Asymptomatic submandibular giant calculus left for 24 years: A case report

Abstract

Sialolithiasis develops from salivary gland calculi and leads to salivary gland obstruction and recurrent painful swelling of the involved gland. A 54-year-old Japanese man had experienced right submandibular swelling since 1995, but he left it untouched because there were no severe symptoms. Eventually, he noticed an increase in swelling and pain, and thus he was referred to our clinic in October 2018. Computed tomography revealed hard tissue of about 30 × 20 mm located in the gland body. The patient underwent surgical extraction of the submandibular salivary gland under general anesthesia in December 2018. Energy dispersive x-ray fluorescence analysis revealed that the main components of the sialolithiasis were Ca: 78.6% and P: 21%. Histological analysis showed atrophy and fibrosis of the submandibular salivary gland. In this report, we present this case of an asymptomatic submandibular giant calculus left untreated for 24 years. *Correspondence to: Tsuyoshi Shimo, Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, 1757 Ishikari-Tobetsu, Hokkaido 061-0293, Japan, E-mail: shimotsu@hoku-iryo-u.ac.jp