Alternative Names salivary gland neoplasms, salivary gland cancer
Definition The salivary gland is one of three pairs of glands that secrete saliva. Saliva helps the body break down food for digestion. Salivary gland tumours are growths in the tissues of these glands.
What is going on in the body? There are three pairs of major salivary glands. The first and largest pair is the parotid glands. They sit in front of and just below the ear. The second largest pair is the submandibular glands. These sit under the side of the jaw. The sublingual glands sit under the tongue in the floor of the mouth. Scattered below the lining of the mouth and throat are minor salivary glands. Each of the glands secretes saliva into the mouth through ducts.
Salivary gland tumours can arise from the cells in the glands, the ducts, or the supporting structures not involved in saliva secretion. These growths can be cancerous or non-cancerous. Approximately 80% of salivary gland tumours occur in the parotid gland.
What are the signs and symptoms of the condition? Most salivary gland tumours are harmless. Usually they are slow growing, non-tender, painless bumps. They are often single masses with distinct edges.
But sometimes the tumours are cancerous. In these cases, the masses do not have distinct edges and appear to be stuck to surrounding tissues. Often they affect nearby nerves, causing a loss of feeling or function of the face or tongue. The tumours may grow quickly, feel lumpy, and cause pain.
Tumours arising from minor salivary glands usually present as painless, slow-growing swellings below the lining of the cheek or hard and soft palate.
What are the causes and risks of the condition? The cause of salivary gland tumours is unknown.
What can be done to prevent the condition? There are no known ways to prevent salivary gland tumours.
How is the condition diagnosed? Initial diagnosis is based on physical examination and the location of the mass within or arising from the salivary glands.
A fine needle aspiration biopsy is usually performed. With this procedure, a fine needle is used to remove cells from the growth for examination. It can then be determined whether or not the mass is cancerous and how it can be treated. The larger the gland is where the growth appears, the more likely it is not cancer-related.
If the mass is cancerous, a CT scan of the neck and face is usually performed. This will help discover the extent of the tumour and whether it has spread.
What are the long-term effects of the condition? For tumours that are not cancerous, the only long-term effects are generally cosmetic. If the tumour prevents saliva from draining, symptoms of blockage or infection may occur. This would include uncomfortable swelling after meals that improves over several hours. Complete blockage would also cause constant pain.
The long-term effects of the cancerous tumours vary based on the type of cancer involved. If untreated, they could lead to death.
What are the risks to others? Salivary gland tumours are not contagious and pose no risk to others.
What are the treatments for the condition? For non-cancerous growths, monitoring is appropriate. It may be necessary to remove some forms of non-cancerous tumours if they look like they may become cancerous. Depending on the recurrence rate associated with the type of tumour and its location, all or part of a gland is sometimes removed.
For cancerous tumours, treatment depends on the type of cancer involved. Treatment may involve removal of a portion of the gland, or the entire gland. Salivary gland tumours can spread to nearby lymph nodes. If this occurs, a radical neck dissection is necessary. A neck dissection is an operation that is done for individuals with cancer of the head and neck.
The purpose is to remove the lymph nodes in the neck Radiation therapy may also be used to treat salivary gland tumours. To date, there are no effective chemotherapy protocols for salivary tumours.
What are the side effects of the treatments? There are possible side effects with any surgery. These include bleeding, infection, and allergic reactions to anaesthesia. Another side effect is nerve damage. This could cause a loss of feeling or function of the face or tongue. If radiation therapy is needed, damage to any remaining salivary glands may occur. This is accompanied by dry mouth and problems with dental cavities.
What happens after treatment for the condition? Non-cancerous tumours do not require further treatment. Cancerous growths may or may not need further treatment, depending on the type of tumour. Follow up also depends of the type of tumour. More aggressive tumours require longer periods of follow up. Less aggressive tumours do not need as regular or as prolonged a follow up.
How is the condition monitored? If a person has a cancerous salivary gland tumour that has been treated, he or she should examine his or her neck regularly. Any new or worsening symptoms should be reported to the doctor.
Author: Mark Loury, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
