Report of a Giant Sialolith of Remarkable Size in Submandibular Duct

Sialolith known as salivary calculi or salivary stone is a calcified organic mass that obstructs salivary duct and may occur in main or accessory glands or ducts. Most of sialoliths (80-90%) happen in submandibular gland and size of the sialoliths is usually 5-10 mm. The sialolith is considered as an unusual size in case it is larger than 10-15 mm. The ones with the size of > 15 mm in any dimension are regarded as giants and are rare. The aim of this study was to report a giant sialolith presenting with some clinical symptoms. A 30-year old male patient presented to the oral and maxillofacial diseases department of outpatient clinic, Mashhad Faculty of dentistry with a history of submandibular swelling and pain in the left. In clinical examination, an exophytic lesion (nodular-like) was observed in the lingual area of lower incisors. The lesion measured 34×18 mm and extended from distal left lower incisor to the midbuccal of left lower second premolar. The lesion texture was hard with a smooth mucosal surface. Cone beam computed tomography revealed a large radiopaque mass in the floor of mouth. The sialolith was surgically removed. Infection of the submandibular salivary gland might be due to stasis of salivary flow associated with stone formation in saliva gland or duct. In order to rule out the diagnosis of sialolith, the dentist should use bimanual palpation from the posterior area of salivary duct to the anterior part. Proper diagnosisand evaluation result in suitable treatment.