Thanion SoopanitWarut PongsapichPrachya ManeeprasopchokeFaculty of Medicine, Siriraj Hospital, Mahidol UniversityChulabhorn Hospital2020-08-252020-08-252020-09-01Otolaryngology Case Reports. Vol.16, (2020)246854882-s2.0-85088104081https://repository.li.mahidol.ac.th/handle/20.500.14594/58016© 2020 Elsevier Inc. The accessory submandibular salivary duct is an infrequent anatomical variation, with an extremely rare, intraluminally located stone. We present a distinctive case of the largest accessory submandibular sialolithiasis ever reported in the literature. A 54-year-old male presented with a slow-growing mass in the right submandibular area. An examination revealed a large calcified mass in the ipsilateral tonsillar fossa. A preoperative CT scan demonstrated the continuation of the pathologic calcification between two areas. The submandibular gland, together with the entire stone in the accessory duct, was safely removed using the external approach in order to prevent neurovascular injuries that could otherwise arise from its distorted location.Mahidol UniversityMedicineArticleSCOPUS10.1016/j.xocr.2020.100204