Multiple Faces of Cervical Lesions in Children

Area of Science:

• Otolaryngology
• Pediatric Radiology
• Oral and Maxillofacial Surgery

Background:

• Pediatric sialolithiasis is an uncommon condition characterized by salivary gland swelling, pain, and inflammation.
• Submandibular gland involvement can be misdiagnosed as lymphadenopathy in children, complicating initial assessment.

Observation:

• A 16-year-old female presented with symptoms suggestive of submandibular gland pathology.
• Initial clinical and ultrasound evaluations incorrectly identified the lesion as adenopathy.
• Computed tomography (CT) imaging was essential in establishing the correct diagnosis of sialolithiasis.

Findings:

• A 10-mm calculus was successfully removed via sialolithotomy.
• Postoperative management included broad-spectrum antibiotics, nonsteroidal anti-inflammatory drugs, and sialagogue therapy.
• The patient experienced a favorable recovery following the surgical intervention.

Implications:

• Pediatric sialolithiasis requires consideration in the differential diagnosis of firm, immobile submandibular masses.
• Advanced imaging like CT plays a vital role in differentiating sialolithiasis from more common pediatric conditions such as adenopathy.
• Prompt diagnosis and surgical management of pediatric sialolithiasis lead to positive patient outcomes.