PAROTID ENLARGEMENT IN CIRRHOSIS OF THE LIVER

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Abstract
This paper presents 2 cases of cirrhosis of the liver accompanied by bilateral parotid hypertrophy. The relationship of the parotid hypertrophy to cirrhosis is discussed. It is interesting that the English medical literature for the past 25 years, including recent text books, does not mention this combination of findings. However, French and Italian literature does indicate that parotid enlargement and cirrhosis of the liver have been noted. In both of the cases presented, there was definite evidence of decompensation of chronic liver disease. The reason for the hypertrophy of the parotid glands is not easy to ascertain. The relationship of parotid enlargement to malnutrition, which has been noted in many parts of the world, is discussed. No specific nutritional element is apparently responsible for the enlargement. However, there is little question that parotid enlargement is not uncommon in groups of patients subject to malnutrition. Histological study of the parotid gland in cases of malnutrition is not specific. This is also true in the 2 cases presented here. Biopsy of the parotid glands did not reveal any specific histological pattern. While concomitant pancreatic disease has been postulated as a possible etiologic factor in the enlargement of the parotid glands, careful scrutiny does not support this hypothesis. Undoubtedly the finding of parotid enlargement in cirrhosis is more common than has been reported in the past and it is believed that careful examination of the parotid glands in this type of patient will demonstrate that the incidence of parotid enlargement is more common than has hitherto been realized. At present, it can be stated that the exact cause for this parotid enlargement in cirrhosis of the liver is not known.

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