Central venous catheter (CVC) placement is a routine procedure in ICUs but can be associated with various complications, including misplacement and thrombosis. We present a rare case of parotid gland enlargement due to catheter-related thrombosis of the external jugular vein following ultrasound-guided placement through the subclavian vein in an 84-year-old woman. This case was managed with systemic anticoagulation and catheter removal. It emphasizes the importance of confirming correct CVC tip positioning and highlights the need for a post-procedure chest X-ray.

Primary Sjögren\'s syndrome (pSS) is an autoimmune systemic disease characterized by the destruction of exocrine glands, mainly salivary and lacrimal glands. The diagnosis is generally made upon objective tests aimed at assessing salivary and lacrimal glandular function, autoantibody assays, and the results of labial salivary gland biopsies. A major salivary gland biopsy is usually reserved to assess lymphoproliferative complications. Recently, the sonographic evaluation of the major salivary glands has gained a crucial role in assessing the glandular parenchyma and early detecting abnormalities, while the role of ultrasonography in the assessment of lacrimal glands is still secondary. Our case report is about a male patient who presented parotid gland swelling and purpuric lesions, with preserved salivary and lacrimal glandular function. Considering the presence of risk factors associated with lymphoproliferative development and the peculiar characteristics detected by salivary and lacrimal gland ultrasonography, we performed a parotid gland biopsy, confirming Sjögren\'s syndrome. Our case demonstrates that lacrimal gland ultrasonography could be implemented, along with major salivary gland ultrasonography, as a routine procedure in evaluating patients with suspected or definite diagnoses of pSS.

Acute postoperative transient sialadenitis, also known as anesthesia mumps, is a rare condition that is transient, usually benign, and self-limiting in nature involving unilateral or bilateral parotid glands. The exact mechanism and etiology have not been fully explained, but the causative factors may include, pneumoparotitis, venous congestion, excess saliva secretion, surgical position, perioperative dehydration, and perioperative use of drugs such as atropine, succinylcholine, morphine, ephedrine, and propofol. We report a case of a 31-year-old pregnant lady who was admitted for elective cesarean section under spinal anesthesia. She developed facial swelling involving the parotid area bilaterally five hours postoperatively. Dexamethasone was given intravenously with intravenous (IV) fluids and paracetamol. The swelling improved gradually and resolved completely after 48 hours. This is a case of anesthesia mumps, one of the rare cases that may develop after anesthesia. Awareness, early recognition and supportive management by rehydration and corticosteroids are essential for the patient\'s reassurance, smooth regression, and recovery, and to avoid extremely rare situations as this condition can progress into airway obstruction.

Arginase deficiency is a progressive neurological disorder characterized by episodic hyperammonemia crises. Our patient had been diagnosed with cerebral palsy (spastic paraplegia) in childhood and received rehabilitation. She had suffered parotid swelling since the age of 5 years, prior to liver dysfunction becoming apparent, and then developed hyperamylasemia at 8 years of age. At age 25 years, she presented with hyperammonemia and elevations of aspartate aminotransferase and alanine aminotransferase. At age 27 years, she was diagnosed with arginase deficiency due to hyperargininemia and absent arginase activity in erythrocytes. Liver cirrhosis was also present. She was hospitalized several times for management of episodic hyperammonemia due to recurrent viral infections, an unbalanced diet, and poor compliance with medications.

Immunoglobulin G4-related disease (IgG4 RD) has a fair prognosis but its diagnosis has been difficult due to the condition\'s wide range of clinical manifestations, limited awareness among common practitioners, and various differentials. Here, we present a case of an elderly male who presented with recurrent dental caries, recurrent sinusitis, persistent dry mouth, and dry eyes along with bilateral parotid gland enlargement without any lymphadenopathy. The patient was evaluated further and found to have elevated levels of IgG4 and on histopathological examination of the parotid gland showed lymphocytic infiltrate with germinal centers without any granulomatous lesions and IgG4-positive plasma cells on immunohistochemistry (IHC). The patient was diagnosed with IgG4 RD and was started on corticosteroids, after which there was a symptomatic improvement.

