Curious case of submandibular swelling

Area of Science:

• Head and Neck Surgery
• Oral and Maxillofacial Surgery
• Pathology

Background:

• A 35-year-old woman presented with a progressively increasing, painless neck swelling over 8 months.
• The swelling was located in the left submandibular region, measuring 3x2 cm, firm, mobile, and non-tender.

Observation:

• Ultrasonography revealed a bilobed, heteroechoic lesion with internal vascularity and macrocalcifications.
• Surgical excision demonstrated the lesion was distinct from the submandibular gland and vascular structures.

Findings:

• The lesion exhibited sinus tract formation extending around the submandibular gland.
• The sinus tract reached the root of a decayed left lower second molar tooth.

Implications:

• This case highlights a rare presentation of a submandibular region swelling with an odontogenic sinus tract.
• Accurate diagnosis and surgical planning are crucial for complete removal and management of such complex cases.