Sialolithiasis is one of the most common salivary gland diseases. Most salivary calculi occur in Wharton’s duct. Salivary calculi can cause salivary duct obstruction, resulting in acute or chronic salivary gland swelling. However, some kinds of salivary gland tumors and hemangiomas are known to exhibit intratumoral calcification. Herein, we present a case of sialolithiasis of the submandibular gland that mimicked a salivary gland tumor accompanied by multiple calculi. A 56-year-old male patient was referred to our hospital because of diffuse swelling of the right submandibular region accompanied by pain and dysphagia. Panoramic radiography revealed multiple radiopaque structures in the right submandibular region. Plain computed tomography （CT） and magnetic resonance imaging （MRI） were performed to confirm the locations of salivary calculi and the extent of the surrounding soft-tissue inflammation. The CT and MR images suggested the presence of a heterogenous space-occupying lesion, containing multiple calcifications, in the oral floor. Therefore, we suspected a malignant salivary gland tumor accompanied by multiple calcifications and inflammation of the surrounding soft tissue. A second CT examination was performed for surgical planning after antiphlogistic treatment. The CT images showed that the lesion had shrunk, and the calcifications had moved along Wharton’s duct. These findings suggested a diagnosis of sialolithiasis rather than a tumorous lesion. The enucleation of both the sublingual and submandibular glands was performed, and a final diagnosis of sialolithiasis and sialadenitis of both glands was made. A follow-up examination showed no recurrence after 12 months.
