{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:27:21Z","timestamp":1793406441734,"version":"4.5.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>The sialolith is a calcified mass resulting from the crystallization of salivary solute made up of calcium phosphates such as hydroxyapatite and octacalcium phosphate with yellowish discoloration and different shapes and sizes in the range of 1\u20132 cm normally, while occurrence of large sialolithiasis is rare, with literature showing sizes from 3.5 cm to 7 cm noted till date. About 80% of sialolithiasis occurs in submandibular glands and 20% in parotid gland and &lt;1% is seen with sublingual gland. For small sialolithiasis and for superficially located sialolithiasis at ductal regions, conservative management is performed. However, for larger sialolithiasis, surgical management is mandatory which includes various methods such as transoral sialolithotomy, laser techniques, and sialendoscopy-assisted techniques. Complete excision of salivary gland is recommended for large, multiple, and recurrent cases of sialolith. In the present study, we have presented the unusual-sized rare case of salivary gland stone found in submandibular salivary gland and not in ductal region which was mimicking an osteoma on OPG and discuss the review of literature. This giant sialolith was managed with extraoral submandibular approach followed by TOTO removal of the sialolith which measured about 38 g in weight and 28 mm in size. Present sialolith was the rarest till date with heavyweight of about 38 g and 28 mm in size. Even the conventional method is sufficient to excise the sialolith when other modalities are not available. Chronic sialolith is common in old male patients and shows positive correlation with chronic smoking.<\/jats:p>","DOI":"10.4103\/njms.njms_475_21","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T06:01:37Z","timestamp":1756620097000},"page":"388-392","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Giant sialolithiasis involving submandibular gland mimicking osteoma of the mandible \u2013 A rare clinicopathological case report and a review of literature"],"prefix":"10.4103","volume":"16","author":[{"given":"Abhay","family":"Datarkar","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavana","family":"Valvi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj","family":"Parmar","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surendra","family":"Daware","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1001\/archotol.129.9.951","article-title":"Sialolithiasis management: The state of the art","volume":"129","author":"Marchal","year":"2003","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00795-005-0290-7","article-title":"Possible etiology of calculi formation in salivary glands: Biophysical analysis of calculus","volume":"38","author":"Mimura","year":"2005","journal-title":"Med Mol Morphol"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/0003-9969(81)90173-4","article-title":"Lipids associated with mineralization of human submandibular gland sialoliths","volume":"26","author":"Boskey","year":"1981","journal-title":"Arch Oral Biol"},{"key":"R4-20260420","first-page":"38","article-title":"Clinico-statistical study on sialolithiasis","volume":"14","author":"Antognini","year":"1971","journal-title":"Mondo Odontostomatologico"},{"key":"R5-20260420","first-page":"682","article-title":"Clinical and statistical considerations on 78 cases of salivary calculi","volume":"18","author":"Defabianis","year":"1969","journal-title":"Minerva Stomatol"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1001\/jama.1962.03050390017005","article-title":"Salivary gland calculi. Pain, swelling associated with eating","volume":"181","author":"Levy","year":"1962","journal-title":"JAMA"},{"key":"R7-20260420","first-page":"571","article-title":"Considering clinicostatistic study on sialolithiasis","volume":"35","author":"Mela","year":"1986","journal-title":"Minerva Stomatol"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.joms.2005.10.053","article-title":"Giant sialolith: Case report and review of the literature","volume":"65","author":"Ledesma-Montes","year":"2007","journal-title":"J Oral Maxillofac Surg"},{"key":"R10-20260420","first-page":"710","article-title":"Large calculus of the submandibular gland: Report of case","volume":"31","author":"Brusati","year":"1973","journal-title":"J Oral Surg"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S1079-2104(99)70218-0","article-title":"Multiple sialoliths and a sialolith of unusual size in the submandibular duct: A case report","volume":"87","author":"Leung","year":"1999","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1177\/00220345810600080101","article-title":"Salivary calculi: Ultrastructural morphology and bacterial etiology","volume":"60","author":"Lustmann","year":"1981","journal-title":"J Dent Res"},{"key":"R13-20260420","first-page":"997","article-title":"Disease of salivary glands","author":"Rauch","year":"1970","journal-title":"Thoma's Oral Pathology"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0901-5027(05)80127-4","article-title":"Sialolithiasis. A survey on 245 patients and a review of the literature","volume":"19","author":"Lustmann","year":"1990","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/S0099-6963(31)80100-0","article-title":"Chronic inflammation of the salivary glands with or without calculi","volume":"17","author":"New","year":"1931","journal-title":"Int J Orthod Oral Surg Radiogr"},{"key":"R16-20260420","first-page":"865","article-title":"Disease of salivary glands","author":"Rauch","year":"1971","journal-title":"Thoma's Oral Pathology"},{"key":"R17-20260420","first-page":"1","article-title":"Submandibular sialolithiasis: A brief overview and report of two cases","volume":"5","author":"Gulati","year":"2018","journal-title":"Modern Res Dent"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/0030-4220(88)90387-8","article-title":"Diagnostic