-seven sources were included. The evidence indicates that LESA is usually characterized by chronic lymphoplasmacytic inflammation, acinar atrophy, lymphoepithelial lesions, and preserved lobular architecture; however, these findings may overlap with early or established MALT lymphoma. Immunohistochemistry, assessment of light-chain restriction, clonality testing, serological markers, and imaging are useful adjuncts, but no single test is independently definitive. Conservative management and symptomatic care are appropriate for stable disease, whereas corticosteroids, immunomodulatory therapy, sialendoscopy, surgery, radiotherapy, or systemic lymphoma therapy may be considered according to clinical context. Conclusions: LESA requires integrated clinicopathological interpretation and multidisciplinary follow-up. Key evidence gaps include the absence of standardized LESA-specific diagnostic criteria, limited validation of molecular and flow cytometric approaches in salivary gland specimens, and lack of consensus surveillance protocols.

Iodinated contrast-enhanced imaging is a well-established and ubiquitous diagnostic tool that offers many benefits in oncology care. However, such benefits are accompanied by risks such as nephrotoxicity. The below report describes a 71-year-old woman with acute myelogenous leukemia who developed iodine contrast-induced sialadenitis, manifested by acute neck swelling and gland tenderness, within a day after undergoing imaging for infectious workup at a tertiary oncology center. Despite the adverse event, the patient proved to have a patent airway and was discharged home after overnight monitoring in the intensive care unit. The patient's rare complication highlights the multitude of risks that can accompany iodine contrast administration and emphasizes the necessity of exercising due caution before using contrast-enhanced imaging.

Extra-intestinal manifestations of inflammatory bowel disease (IBD) can involve most organ systems, although the immunologic underpinnings are not well understood. Most patients who present with an extra-intestinal manifestation have a single site of extra-intestinal involvement; however, a small cohort presents with multiple different sites of involvement. Ocular and facial muscle and salivary gland involvements are rarely seen in IBD, especially in children with ulcerative colitis (UC). In this study, we describe a case of ocular facial myositis and sialadenitis in a child with new-onset UC.

An 87-year-old man with a history of World Health Organization (WHO) grade IV glioblastoma resection developed hydrocephalus and underwent a ventriculoperitoneal (VP) shunt insertion as an American Society of Anesthesiologists (ASA) class 4E patient with a body mass index (BMI) of 24.3 and postoperatively was found to have acute bilateral parotid glands swelling after 2 h post-extubation. He became acutely unwell with sinus tachycardia, hypertension, and a drop in SpO2 to 82%. Primary interventions included oxygen supplementation, 1 L bolus of normal saline, pain control, and a non-contrast computed tomography of the head and neck to evaluate cause of swelling, which revealed subcutaneous edema without evidence of hematoma. Patient was weaned off oxygen and monitored over the next 48 h, and face and neck swelling resolved without any further interventions. To our knowledge, the occurrence of anesthesia mumps (AM) described as acute, transient bilateral parotid gland swelling without purulence, has not been documented in the setting of a VP shunt insertion. This case represents a novel contribution to the literature and expands our understanding of the clinical contexts in which AM may arise. Risk factors for AM in this case included poor oral hygiene and nutritional status, prolonged "nothing by mouth" (NPO) status while awaiting surgery, and significant rotation of the head in neurosurgery such as a VP shunt insertion.

We present a case series of four paediatric patients who successfully tolerated sialendoscopy of the submandibular duct under local anaesthesia in the Royal Gwent Hospital Maxillofacial Department, Newport. Both diagnostic and interventional sialendoscopy procedures are reported in the case series, including basket retrieval and lithotripsy. These cases demonstrate the feasibility and effectiveness of both diagnostic and interventional sialendoscopy under local anaesthesia in the paediatric patient and propose that this may be considered a primary treatment option in cases of paediatric obstructive sialadenitis of the submandibular duct.

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is an extremely rare malignant neoplasm. Here we describe an infant girl with sublingual SETTLE. Diagnosis was complicated by initial histopathology result from incisional biopsy showing features of chronic sialadenitis. Gross total resection of the lesion demonstrated a low-grade spindle epithelial cell neoplasm, which was confirmed to be SETTLE on specialist pathology review. Previous literature has not identified a case occurring at such a young age or involving a tumor located outside the thyroid gland.