Endocrine Abstracts

Introduction: Primary hyperparathyroidism is associated with lithiasis, but this has been universally considered to refer to kidney lithiasis. Sialolithiasis as a comorbidity or result of primary hyperparathyroidism is uncommon. We report a rare case of submandibular lithiasis in a child and discuss the etiological assessment of this condition.

Materials and Methods: We report a rare case of submandibular lithiasis in a child revealing primary hyperparathyroidism.

Results: A 13-year-old child with no previous history was referred for episodes of right painful submandibular swelling evolving for 1 month. Physical examination revealed a firm and mobile right submandibular swelling measuring 3 cm. Upon intraoral examination, a 5 mm hard mass was felt over the right floor of the mouth area. A neck ultrasonography showed a hypoechoic enlarged submandibular gland associated with a 5 mm intracanal stone causing dilatation of the submandibular duct associated with an hyperplasia of the inferior right parathyroid gland measuring 1.5 cm. The phosphocalcic evaluation and parathormone dosage concluded to a primary hyperparathyroidism. The patient had an intra-oral removal of stone under local anesthesia. The spectrophotometric analysis of the stone confirmed its phosphocalcic nature. An excision of the parathyroid adenoma was performed. Histological findings revealed a parathyroid adenoma. The clinical course was marked by clinical and biological improvement.

Conclusion: Salivary lithiasis is common. An etiological investigation is necessary in children and in recurrent forms to identify the possibility of hyperparathyroidism.