SUMMARYA case of submandibular gland pleomorphic adenoma in association with duct lithiasis is presented. These are probably incidental findings, but it is possible that they may be causally related. associated with duct lithiasis. Such a case is presented here and the possible aetiological factors are discussed.
EXAMINATION of the recent
CASE REPORTM. M., a Bantu female aged 43 years, was admitted to the General Hospital, Johannesburg, in February, 1971, with a 1-year history of a painful tender swelling in the area of the left submandibular gland. The mass had slowly been increasing in size and was more tender and painful during mastication. There had been a recent weight-loss of about 4 kg. Systematic and past history revealed nothing of significance.On examination the patient was found to be a fit middle-aged female with a discrete oval swelling measuring 2.5 x 3 cm. in the position of the left submandibular gland. The surface of the mass was slightly lobulated and the gland was mildly tender. No cervical lymphadenopathy was detected. Palpation of the floor of the mouth revealed a 1-cm. calculus in the posterior part of the left submandibular duct. This was confirmed radiographically (Fig. I). The lungs were clinically and radiologically normal.A diagnosis of sialitis secondary to duct lithiasis was made. Under general anaesthesia and endotracheal intubation a longitudinar mucosal incision was made over the calculus, which was removed. The wound was not sutured. A mild cellulitis at the operative site was treated with antibiotics and it settled after 3 days. The gland remained tender and swollen for 7 days and then diminished slightly in size and became non-tender. The patient was discharged on the fifteenth postoperative day. Over the next 9 weeks the gland remained the same size and without tenderness.The patient was readmitted in May, 1971, for complete removal of the left submandibular gland. This was