Giant Sialolithiasis in Submandibular Gland Growing over Extended Period: A Case Report

Sialolithiasis is a common disease of the salivary glands. This report describes a rare case of a submandibular gland sialolithiasis that grew over an extended period. The patient was a 72-year-old woman who presented with a mass in the right submandibular gland that had remained untreated for approximately 34 years. She had noticed the mass from the beginning, but had ignored it as it had caused no pain. She was eventually referred to our hospital, however, because panoramic X-ray images taken at another facility showed that it had grown over the previous 10 years. Extraoral findings at our clinic revealed a hen egg-sized, elastic, hard mass in the right submandibular region, strongly suggesting intraglandular sialolithiasis of the right submandibular gland. Extraction of the right submandibular gland was performed under general anesthesia. The size of the sialolith inside the submandibular gland was 42×22×15 mm, with a visually rough and yellowish-white surface. Histopathological findings showed a lamellar structure with basophilically stained bacteria in the hard material at the core, a finding typical of sialoliths. Therefore, the diagnosis was intraglandular sialolithiasis of the right submandibular gland. This report describes a case of a rare giant sialolith located within the right submandibular gland.