Giant sialolith in the left submandibular gland: a case report

Paulo Sergio Pina; Antônio Roberto Garcia Júnior; Catarina Melquiades Velane; Isabelle Elise Squillace Mendes; Celso Augusto Lemos; Camilla Vieira Esteves

doi:10.5327/2525-5711.460

Authors

Paulo Sergio Pina Universidade de São Paulo, School of Dentistry, Department of Oral Patology – São Paulo (SP), Brazil. https://orcid.org/0000-0001-8205-9935
Antônio Roberto Garcia Júnior Universidade de São Paulo, School of Dentistry, Department of Stomatology – São Paulo (SP), Brazil. https://orcid.org/0000-0003-2400-8982
Catarina Melquiades Velane Universidade de São Paulo, School of Dentistry, Department of Stomatology – São Paulo (SP), Brazil. https://orcid.org/0000-0001-8205-9935
Isabelle Elise Squillace Mendes Universidade de São Paulo, School of Dentistry, Department of Stomatology – São Paulo (SP), Brazil. https://orcid.org/0009-0002-3035-8313
Celso Augusto Lemos Universidade de São Paulo, School of Dentistry, Department of Stomatology – São Paulo (SP), Brazil. https://orcid.org/0000-0002-3372-6719
Camilla Vieira Esteves Universidade de São Paulo, School of Dentistry, Department of Stomatology – São Paulo (SP), Brazil. https://orcid.org/0000-0001-9673-2756

DOI:

https://doi.org/10.5327/2525-5711.460

Keywords:

Salivary gland calculi, Submandibular gland, Salivary calculi, Surgery, oral, Case reports

Abstract

Sialolithiasis is the most common cause of salivary gland obstruction, predominantly affecting the submandibular gland. Giant sialoliths are rare and may pose diagnostic challenges, particularly when symptoms are atypical. This case report describes a 40-year-old female who presented with a two-month history of a foreign body sensation in the floor of the mouth, associated with intermittent purulent discharge. Clinical examination and cone-beam computed tomography revealed a large radiopaque mass measuring 23 × 10 × 6 mm in the left submandibular gland region. The lesion was successfully managed through intraoral surgical removal, followed by uneventful healing. Histopathological examination confirmed the diagnosis of sialolithiasis, demonstrating ductal alterations and chronic inflammatory changes consistent with long-standing obstruction. Despite the relatively short duration of symptoms, the size of the calculus suggests prolonged asymptomatic growth. This report highlights the importance of recognizing atypical subjective complaints as potential indicators of salivary duct obstruction and supports conservative, gland-preserving surgical management for giant submandibular sialoliths to achieve favorable functional outcomes.

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