The Silent Giant: A Case of Giant Submandibular Sialolithiasis with Minimal Symptoms

Background: Sialolithiasis is a common condition affecting the salivary glands, typically presenting with pain and swelling, typically during meals. giant sialoliths (>15mm) are rare and usually symptomatic, often requiring surgical intervention.

Case Presentation: We report the case of a patient who remained completely asymptomatic despite harbouring a 35 x 20mm ovoidal sialolith in the submandibular gland. the patient presented to the emergency department with sudden onset of submandibular pain during the night prior to admission. Clinical examination and imaging confirmed the presence of a large, well-defined, spherical calculus. Remarkably, the stone was manually removed by an otolaryngologist without the need of surgical intervention or anaesthesia.

Discussion: This case is notable for the unusually large size and spherical shape of the sialolith, the absence of prior symptoms, and the successful non-surgical removal. such presentations are extremely rare and highlight the importance of considering sialolithiasis even in atypical clinical scenarios.

Conclusion: This case contributes to the limited literature on asymptomatic giant sialoliths and supports the feasibility of non-invasive management in select cases.