Salivary gland neoplasms are benign or malignant tumors of a salivary gland (parotid, submandibular, or sublingual).
PHYSICAL FINDINGS AND CLINICAL PRESENTATION
● Parotid gland
● Painless swelling overlying the masseter muscle (under the temporomandibular joint)
● Facial nerve palsy
● Cervical lymph nodes
● Mass in oral cavity
● Submandibular gland: swelling under anterior portion of the mandible
● Sublingual gland: intraoral swelling under the tongue, medial to the mandible
● Salivary gland neoplasms most often present as slowgrowing, well-circumscribed masses. Pain, rapid growth,
nerve weakness, fixation to skin or underlying muscle, and paresthesias usually are indicative of malignancy.
● Mixed tumor (usually parotid)
● Adenolymphoma (Warthin’s tumor)
● Pleomorphic adenoma
● Capillary hemangioma, lymphangioma (in children)
● Intraductal papilloma
● Other (e.g., myoepithelioma, canalicular adenoma, basal cell adenoma)
● Mucoepidermoid carcinoma (most common malignant tumor of the parotid gland)
● Adenoid cystic carcinoma
● Malignant mixed tumor
● Squamous cell carcinoma
● Fine-needle aspiration. The sensitivity, specifi city, and accuracy of parotid gland aspirates are approximately 92%,
100%, and 98%, respectively
● Imaging by CT scan or MRI
● Open biopsy (rarely indicated)
● Surgery is the mainstay of treatment; gland resection and neck dissection if lymph nodes are involved
● A lateral lobectomy with preservation of facial nerve should be considered for tumors confi ned to the superfi cial
lobe of the parotid gland. Gross tumor should not be left in situ, but if the facial nerve is able to be preserved by “peeling” the tumor off the nerve, it should be attempted, followed by radiation therapy for microscopic disease.
● Postoperative radiation is indicated for high-grade malignancies demonstrating extraglandular disease, perineural
invasion, direct invasion of surrounding tissues, or regional metastases.
● Surgery for tumor resection