A 45-yesr-old woman who complained of a swelling and induration of the right submandibular region visited our hospital on August 12, 1990. Although symptoms were present for 10 years, she had not previously sought medical attention. X-ray examination revealed a calculus in the right submandibular salivary gland duct. The calculus was removed under local anesthesia on her first visit.
The postoperative course was uneventful for about 10 months. She noted a recurrence of submandibular swelling in the middle of June 1991. The swelling persisted and its size did not change. It was a nontender, fluctuant mass. Although X-ray examination did not show any signs of a calculus, an echogram revealed a cyst in the submandibular region.
Surgical exploration revealed a thin-walled cystic mass adhering to the posterior portion of the atrophic submandibular gland. The dimensions of the mass and the cyst were 68×55×40mm and 45×40×38mm, respectively. The cyst contained mucous liquid with histiocytes, erythrocytes and lymphocytes.
Microscopic findings: The cyst was surrounded by fibrous and hemorrhagic granulation tissue with many foamy macrophages. A large duct communicating with the cyst was present.
