CASE REPORT   

Otorinolaringologia 2019 June;69(2):122-5

DOI: 10.23736/S0392-6621.19.02199-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

The diagnostic process of Mikulicz’ disease: a case with lachrymal glands exclusive involvement

Giulia DALMASSO ¹ ✉, Mathilde COUTURIER ², Alessandro GRIFFA ², Vincent ROSSI ², M’Hamed ALAMI ², Sami WAJSBROT ², Flavio PEROTTINO ²

¹ ENT Department, Città della Salute e della Scienza, University of Turin, Turin, Italy; ² Unit Head and Neck, Hospital of Escartons, Briançon, France

Mikulicz’ disease is an uncommon pathology of uncertain origin, that needs a series of evaluation to be determined. Salivary and lacrimal glands are typically involved, with persistent swelling without significant loss of function. Historically, a large debate took place to define the Mikulicz’ disease and its etiology. Some new criteria have been recently described by Japanese studies to include Mikulicz in the so called IgG4 related diseases, where an augmentation of the rate of the IgG4 is responsible of a systemic disease; by this new point of view the Mikulicz’ disease has become a systemic pathology. We report an atypical case with isolated lacrimal gland involvement in a middle-aged man. Aim of our report was to stress the hard-diagnostic process carried out by eliminating step by step several differential diagnoses. By our study and by a review of the literature (that is provided), we conclude that diagnosing the Mikulicz’ disease is still challenging; collaboration between the radiologist, the rheumatologist and the head and neck specialist is needed.

KEY WORDS: Mikulicz’ disease - Lacrimal apparatus - Lymphoid tissue