Non-Neoplastic Salivary Gland Diseases: Swellings

Abstract

Non-neoplastic salivary gland disease is a heterogeneous and growing group of conditions, including recently described diseases such as IgG4-related disease, hyper-eosinophilic sialodochitis, and immune checkpoint inhibitor sialadenitis. This review covers the spectrum of non-neoplastic salivary gland pathology using a systematic literature search of the MEDLINE database from 1900 to 2025. Congenital syndromes and anomalies: Salivary gland agenesis and ductal anomalies related to ectodermal dysplasia and genetic syndromes are discussed. These etiologies include viral infections (mumps, HIV, hepatitis C, SARS-CoV-2) and bacterial etiologies of acute suppurative sialadenitis. Inflammatory disorders: Sjogren’s syndrome, immunoglobulin G4 (IgG4)-related disease, Sarcoidosis, Obstructive disorders of which Sialolithiasis is the most common, are reviewed along with minimally invasive treatments sialoendoscopy and extracorporeal shock wave lithotripsy. Other disorders, such as Sialosis, Drug-induced disorders, Pneumoparotitis, and Buccinator window syndrome, as well as some uncommon conditions, are also reviewed. With the development of improved imaging modalities, sialoendoscopy and revised classification, the diagnostic strategies have been changed especially for IgG4-related disease. Treatment approaches focus on gland preserving practices and targeted therapies. Although the incidence of these disorders is probably greater than that of salivary gland neoplasms, they are often resistant to diagnosis because of their clinical similarity to malignant disease. It offers the current state of non-neoplastic salivary pathology and highlights ongoing awareness of new disease entities and multidisciplinary management principles required for the best patient management.