Phleboliths, not Sialoliths: a submandibular gland venous malformation: case report and literature review

Abstract

Although venous malformations occurring in the submandibular gland are extremely rare, most have been diagnosed as "hemangiomas". Based on the literature review very few cases of submandibular gland venous malformation were reported for the last 55 years. We provide one of this rare cases; A 62-year-old female patient presented with swelling in the left submandibular area for 6 months with no complaints of xerostomia nor suppuration from the salivary ducts. Ultrasound Sonography test of the neck and CT scan revealed an heterogenous lesion in left submandibular area with multiple calcifications. The mass was surgically excised, the histopathological examination reported a submandibular gland venous malformation with phleboliths. Low-flow vascular malformations of the head and neck region can develop phleboliths that may be mistaken for sialoliths given the similar calcified nature and location specially in salivary gland area. Appropriate history, clinical examination and investigation leads to the correct diagnosis and treatment.