Giant Sialolith of the Submandibular Salivary Gland

Long-term rare giant sialolithiasis for 30 years: A case report and review of literature

BACKGROUND

Sialolithiasis is one of the most common salivary gland disorders, most commonly affecting the submandibular gland. Submandibular sialolithiasis can be treated using non-invasive conservative measures and invasive treatments. Treatment selection was based on the ductal system anatomy and the size and location of the stones. This study aimed to review the updates on sialolithiasis treatment and compare the different management strategies of the variables.

CASE SUMMARY

This report presents a case of a long-term, rare, and giant sialolithiasis within the submandibular gland parenchyma for 30 years in an older adult. Our patient presented with painless right submandibular swelling. Computed tomography revealed a calcified mass measuring 35 mm × 20 mm within the right submandibular gland. In this case, the infection and fibrosis of the affected gland and size of the stone did not provide us with other alternatives except for the excision of the involved gland. Thus, right submandibular sialoadenectomy was performed via the transcervical approach. After the surgery, the patient recovered without any complaints, side effects, or complications.

CONCLUSION

Tailored management is important for preserving gland function, maintaining low risk, and reducing patient discomfort.

Long-term rare giant sialolithiasis for 30 years: A case report and review of literature

BACKGROUND

Sialolithiasis is one of the most common salivary gland disorders, most commonly affecting the submandibular gland. Submandibular sialolithiasis can be treated using non-invasive conservative measures and invasive treatments. Treatment selection was based on the ductal system anatomy and the size and location of the stones. This study aimed to review the updates on sialolithiasis treatment and compare the different management strategies of the variables.

CASE SUMMARY

This report presents a case of a long-term, rare, and giant sialolithiasis within the submandibular gland parenchyma for 30 years in an older adult. Our patient presented with painless right submandibular swelling. Computed tomography revealed a calcified mass measuring 35 mm × 20 mm within the right submandibular gland. In this case, the infection and fibrosis of the affected gland and size of the stone did not provide us with other alternatives except for the excision of the involved gland. Thus, right submandibular sialoadenectomy was performed via the transcervical approach. After the surgery, the patient recovered without any complaints, side effects, or complications.

CONCLUSION

Tailored management is important for preserving gland function, maintaining low risk, and reducing patient discomfort.

[Narrative review of imaging studies of calcifications of the submandibular gland]

Sialolithiasis is one of the most common pathologies of the major salivary glands and occurs more frequently in the submandibular glands. Between 80 and 95% of sialoliths develop in the submandibular glands, between 5 and 20% in the parotid gland, and only 1% in the sublingual gland. Sialoliths form within the parenchyma and associated duct systems. In Wharton's duct (80-90%) and only 15% in the gland. Sialolithiasis is the cause of pain and inflammation of the salivary gland by obstructing the duct and preventing salivary secretion, before, during and after food.The objective of this article was to review the different diagnostic imaging methods used for the study of calcifications of the submandibular gland, based on different studies reported in contemporary scientific literature, in order to establish the correct diagnosis. A search of the literature was carried out in the main information sources including Medline (via PubMed), SEVIER, SCIELO, and LILACS, using the search terms with a date limitation of the last 5 years on average. The selected articles included information regarding the calcifications of the salivary glands. Imaging studies of salivary gland calcifications can be obtained with conventional radiographs, Sialography, Ultrasonography (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MR).

Giant sialoliths of Wharton duct: Report of two rare cases and review of literature

Sialolithiasis is a common disease of the major salivary glands, characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions. Sialoliths usually measure from 1 mm to <10 mm. They rarely measure more than 15 mm, and infrequently giant salivary gland calculi >15 mm have been reported in the literature. The submandibular gland and its duct appear to be the most susceptible sites for this disease. In this article, we report two unique cases, including a giant bilateral case, measuring 50 mm in length and 5 mm in width on the right side and one, 30 mm in length, and 5 mm in width on the left side; and another case, measuring 83 mm in length. The diagnostic and therapeutic approaches consisted of transocclusal radiography with the conservative transoral surgical technique in both cases. The follow-up showed the normal function of the relevant salivary glands. To the best of our knowledge and belief, similar cases have not been reported in the literature.