imaging in salivary gland disease","volume":"66","author":"van den Akker","year":"1988","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"R20-20260420","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/00020840-200306000-00008","article-title":"Salivary stones: Innovative techniques in diagnosis and treatment","volume":"11","author":"Katz","year":"2003","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"R21-20260420","first-page":"4936","article-title":"Intra-tumoral salivary gland calcificaction: A systematic review","volume":"61","author":"Farid","year":"2016","journal-title":"Egypt Dent J"},{"key":"R22-20260420","first-page":"4315","article-title":"Calculi of the salivary glands and ducts","volume":"43","author":"Harrison","year":"1926","journal-title":"Surg Gynecol Obstet"},{"key":"R23-20260420","first-page":"41","article-title":"Clinical-statistical considerations on 102 cases of salivary calculi","volume":"27","author":"Pizzirani","year":"1985","journal-title":"Mondo Odontostomatol"},{"key":"R25-20260420","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1159\/000274855","article-title":"Clinical contribution to the diagnosis and therapy of Diseases of the submaxillary salivary glands","volume":"30","author":"Eggenschwiler","year":"1968","journal-title":"ORL"},{"key":"R26-20260420","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.ijom.2016.02.007","article-title":"Association of serum electrolytes and smoking with salivary gland stone formation","volume":"45","author":"Yiu","year":"2016","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R27-20260420","first-page":"110","article-title":"Effect of long-term smoking on whole-mouth salivary flow rate and oral health","volume":"4","author":"Rad","year":"2010","journal-title":"J Dent Res Dent Clin Dent Prospects"},{"key":"R28-20260420","doi-asserted-by":"crossref","first-page":"E59","DOI":"10.3390\/antibiotics9020059","article-title":"Bacterial biofilm and its role in the pathogenesis of disease","volume":"9","author":"Vestby","year":"2020","journal-title":"Antibiotics (Basel)"},{"key":"R29-20260420","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.archoralbio.2009.11.006","article-title":"Increased calcium and decreased magnesium and citrate concentrations of submandibular\/sublingual saliva in sialolithiasis","volume":"55","author":"Su","year":"2010","journal-title":"Arch Oral Biol"},{"key":"R30-20260420","first-page":"420","article-title":"Large calculus in submaxillary gland","volume":"48","author":"Meyers","year":"1942","journal-title":"Dent Digest"},{"key":"R31-20260420","first-page":"129","article-title":"Calculus of unusual size in Wharton\u2019s duct","volume":"79","author":"Mustard","year":"1945","journal-title":"Br Dent J"},{"key":"R32-20260420","first-page":"65","article-title":"A sialolith within the submaxillary duct and gland: Report of case","volume":"14","author":"Allen","year":"1956","journal-title":"J Oral Surg (Chic)"},{"key":"R33-20260420","first-page":"90","article-title":"Some cases of salivary calculi of particular interest","volume":"14","author":"Cavina","year":"1965","journal-title":"Minerva stomatologica"},{"key":"R34-20260420","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/0030-4220(68)90033-9","article-title":"Large calcified mass in the submaxillary gland","volume":"25","author":"Hoggins","year":"1968","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"R35-20260420","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/0030-4220(69)90340-5","article-title":"Oddities of salivary calculi","volume":"28","author":"Rust","year":"1969","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"R36-20260420","first-page":"142","article-title":"Submandibular gland sialolith of unusual size and shape","volume":"33","author":"Raksin","year":"1975","journal-title":"J Oral Surg"},{"key":"R37-20260420","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0300-9785(82)80024-0","article-title":"The gigantiform salivary calculus","volume":"11","author":"Isacsson","year":"1982","journal-title":"Int J Oral Surg"},{"key":"R38-20260420","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1038\/sj.bdj.4806773","article-title":"An extraordinarily large asymptomatic submandibular salivary calculus","volume":"166","author":"Tinsley","year":"1989","journal-title":"Br Dent J"},{"key":"R39-20260420","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/0030-4220(90)90133-D","article-title":"Megalith","volume":"70","author":"Hubar","year":"1990","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"R40-20260420","first-page":"123","article-title":"A submandibular sialolith of unusual size","volume":"20","author":"Akin","year":"1991","journal-title":"J Otolaryngol"},{"key":"R41-20260420","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1017\/S0022215100131263","article-title":"Salivary megalith with a sialo-cutaneous and a sialo-oral fistula: A case report","volume":"109","author":"Paul","year":"1995","journal-title":"J Laryngol Otol"},{"key":"R42-20260420","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1067\/moe.2002.123863","article-title":"Giant salivary gland calculi: Diagnostic imaging and surgical management","volume":"94","author":"Bodner","year":"2002","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"}],"container-title":["National Journal of Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/njms.njms_475_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:57:18Z","timestamp":1786647438000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/njms.njms_475_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":39,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/njms.njms_475_21","relation":{},"ISSN":["0975-5950","2229-3418"],"issn-type":[{"value":"0975-5950","type":"print"},{"value":"2229-3418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2021-09-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}