Parotid Sialolithiasis without Classical Clinical or Imaging Features: A Case Report

Sialolithiasis of the parotid gland is an uncommon occurrence, accounting for only 10–20% of all salivary calculi. This report describes an unusual case of parotid sialolithiasis in a 42-year-old female who presented with a soft, tender, and ill-defined swelling on the left side of the face persisting for one year. Clinical examination showed no notable extraoral or intraoral swelling. Magnetic resonance imaging revealed an intensely enhancing lesion anterior to the left masseter region, suggestive of a soft tissue neoplasm such as lipoma, fibroma, or hemangioma. Histopathological examination aided in the identification of sialolith within the excretory duct, accompanied by extensive destruction of the serous acini by chronic lymphoplasmacytic infiltrate, aiding in the diagnosis. This case underscores the diagnostic challenge posed by parotid sialoliths lacking classical symptoms and the absence of its detection in diagnostic imaging.