A case of a 64-year-old woman is reported, who developed new-onset pain over a preexisting area of right mandibular fullness. Clinical examination, MRI, and fine-needle aspiration cytology confirmed the diagnosis of a benign parotid gland tumor-pleomorphic adenoma, which was treated by total parotidectomy with complete removal of the tumor. When evaluating a patient with orofacial pain, oral health care providers should be cognizant of all potential differential diagnoses, especially in the setting of red flags such as persistent or enlarging facial swelling/fullness.

OBJECTIVE: To assess the prevalence of parotid gland swelling (PGS), and its association with features of Sjögren\'s syndrome (SS) and other causes of sialadenosis in a Latin-American cohort of primary SS.
METHODS: We included 668 patients from Argentina, Brazil, Mexico, and Paraguay. We retrospectively registered demographics, disease duration, oral/ocular symptoms, serology and scored the basal ESSDAI. We defined PGS as a recurrent or persistent increase of volume of any parotid glands during adulthood (self-reported and/or physical examination). We registered the presence of diabetes mellitus, dyslipidaemia, body mass index, and alcohol consumption. We used logistic regression analysis reporting OR and 95% CI.
RESULTS: PGS was present in 242 patients (36.2%): 78 previous to SS diagnosis, 86 concomitantly, 73 during follow-up, and five unknown. At the multivariate analysis, PGS was associated with RF (OR 2.47, 95% CI 1.1-6.5, p= 0.0001), basal articular ESSDAI domain (OR 1.63, 95% CI 1.01-2.6, p= 0.04), and alcohol consumption (OR 2.42, 95% CI 1.41-4-15). Patients with PGS during the follow-up had a higher prevalence of alcohol consumption (45.3%) compared with the remaining PGS cases (26.8%; OR 2.41 95% CI 1.2-4.7), or patients without parotid gland swelling (15.6%; OR 3.8 95% CI 1.7-8.2) in all the adjusted models.
CONCLUSIONS: PGS generally precedes or presents concomitantly with SS diagnosis, and is related to RF and articular activity. Alcohol consumption is an additional factor in PGS, especially during follow-up. The meaning of this last finding as well as its prognostic implications remains to be elucidated and deserves further evaluation in prospective studies.

Sialadenosis (sialosis) is a chronic, noninflammatory, nonneoplastic, bilateral, often painless enlargement of the salivary glands, most frequently affecting the parotid glands. Approximately 50% of cases are associated with an underlying disease process. The pathogenesis of sialadenosis is unknown but likely results from an autonomic neuropathy. The key to management is diagnosis and management of any poorly controlled underlying medical process.

We encountered a 59-year-old man who first underwent left internal carotid endarterectomy for left internal carotid artery stenosis and then presented with postoperative swelling of the bilateral salivary glands. He then developed upper airway obstruction that required emergency tracheal intubation. The most likely cause was thought to be anesthesia mumps, which involves a complex interaction of multiple factors including pneumoparotitis, venous congestion, and excess saliva secretion. Many cases of salivary gland swelling recover after follow-up observation alone if there are no inflammatory findings; however, severe complications may sometimes occur. If upper airway obstruction develops as in the present case, then emergency airway management must also be considered and conscientious observation is necessary.

A diffuse, chronic, usually bilateral, noninflammatory, nonneoplastic enlargement of major salivary glands is termed as Sialosis or Sialadenosis. It is an extremely uncommon cause for enlargement of the parotid gland. We hereby present a case of a 45-year-old female patient having a swelling at the left preauricular region. The swelling was gradually increasing in size since 6 months. On clinical examination, the swelling was 3 cm × 3 cm, mobile, and nontender. On ultrasonography, it was suggestive of benign parotid lesion or parotitis with cervical lymphadenopathy. On fine needle aspiration cytology, it was suggestive of sialadenosis. This is an extremely rare salivary gland lesion with specific cellular features. It is very important to distinguish sialadenosis from other causes of enlargement of the parotid gland as treatment modality differs.