Salivary gland tumors

Tumor - salivary duct

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 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.

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
• Sjögren syndrome

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

Malignant salivary gland tumors are usually carcinomas.

• 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.

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 verify that there is a mass and to see if cancer has spread to lymph nodes in the neck
• Salivary gland biopsy or fine needle aspiration to determine if the tumor is noncancerous (benign) or cancerous (malignant)

The recommended treatment is usually surgery to remove the affected salivary gland. If the tumor is noncancerous (benign), no other treatment is usually needed. Surgery on the parotid gland usually helps maintain the function of the nerve that controls the muscles of the face.

Radiation therapy or extensive surgery may be required 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.

Most salivary duct tumors are noncancerous (benign) and slow growing. Removing the tumor by surgery usually cures the condition. In rare cases, the tumor is cancerous (malignant) and more extensive treatment is required.

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

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

Scianna JM, Petruzzelli GJ. Contemporary management of tumors of the salivary glands. Curr Oncol Rep. 2007;9:134-138.