Giant sialolith in submandibular gland with radiological findings: A case report

Year 2020, Volume: 3 Issue: 1, 20 - 25, 26.02.2020

Sedef Ayşe Taşyapan , Ahmet Faruk Ertürk İlknur Özcan

Abstract

A sialolith is defined as one or more calcific foci in oval or round form within a parenchyma or duct of a salivary gland. It is most commonly seen in the submandibular salivary gland and in the 30-60 age range. A 46-year-old male patient was admitted to the Department of Oral and Maxillofacial Radiology of Istanbul University Faculty of Dentistry for dental treatment. A panoramic radiography incidentally showed a radiopaque formation in the right mandible angulus. No symptoms were detected in the clinically relevant region. A cone beam computed tomography showed a mixed, hyperdense focus in the lingual area in the right angulus region and a sialolith was detected. On ultrasonography, a sialolith was found in submandibular salivary gland duct. Due to the absence of any symptoms, regular followup was provided. The determination of localization and size of the sialolith with clinical and radiographic findings are important in treatment planning. In this case report, we aimed to present the radiological findings of an asymptomatic case of a large sialolith.

Keywords

Sialolith, cone-beam computed tomography, ultrasonography

Radyolojik bulgularla submandibular bezde dev siyalolit: Olgu sunumu

Abstract

Siyalolit, bir tükürük bezi parankimi veya kanalı içerisinde, bir veya daha fazla sayıda, oval ya da yuvarlak formdaki kalsifik odak olarak tanımlanmaktadır. En sık submandibular tükürük bezinde ve 30-60 yaş aralığında görülmektedir. 46 yaşında erkek hasta dental tedavileri için İstanbul Üniversitesi Diş Hekimiği Fakültesi Ağız, Diş ve Çene Radyolojisi Kliniği’ne başvurmuştur. Panoramik radyografisinde rastlantısal olarak sağ mandibula angulus bölgesinde radyoopak bir oluşum görülmüştür. Klinik olarak ilgili bölgede herhangi bir semptom saptanamamıştır. Konik ışınlı bilgisayarlı tomografi incelemesinde sağ angulus bölgesinde, lingual alanda, iç yapısı mikst, hiperdens odak izlenmiş olup siyalolit olduğu tespit edilmiştir. Ultrasonografide ise submandibular tükürük bezi kanalı içerisinde olduğu belirlenmiştir. Herhangi bir semptom bulunmaması nedeniyle hastanın düazenli takibi sağlanmıştır. Klinik ve radyografik bulgular ile siyalolitin lokalizasyon ve ebatlarının belirlenmesi tedavi planlamasında önemlidir. Bu vaka sunumunda asemptomatik büyük boyutlu bir siyalolit olgusunun radyolojik bulgularını sunmak amaçlanmıştır.

Keywords

Siyalolit, konik ışınlı bilgisayarlı tomografi, ultrasonografi

References

• 1. Haas OL. Jr. et al. Sialolith removal in the submandibular region using surgical diode laser: report of two cases and literature review. Oral Maxillofac Surg, 2018;22(1): 105-111.
• 2. Takeda Y. et al. Sialolith of the submandibular gland with bone formation. Pathol Int, 2003;53(5): 309-312.
• 3. Biddle RJ., Arora S. Giant Sialolith of the Submandibular Salivary Gland. Radiol Case Rep, 2008;3(2): 101.
• 4. Rodrigues GHC. et al. Giant submandibular sialolith conservatively treated. Autops Case Rep, 2017;7(1): 9-11.
• 5. Arunkumar KV, Garg N, Kumar V. Oversized submandibular gland sialolith: a report of two cases. J Maxillofac Oral Surg, 2015;14(1): 116119.
• 6. Arslan S. et al. Giant sialolith of submandibular gland: report of a casedagger. J Surg Case Rep, 2015;2015(4).
• 7. Purcell YM. er al. The Diagnostic Accuracy of Contrast-Enhanced CT of the Neck for the Investigation of Sialolithiasis. AJNR Am J Neuroradiol, 2017;38: 2161-2166.
• 8. Iwai T. et al. Giant Sialolith of the Submandibular Gland. J Clin Diagn Res, 2017;11(8): ZJ03-ZJ04.
• 9. Ledesma-Montes C. et al. Scanning electron micrographic features of a giant submandibular sialolith. Ultrastruct Pathol, 2007;31(6): 385391.
• 10. Van Der Meij EH, Karagozoglu KH, De Visscher JGAM. The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy. International Journal Of Oral And Maxillofacial Surgery, 2018;47.2: 223227.
• 11. Thomas W. Walsh Douglas, Jennifer E. Rassekh, Christopher H. Accuracy of ultrasonography and computed tomography in the evaluation of patients undergoing sialendoscopy for sialolithiasis. Otolaryngology–Head and Neck Surgery, 2017;156.5: 834-839.
• 12. Jung JH. et al. A large sialolith on the parenchyma of the submandibular gland: A case report. Exp Ther Med, 2014;8(2): 525-526.
• 13. de Santana Santos T. et al. Intraoral approach for removal of large sialolith in submandibular gland. J Craniofac Surg, 2012;23(6):1845-1847.
• 14. Franco Aç, et al. Massive Submandibular Sialolith: Complete Radiographic Registration and Biochemical Analysis through X-Ray Diffraction. Case Rep Surg, 2014;2014: 659270.