Salivary Gland Cancer
Benign and malignant tumours of the parotid and submandibular glands — what they are and how they are treated.
What are Salivary Gland Tumours?
Salivary gland tumours arise in the major salivary glands — the parotid (in front of and below the ear), submandibular (under the jaw), and sublingual glands — or in the many minor salivary glands scattered through the mouth and throat.
The majority of salivary gland tumours are benign. The most common is pleomorphic adenoma — a slow-growing benign tumour that nonetheless requires surgical removal because of a small but real risk of malignant transformation over time. Warthin's tumour is another common benign parotid tumour.
Malignant salivary gland tumours include mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, and carcinoma ex pleomorphic adenoma. They vary widely in behaviour from slow-growing to aggressive.
Warning Signs
A lump in front of or below the ear, a swelling under the jaw, facial weakness (indicating facial nerve involvement — urgent), pain in the region, and skin involvement or fixation to surrounding structures.
Any facial weakness associated with a parotid swelling suggests malignant involvement of the facial nerve and requires urgent specialist assessment.
Treatment
Surgery is the primary treatment for both benign and malignant salivary gland tumours. For parotid tumours, parotidectomy (removal of part or all of the parotid gland) is performed with careful preservation of the facial nerve. For malignant tumours, adjuvant radiation is often given post-operatively.
Adenoid cystic carcinoma is known for its tendency toward perineural invasion and late recurrence — long-term follow-up is essential.
Dr. Narayana Subramaniam
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