Giant sialoliths of submandibular gland duct: Report of two cases with unusual shape
A 48-year-old male patient reported with the complaint of intermittent, dull aching pain, and swelling in left submandibular area for the last 3 months. These symptoms occurred 6-7 times per week, during meals. The patient noted that sour foods were more likely to produce symptoms than were other types of food.\nOn examination, he was found to have a firm mass of approximately 3 cm × 1 cm on the floor of his mouth, along the course of the left submandibular duct. Salivary flow was negligible from left submandibular duct orifice. The left submandibular gland was tender and enlarged measuring approximately 3 cm × 2 cm. An occlusal radiograph showed a large radiopaque calculus in the floor of mouth. Left submandibular sialogram showed obstruction of the left submandibular duct by a radiopaque calculus approximately 3 cm proximal to the orifice of the duct []. The calculus was removed via intraoral approach under local anesthesia [] and transposition of ductal opening was done. The shape of calculus was unusually similar to the canine tooth []. The thicker and thinner portions of calculus looks like the crown and root of canine tooth. The length and width was measured to be 28 mm and 11 mm, respectively, which are close to the dimensions of canine tooth. In subsequent clinical follow-up of 2 years, the complete remission of the symptoms, the effectiveness of the salivary drainage, and the normal functioning of the submandibular gland were observed.