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This case report describes an elderly woman with late-stage Sjögren's syndrome presenting with bilateral parotid cystic swellings. Viral tests excluded HIV and HCV, and fine-needle aspiration showed inflammatory cystic lesions without malignancy. MRI demonstrated multiple fluid-filled nodules in both parotid glands. Elevated Anti-Ro/SSA, Anti-La/SSB, ANA, and rheumatoid factor supported the diagnosis, and literature synthesis supports differential diagnosis considerations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/bilateral-parotid-gland-cysts-as-an-atypical-indicator-of-sjogrens-syndrome-a-case-study-and-literature-overview/454914/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/bilateral-parotid-gland-cysts-as-an-atypical-indicator-of-sjogrens-syndrome-a-case-study-and-literature-overview/454914.png","ImageObject",300,407,{"name":92,"@type":93},"supergirl","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How were viral infections evaluated in the case report?","Question",{"text":112,"@type":113},"Viral screening for HIV and HCV returned negative, helping exclude viral causes of the presentation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did fine-needle aspiration biopsy show for the parotid lesions?",{"text":117,"@type":113},"Fine-needle aspiration identified cystic structures with inflammatory infiltration, excluding malignancy and several other cystic diagnoses.",{"name":119,"@type":110,"acceptedAnswer":120},"Why was surgical treatment not pursued, and what was the follow-up outcome?",{"text":121,"@type":113},"Due to comorbidities, advanced age, and lack of symptoms, surgery was not performed. 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Laboratory testing eliminated viral infections including HIV and HCV. Fineneedle aspiration biopsy of parotid swellings revealed inflammatory cystic lesions, excluding malignancy and other common cystic conditions. MRI revealed several fluid-filled nodules in both glands.  \nConclusion:  \nThis report supports including Sjögren's syndrome in the differential diagnosis for bilateral cystic lesions of the parotid glands. A synthesis of similar literature cases is included.  \nKeywords: Autoimmune salivary gland disorder, Sjögren's syndrome, Bilateral parotid cysts, Case report, Literature review  \nReceived date:10 Feb 2025  \nAccepted date: 29 Jul 2025  \n*Please cite this article; Troise S, Tarallo G, Carraturo E, Di Blasi F, Sarcinella M, Esposito M, Calabria F, Vincenzo I, Dell’Aversana Orabona G. Bilateral Parotid Gland Cysts as an Atypical Indicator of Sjögren's Syndrome: A Case Study and Literature Overview. Iran J Otorhinolaryngol. 2025:37(6):349-351. Doi: 10.22038/ijorl.2025.85419.3869  \n1Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy.  \n*Corresponding author:  \nMaxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of  \nNaples Federico II, Naples, Italy. E-mail: [emanuele.c2971995@gmail.com](emanuele.c2971995@gmail.com)  \nIntroduction  \nSjögren's syndrome (SS) is a chronic autoimmune disease which the patient’s immune system primarily targets moistureproducing glands, particularly the lacrimal and salivary tissues (1) .  \nThe autoimmune insult reduces glandular secretions, leading to common symptoms such as dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca), but SS may also affect systemic organs including joints, lungs, skin, kidneys, and the peripheral nervous system (1,2) .  \nThe disease manifests variably, with hallmark symptoms such as ocular and oral dryness, swallowing difficulties, hoarseness, joint discomfort, fatigue, skin issues, and respiratory symptoms.  \nDiagnosing SS involves clinical evaluation, laboratory screening for characteristic antibodies, functional glandular testing, imaging, and frequently biopsy confirmation (2,3) . Although not routinely used, advanced imaging like MRI may incidentally detect parotid cysts in atypical SS presentations (4) . This report documents such a presentation and compares it to cases previously described in scientific literature.  \nCase Report  \nThis case was managed at the Maxillofacial Surgery Unit of \"Federico II\" University Hospital, as part ofa broader review.  \nAn 81-year-old woman presented with bilateral swelling localized in the parotid region. Physical assessment revealed a 4 x 4.5 cm lesion in the left parotid gland (Figure 1) .  \nFig 1: Dimensions of the left parotid mass displayed in sagittal (B) and vertical (A) MRI slices.  \nThe patient reported no discomfort, and facial nerve function was intact. She had been previously diagnosed with untreated grade IV Sjögren's syndrome. Viral screenings for HIV and HCV returned negative. Cytological analysis using fine-needle aspiration indicated cystic structures with inflammatory infiltration, excluding diagnoses such as Warthin tumour, mucoceles, lymphoepithelial cysts, and malignancy. MRI scans identified multiple fluid-filled cysts in b","cbCailnMLrF5hxOl","https://ap.wps.com/l/cbCailnMLrF5hxOl","pdf",326190,"English","# Abstract\n# Introduction\n# Case Report\n# Discussion\n# Conclusion","[{\"question\":\"How were viral infections evaluated in the case report?\",\"answer\":\"Viral screening for HIV and HCV returned negative, helping exclude viral causes of the presentation.\"},{\"question\":\"What did fine-needle aspiration biopsy show for the parotid lesions?\",\"answer\":\"Fine-needle aspiration identified cystic structures with inflammatory infiltration, excluding malignancy and several other cystic diagnoses.\"},{\"question\":\"Why was surgical treatment not pursued, and what was the follow-up outcome?\",\"answer\":\"Due to comorbidities, advanced age, and lack of symptoms, surgery was not performed. The patient was monitored for six months, during which the condition remained stable.\"}]","Bilateral Parotid Gland Cysts as an Atypical Indicator of Sjögren's Syndrome - A Case Study and Literature Overview | PDF"]