Image obtained by MRI (magnetic resonance imaging) of the head of one of the patients, with the newly discovered glands within a red box. Netherlands Cancer Institute (NKI) / EFE
Doctors have accidentally discovered a mysterious anatomical structure that appears to be a set of salivary glands hidden inside our heads, when examining patients using an advanced imaging technique. Something that has gone unnoticed for centuries.
Researchers at the Netherlands Cancer Institute (NKI) discovered two unexpected areas located deep in the nasopharynx in patients they were exploring, using a new imaging technique, in investigations aimed at avoiding the sequelae of radiotherapy in the head and neck.
The uncovered areas resemble the known major salivary glands “but at the back of the nasopharynx there should be no large salivary glands, as people have three sets of these organs, but they are not there,” explains radiation oncology therapist Wouter Vogel , from the NKI.
As far as was known, the only salivary or mucous glands in the nasopharynx are microscopic, and there are about a thousand of these glands evenly distributed throughout the mucosa, so the researchers were very surprised when they found these new areas.
Thanks to the most advanced imaging technologies that allow us to visualize organs, cells and even molecules, it is to be expected that we already know all the parts and corners of the human body and it seems unlikely to make a new anatomical discovery in our body.
That's why it's easy to imagine the surprise of two Dutch medical researchers who have just discovered a mysterious hidden organ in the center of the human head: what appears to be a collection of salivary glands that scientists had overlooked for centuries.
This “unknown entity” was accidentally identified by two scientists who were examining patients with prostate cancer using an advanced type of scan called PSMA PET / CT, a diagnostic tool that highlights the presence of tumors in the body when injected into the body. patient with radioactive glucose, according to the Science Alert portal.
Radiation oncologist Wouter Vogel and oral and maxillofacial surgeon Matthijs Valstar of the Netherlands Cancer Institute (NKI) were studying patients with prostate cancer using this scanning scanner when they discovered that, deep inside the nasopharynx of those examined, two unexpected areas had illuminated.
Areas that “shouldn't be there”
The areas they discovered looked similar to the known major salivary glands, “but there, at the back of the nasopharynx, there should be no large salivary glands, since people have three sets of these organs, but they are not in that place.” explains Dr. Vogel.
As far as was known, the only salivary or mucosal glands in the nasopharynx are small, microscopic in scale. They are about a thousand glands distributed evenly throughout the mucosa, and the researchers were very surprised when they found these new areas, according to this research center, based in Amsterdam.
In collaboration with their colleagues at UMC Utrecht University Hospital (www.umcutrecht.nl/en), Vogel and Valstar found that all 100 prostate cancer patients who were scanned by PET / CT with PSMA had a set of these glands, according to the NKI.
“In these types of images the salivary glands are shown quite clearly,” explains Dr. Valstar, who points out that the two new areas that lit up had some characteristics typical of the salivary glands.
The NKI (www.nki.nl) findings were confirmed by studying tissue from two human bodies at the UMC University Medical Center in Amsterdam.
“We call them tubal glands, in reference to their anatomical location (at the back of the nasopharynx),” say Vogel and Valstar.
These doctors are dedicated to investigating the side effects that radiation can have in patients with head and neck cancer and, when they made the finding, they were scanning the salivary glands of patients with prostate cancer, with the aim of gathering information to be able to preserve these glands during radiotherapy treatments.
“Radiation therapy can damage the salivary glands, which can lead to complications. Patients can have problems eating, swallowing or speaking,” explains radiation therapist Vogel.
The researchers found that, as with known salivary glands, irradiation of these “new” glands also increases complications in irradiated patients, so they think that, in addition to being surprising, this finding could benefit patients. cancer patients.
Vogel believes it should be technically possible to avoid giving radiation to most patients at this newly discovered location, just as we tried to do so to try to preserve known glands.
“The knowledge of these new glands is helping us to understand a toxicity that until now was inexplicable and suffered by some patients who report a sensation of dryness in the back of the mouth, when all known salivary glands seem to function normally”, explains Dr. Vogel to Efe.
“This new information can also help us inform patients about the possible toxicity of radiation therapy and can be taken into account to make personalized decisions about treatment,” according to this radiation therapist.
Vogel notes that they do not plan to immediately change treatment for all patients, as they first need to get independent validation of their findings from another center, and then they need to confirm whether keeping these 'new' glands without irradiating actually helps patients. and in what cases.
“After completing these steps, the international guidelines may be updated with a new validated treatment strategy,” he says.