Painless Giant Submandibular Gland Sialolith: A Case Report

Abstract

Sialolithiasis is one of the most common diseases involving the salivary glands. It is a condition that occurs due to an obstruction in a salivary gland or its duct due to a calculus. The formation of a salivary stone is believed to be secondary to the deposition of mineral salts around a nidus, which is frequently associated with a recurrent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. The size of the calculus varies from <1 mm to a few centimeters. The frequency of sialolithiasis is relatively common. It is estimated to affect 12 in 1000 of the adult population. However, the occurrence of giant sialoliths, >15 mm in any diameter, is rare. Here, we describe our experience with a case of giant submandibular sialolithiasis measuring 25 mm presenting as a painless submandibular mass. The patient underwent submandibular gland excision followed by a full recovery.

Sialolito de grandes proporções em glândula submandibular

“…O diagnóstico de sialolitíase é feito com base em sua apresentação clínica e exames de imagem que são utilizados para completar o diagnóstico. A radiografia oclusal de mandíbula é muito utilizada para visualização das pedras que se apresentam radiopacas em mais de 80% dos casos (Thong et al, 2021). Quando os sialólitos são radiolúcidos ou estão localizados dentro das glândulas salivares podem ser investigados utilizando a sialografia, mas este exame é doloroso durante a inserção do contraste e é contraindicado nos casos de alergia ao contraste ou infecção (Rzymska-Grala et al, 2010).…”

“…Os sialolitos, também chamados de cálculos, são estruturas calcificadas compostos por um núcleo mineralizado amorfo cercado por camadas de substâncias orgânicas e inorgânicas, que podem se formar no interior das glândulas salivares ou de seus ductos excretores causando a sialolitíase (Thong et al, 2021).…”

Sialolith of Unusual Size and Shape in the Anterior Segment of the Submandibular Duct

“…Sialolithiasis is a frequent salivary gland condition in which calcifications or calculi (sialoliths) form inside salivary glands or in their ductal system [ 1 ]. It is estimated to occur in 1.2% of the adult population with a slight male predominance [ 2 , 3 ]. Sialoliths are usually unilateral and localized within the duct more frequently than inside the gland [ 4 , 5 ].…”

“…Giant or unusually large sialoliths are referred to those whose dimension exceeds 1.5 cm [ 6 - 8 ]. Any salivary gland can develop sialoliths, with the most common being submandibular (80%-95%) followed by the parotid (5%-20%) glands [ 2 , 3 , 7 , 9 ]. The sublingual and minor salivary glands are rarely affected (1%-2%) [ 9 ].…”

Extremely Large Submandibular Sialolith Removal - A Case Report

“…Giant sialoliths are rare and classified as those measuring >15 mm in the greatest dimension. [ 2 ] Large calculi may perforate the floor of the mouth by ulcerating the duct or may result in a skin fistula by causing a suppurative infection. The most common symptoms of sialoliths are recurrent pain and swelling of the associated gland during meals.…”