Case report: giant parotid sialolith presenting in a two‐year‐old boy ‐ an important differential diagnosis in paediatric facial pain

Abstract

Paediatric sialolithiasis is rare, with most sialoliths under 10 mm in their largest dimension and usually found in the submandibular gland. We present a case of a 25 mm parotid sialolith in a two-year-old boy. He presented to the emergency department with recurrent right-sided facial swelling and was admitted for management of suspected parotitis. An ultrasound completed the next day revealed massive dilatation of the right Stensen's duct throughout its length. After 24 h of intravenous coamoxiclav did not relieve symptoms, the patient was listed for examination under general anaesthesia. A 25 mm calculus was dissected from the right parotid duct alongside copious free-flowing pus, with follow-up showing normal healing. This case highlights the importance of not omitting this differential diagnosis in paediatric facial swelling, despite its rarity in children. InvestigationsThe ultrasound report showed a massive dilatation (approximately 7 mm) of the right Stensen's duct Oral Surgery 13 (2020) 135--138.