PRIMARY TUBERCULOSIS OF THE SUBMANDIBULAR GLAND: A CASE REPORT

Chronic sialadenitis is a disease of salivary glands associated with chronic infections, systemic diseases and silolithiasis pathogenesis of the disease. Primary tuberculous submandibulitis is not a reported disease. The diagnosis was confirmed when a 45 years old lady suspicious to submandibular gland tumor was operated on for excisional biopsy. Histological examination of the specimen by expert pathologist ruled out malignancy, granuloma or caseous necrosis. Cultures of discharge and tissue were negative for mycobacterium tuberculosis. The only positive diagnostic modality was Polymerase Chain Reaction for mycobacterium tuberculosis. Therefore, the four drug anti-TB regimen was initiated. After that a surgical fistula was healed and the patient left the hospital on her foot and there was no recurrence at least for one year. The endemic condition of tuberculosis in some populations has increased the rate of extra-pulmonary tuberculosis. One of the extra pulmonary sites may be the submandibular gland. It is recommended to consider tuberculosis in the differential diagnosis of submandibular gland masses especially in populations with endemic tuberculosis.