GIANT SIALOLITHIASIS OF SUBMANDIBULAR GLAND- A RARE CASE REPORT AND LITERATURE REVIEW

OBJECTIVE- Sialoliths measuring more than 3.5 cms are called Giant sialoliths. They are extremely rare with only 18 cases published in literature. We report a giant sialolithiasis of left submandibular gland of size 4.7 x 2.1 cms and weighing 25 grams in a middle aged male patient. METHOD- Case report and review of medical literature. CASE REPORT- A middle aged male patient presented with complaints of swelling in right submandibular region for 5 months insidious in onset and gradually progressive. The swelling was associated with throbbing pain during meals. On examination a swelling of size 6 x 5 cms, ovoid shape noted in right submandibular region, Skin over the swelling was normal. The swelling was not warm, mild tenderness was present with nodular surface and hard in consistency. Swelling was bidigitally palpable. Orthopantomogram showed a radio-opaque stone of size 5 x 2.5 cm in submandibular gland. Submandibular gland excision was done. CONCLUSION- Giant sialolithiasis are rare finding in salivary gland pathology. Only about 18 cases were reported in medical literature. Transocclusal endoral radiograph and orthopantomogram are useful for radio-opaque stones, however radio-lucent stones are seen mainly on sialogram and ultrasonagram. Giant sialoliths are mostly associated with chronic sialadenitis and fibrosis of salivary gland and hence often requires complete excision of the gland.