Recurrent parotitis in monovular twins. Diagnosis by magnetic resonance sialography

Recurrent parotitis is rare in childhood. Its occurrence is characterized b y recurrent episodes of swelling and pa in in the parotid gland,which are u sually accompanied by fever and malaise. Inflammation usually resolves spon taneously during adolescence. The disorder is a condition of unknown etiolo gy. Sialectasis and stricturing occurs in the distal ducts, whereas inflamm ation of the gland and duct epithelium is probably caused by a low salivary flow rate. Which one can be considered the primary event or secondary chan ge remains unknown. The mainstay of diagnosis is sialography, which depicts typical intraparotidal duct system lesions as strictures or ectasias and e xcludes sialolithiasis. We here report two 10-year-old male monovular twins who suffered from recurrent swelling and pain in only their left parotid g lands. Symptoms were noted approximately every 6 weeks in both patients str ictly. Characteristic sialectasis of the distal ducts was demonstrated by m agnetic resonance-sialography. Our findings support the hypothesis that rec urrent parotitis is caused by a congenital abnormality of the salivary glan d duels. Diagnostic imaging was performed by magnetic resonance imaging dur ing the acute phase of the disease. This technique helps to make the diagno sis without retrograde application of a contrast agent.