Salivary gland tumors

Answer 1

Definition

Salivary gland tumors are abnormal cells growing in the ducts that drain the salivary glands.

Alternative Names

Tumor - salivary duct

Causes, incidence, and risk factors

The salivary glands are located around the mouth. They produce saliva, which moistens food to help with chewing and swallowing.

Saliva contains enzymes that begin the digestion process, and help cleanse the mouth by washing away bacteria and food particles. By keeping the mouth moist, saliva helps to keep dentures, retainers, or other orthodontic appliances in place.

There are three pairs of major salivary glands. The largest are the parotid glands, located in each cheek over the jaw in front of the ears. Two submandibular glands are at the back of the mouth on both sides of the jaw. Two sublingual glands are under the floor of the mouth. There are also thousands of minor salivary glands around the rest of the mouth.

All of the salivary glands empty saliva into the mouth through ducts that open at various locations in the mouth.

Salivary gland tumors are rare, especially in children. Swelling of the salivary glands is most commonly due to:

• Abdominal surgery
• Cirrhosis of the liver
• Infections
• Other cancers
• Salivary duct stones
• Salivary gland infections
• Sarcoidosis
• Sjogren syndrome

The most common type of salivary gland tumor is a slow-growing noncancerous (benign) tumor of the parotid gland that gradually increases the size of the gland. However, some of these tumors can be cancerous (malignant).

Malignant salivary gland tumors are usually carcinomas.

Symptoms

• A firm, usually painless swelling in one of the salivary glands (in front of the ears, under the chin, or on the floor of the mouth); the size of the swelling gradually increases.
• Difficulty moving one side of the face, known as facial nerve palsy

Signs and tests

An examination by a health care provider or dentist shows a larger-than-normal salivary gland, usually one of the parotid glands.

Tests may include:

• X-rays of the salivary gland (called a ptyalogram or sialogram) to look for a tumor
• CT scan or MRI to confirm that there is a growth, and to see if the cancer has spread to lymph nodes in the neck
• Salivary gland biopsy or fine needle aspiration to determine whether the tumor is benign or malignant

Treatment

The recommended treatment is usually surgery to remove the affected salivary gland. If the tumor is benign, no other treatment is usually needed.

Radiation therapy or extensive surgery may be needed if the tumor is cancerous. Chemotherapy is sometimes used in patients who are considered high risk, or when the disease has spread beyond the salivary glands.

Expectations (prognosis)

Most salivary gland tumors are noncancerous and slow growing. Removing the tumor with surgery usually cures the condition. In rare cases, the tumor is cancerous and further treatment is needed.

Complications

• Cancerous tumors may cause further complications, including spread to other organs (metastasis).
• Rarely, surgery to remove the tumor can injure the nerve that controls movement of the face.

Calling your health care provider

Call your health care provider if:

• You have pain when eating or chewing
• You notice a lump in the mouth, under the jaw, or in the neck that does not go away in 2 - 3 weeks or is getting larger

References

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Head and Neck Cancers. National Comprehensive Cancer Network: 2009. Version 1.2009.

Posner M. Head and neck cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 200.

Reviewed By

Review Date: 02/01/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.