Abstract
Background: Cheilitis glandularis (CG) is a rarely diagnosed benign condition of the minor salivary glands, classically presenting with lower lip involvement in middle-aged and elderly men. CG has an unclear pathophysiology with nonspecific histological findings, however, the clinical presentation is distinctive. Current consensus suggests this is a reactive condition, with hyposalivation, tobacco smoking, UV exposure, and immunosuppression as possible etiological factors. Although debate persists regarding CG's malignant potential, it is probable that early reports were confounded by shared risk factors with epithelial malignancies.
Case report: We present a singular case identified following a clinical audit (2018-2023), at the University of Otago Oral Pathology Centre. A 43-year-old woman presented clinically with a history of high UV exposure, and examination demonstrated lower lip inflammation with prominent minor salivary gland orifices producing a mucoid discharge. Histologically, CG was differentiated from sialadenitis due to prominent sialectasia with mucous metaplasia, on a background of nonspecific mixed chronic inflammation, early fibrosis, and atrophy of the minor salivary glands. In addition, prominent solar elastosis was noted with mild dysplasia in the overlying epithelium.
Discussion: Whereas this case was typical for CG, readily meeting the Reiter's clinical and histological criteria for diagnosis, the relatively nonspecific histology demonstrated the importance of clinicopathologic correlation.
Conclusions: The actual diagnosis of CG may not be important in itself, yet its association with concomitant actinic cheilitis should prompt thorough assessment to exclude this clinically and histologically. We suggest that CG may be a surrogate marker of a potentially malignant condition.