Küttner tumour as the cause of a hypoglossal nerve palsy: case report and literature review
Chronic sclerosing sialadenitis, also known as Küttner's tumor, is a benign tumour-like chronic inflammatory lesion of the salivary glands predominantly involving the submandibular gland. It was first described in 1896 by H. Küttner, a German physician. Histopathological examination reveales dilated ducts with a dense lymphoplasmacytic infiltration, periductal fibrosis and acinaratrophy. Clinical characteristics include painless swelling of the submandibular gland. Mostly the submandibular gland is affected unilaterally. For the moment Küttner's tumor is thought to be a lesion of immunoglobulin G4-related disease (IgG4-related disease). This is an inflammatory condition accompaniedby dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, fibrosis in various organs and elevated serum IgG4 levels. Küttner's tumour creates an interesting diagnostic dilemma in clinical practice because it resembles closely the clinical characteristicsof malignancy. Herein, we report the case of a 69-year-old female with the hypoglossal nerve paresis caused by IgG4-associated chronic sclerosing sialadenitis. At first stroke was suspected.