Hemangioma with Phleboliths, Misdiagnosed as Sialoliths in Submandibular Gland

ABSTRACT

Hemangiomas are relatively common benign lesions in head and neck, and are easily diagnosed when they present as cutaneous lesions. However, when a vascular lesion is located within the deeper tissues without a cutaneous component, it results in a large differential diagnosis and sometimes is misdiagnosed even using modern imaging studies. In certain instances, simple radiographic studies may be helpful in diagnosis. Hemangioma in the submandibular gland is extremely rare and when it has phleboliths within it, it is easily confused with calculis in the salivary gland. Recently we experienced one such case. The 63-years-old man complained of a painful bulging mass without cutaneous lesions in the right submandibular area, which had occurred in 2 or 3 times over a 2 year periods. Plain skull films revealed two radioopaque densities in submandibular area and ultrasonography revealed similar findings. Preoperatively he was thought to have sialoliths of a submandibular gland, but it was confirmed as a hemangioma with phleboliths after the operation.