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Unilateral Submandibular Gland with False PET Positive Uptake in a Patient with Breast Cancer: Case Report and Review of the Literature

Susan B Nguyen, Young S Paik, Uzma Khan and Jeffrey B Jorgensen

Unilateral submandibular gland aplasia is a rare entity with only thirteen cases reported in the literature. Most of the published patients were asymptomatic on presentation without any associated facial anomalies.We present a patient with a history of breast cancer with an incidental finding of unilateral submandibular gland aplasia presenting with asymmetric uptake of fluoro-2-deoxy-glucose (FDG) in the remaining submandibular gland on a positron emission tomography/computed tomography (PET/CT). Multiple options exist for imaging of the salivary glands which include plain radiographs, Tc-pertechnatate scintigraphy, sialography, ultrasonography, magnetic resonance imaging, and computed tomography. There are certain characteristics found in each category that would warrant further diagnostic inquiry. For combined PET/CT of the head and neck, there is inherent variable uptake of FDG due to the anatomy and structures involved in this region. Both the otolaryngologist and radiologist should work closely in assessing suspicious salivary gland tissue within PET/CT of the head and neck and correlating these findings clinically to consider further investigation.