0:00

This was a patient who had discomfort in the left

0:03

side of the floor of the mouth and was being

0:06

evaluated for a potential cyst in the floor

0:09

of the mouth. When we did the MRI scan,

0:11

we were a little bit confused because we saw this

0:13

big black thing that was associated

0:16

with the submandibular gland.

0:18

Now this is a big black thing in

0:19

the gland rather than the duct.

0:22

If we look on the T2-weighted scan,

0:25

we see that it is entirely within the gland.

0:28

But within the gland, you see focal ductal dilatation

0:33

of the glandular ductal system.

0:35

So this was not a Wharton's duct,

0:37

a submandibular ductal calcification.

0:39

This was a glandular calcification that

0:41

was obstructing the ductal system,

0:43

compared these ducts to the normal caliber

0:46

of the right-sided duct.

0:48

Not only that,

0:49

but on the right side you see a nice example of

0:51

Wharton's duct crossing into the sublingual space.

0:55

Here we have the mass that is still contained

0:58

within the submandibular tissue.

1:01

On post-gadolinium-enhanced scan, we notice that there

1:04

is this non-enhancing lesion within the gland.

1:08

The gland itself is a little bit enlarged

1:10

compared to the right side.

1:12

Nothing going on in the floor of the mouth.

1:14

This was a big rock.

1:16

This was a big stone in the gland.

1:18

And there is a difference between the stones in

1:21

the gland versus the stones in the ducts.

1:23

The stones in the ducts tend to be obstructive and

1:26

lead to more symptoms than those that are

1:28

just located in the gland itself.

Submandibular Saialithiasis on MRI

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