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Article: Volume 47 Number 1 Page 71 - January 2020

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  Dental Update 474: 71-74

Oral Pathology:  A Sialolith and a Megalith: a Report of Two Cases

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Abstract: Sialolithiasis is considered as one of the most frequently encountered diseases of the salivary glands. The most susceptible site is the submandibular gland and its duct. However, megaliths have been sparsely reported in the literature. This article portrays management of a sialolith and a megalith in a 26-year-old and a 59-year-old male patient, respectively. The sialolith in the first case case was 4 mm long, whereas the second case demonstrated a megalith measuring 46 mm at its greatest size. Follow-up revealed normal functioning and a painless gland in the first case, while the second case showed no eventful complications. It is interesting to know that both patients remained relatively pain-free, despite having such longstanding sialolith/megaliths. After removal of the small sialolith, the gland regained its normal functioning swiftly, whereas in the case of the megalith, the gland removal was mandatory because such a longstanding megalith led to irreversible functional injury to the gland.

Clinical relevance: A giant sialolith can be easily misdiagnosed as a submandibular infection or neoplasm, especially when the patient presents with a longstanding pain-free swelling. Hence, early and appropriate referral and investigation is necessary for early diagnosis and treatment.

Author notes: Jawaad Ahmed Asif, BDS, MOMS, FRACDS, Senior Lecturer, Oral and Maxillofacial Surgery Unit, Paras Ahmad, BDS, MSc, Postgraduate Student, Oral Medicine Unit, Tahir Yusuf Noorani, DDS, MResDent, FRACDS, Senior Lecturer, Conservative Dentistry Unit (, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.

Objective: To report two varied presentations of sialolithiasis and demonstrate the importance of early diagnosis and appropriate referral to prevent irreversible damage to the salivary gland.

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