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Venous malformation phleboliths mimicking submandibular sialadenitis in children
Konstantina Chrysouli1, Sotirios Karamagkiolas2
1Department of Otorhinolaryngology, Penteli Children Hospital, Athens, Greece konstantinachr@hotmail.com.
Insights
A rare venous vascular malformation mimicked sialadenitis in a pediatric patient. Careful review of imaging revealed phleboliths, leading to correct diagnosis and surgical resection of the venous malformation.
Area of Science:
- Vascular Surgery
- Pediatric Radiology
- Otolaryngology
Background:
- Venous vascular malformations (VVMs) are rare congenital anomalies.
- Phleboliths, calcified venous thrombi, are characteristic of VVMs.
- Sialolithiasis, salivary stones, can cause sialadenitis, particularly in adults.
Observation:
- A pediatric patient presented with a left submandibular mass and symptoms suggestive of sialadenitis.
- Initial imaging suggested sialolithiasis as the cause.
- The mass was identified as a venous vascular malformation with phleboliths.
Findings:
- Phleboliths in VVMs can be mistaken for sialoliths on imaging.
- Sialoliths are exceptionally rare in pediatric patients.
- The patient's submandibular mass was definitively diagnosed as a venous malformation.
Implications:
- Misdiagnosis of VVMs as sialadenitis due to phlebolith mimicry can occur.
- Early and accurate diagnosis is crucial for appropriate management.
- Complete surgical resection is the recommended treatment for symptomatic VVMs.
Abstract:
To report one paediatric patient who presented with a rare venous vascular malformation as a mass in the left submandibular region with a clinical picture compatible with sialadenitis. Phleboliths are a specific feature of venous malformations due to venous stasis and may mimic sialoliths on various imaging modalities. Thus venous malformations are often misdiagnosed as sialadenitis due to sialolithiasis. Sialoliths are extremely rare in paediatric patients. In an early adolescent presenting with a submandibular mass and suspected sialadenitis arising from sialoliths, a detailed history, clinical examination and careful review of the radiological findings will allow the diagnosis of venous vascular malformation and provide the complete surgical resection. Our patient was initially referred with a presumed diagnosis of submandibular sialadenitis, and instead a venous malformation with phlebolith was diagnosed.
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