Salivary gland tumors

Definition

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

Causes, incidence, and risk factors

The salivary glands are located around the mouth. They produce saliva, which moistens food to aid chewing and swallowing. Saliva contains enzymes that begin the digestion process, and helps 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. 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 most commonly occurs in response to salivary gland infections, salivary duct stones, and conditions occurring elsewhere in the body such as cirrhosis of the liver, sarcoidosis, abdominal surgery, other cancers, Sjögren's syndrome, and infections.

The most common type of salivary duct tumor is a slow-growing tumor of the parotid gland. This is usually a benign (noncancerous) and self-contained growth that gradually increases the size of the gland. It occasionally can be malignant (cancerous). Malignant salivary gland tumors are usually carcinomas.

Symptoms

• A painless swelling in one of the salivary glands (in front of the ears, under the chin, or 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.

X-rays of the salivary gland (called a ptyalogram or sialogram) may be done to look for a tumor. More often, however, CT scan or MRI is used to verify the presence of a mass and to see if cancer has spread to lymph nodes in the neck.

A salivary gland biopsy or fine needle aspiration may be performed to determine if 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 recommended. Surgery on the parotid gland is usually designed to maintain the function of the facial nerve which controls the facial muscles.

Radiation therapy or extensive surgery may be required if the tumor is malignant. 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 duct tumors are benign (noncancerous) and slow growing. Removing the tumor by surgery usually cures them. In rare cases, the tumor is malignant (cancerous) and more extensive treatment is required.

Complications

• Rarely, surgery to remove the tumor can injure the facial nerve. This nerve controls movement of the face on that side.
• Cancerous tumors may cause further complications.

Calling your health care provider

Call your health care provider if:

• A lump is noticed in the mouth, under the jaw, or in the neck that does not go away in 2 - 3 weeks or is getting larger
• If you have pain when eating or chewing

Illustrations

Head and neck glands

Page Content:

Tumor - salivary duct