Salivary gland tumours, or neoplasms, are tumours that form in the tissues of salivary glands. The salivary glands are classified as major or minor. The major salivary glands consist of the parotid, submandibular, and sublingual glands. The minor salivary glands consist of 800 to 1000 small mucus-secreting glands located throughout the lining of the oral cavity. People with these types of tumours may be asymptomatic.
Presentation Salivary gland tumours usually present as a lump or swelling in the affected gland, which may or may not have been present for a long time. The lump may be accompanied by symptoms of ductal obstruction (e.g., xerostomia). Usually, in their early stages, it is not possible to distinguish a benign tumour from a malignant one. One of the key differentiating symptoms of malignant growth is nerve involvement; for example, signs of facial nerve damage (e.g., facial nerve paralysis) are associated with malignant parotid tumours. Facial pain and paresthesias are also very often associated with malignant tumours. Other red-flag symptoms which may suggest malignancy and warrant further investigation are fixation of the lump to the overlying skin, ulceration and induration (hardening) of the mucosa.
Diagnosis The diagnosis and differentiation of salivary gland tumors involves multi-modal methods: Physical exam and history: An exam of the body to check general signs of health. The head, neck, mouth, and throat will be checked for signs of disease, such as lumps or other abnormalities. A medical history will also be taken. Endoscopy: A procedure to look at orifices in the body to check for abnormal areas. For salivary gland cancer, an endoscope is inserted into the mouth to look at the mouth, throat, and larynx. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. MRI and/or CT Scan: These tests can confirm the presence of a tumour. An MRI and/or CT scan can also show whether metastasis has occurred. Biopsy: The removal of abnormal cells or tissues for viewing under a microscope by a pathologist to check for signs of cancer. Fine needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle. An FNA is the most common biopsy for salivary gland cancer and has been shown to yield accurate results in distinguishing benign from malignant tumours. Radiographs: An orthopantomogram can be taken to rule out mandibular involvement. A chest radiograph may also be taken to rule out any secondary tumours. Ultrasound: Ultrasound can be used to initially assess a tumour that is located superficially in either the submandibular or parotid gland. It can distinguish an intrinsic from an extrinsic neoplasm. Ultrasonic images of malignant tumours include ill-defined margins. Furthermore, high-resolution ultrasound can identify the exact tumour location within the parotid gland, its relationship to the retromandibular vein, and assist surgical excision.
Classification
Due to the diverse nature of salivary gland tumours, many different terms and classification systems have been used. Perhaps the most widely used currently is that system proposed by the World Health Organization in 2005. This system defines five broad categories of salivary gland neoplasms: benign epithelial, malignant epithelial, soft tissue, hematolymphoid, and secondary. Benign epithelial tumours
Pleomorphic adenoma Warthin's tumor Myoepithelioma Basal cell adenoma Oncocytoma Canalicular adenoma Lymphadenoma Sebaceous lymphadenoma Nonsebaceous lymphadenoma Ductal papilloma Inverted ductal papilloma Intraductal papilloma Sialadenoma papilliferum Cystadenoma Malignant epithelial tumours Acinic cell carcinoma Mucoepidermoid carcinoma Adenoid cystic carcinoma Polymorphous low-grade adenocarcinoma Epithelial-myoepithelial carcinoma clear-cell adenocarcinoma, not otherwise specified Basal cell adenocarcinoma Sebaceous carcinoma Sebaceous lymphadenocarcinoma Cystadenocarcinoma Low-grade cribriform cystadenocarcinoma Mucinous adenocarcinoma Oncocytic carcinoma Salivary duct carcinoma Salivary duct carcinoma, not otherwise specified Adenocarcinoma, not otherwise specified Myoepithelial carcinoma Carcinoma ex pleomorphic adenoma Mammary analogue secretory carcinoma Carcinosarcoma Metastasizing pleomorphic adenoma Squamous cell carcinoma Large cell carcinoma Lymphoepithelial carcinoma Sialoblastoma Soft tissue tumours Hemangioma Hematolymphoid tumours Hodgkin lymphoma Diffuse large B-cell lymphoma Extranodal marginal zone B cell lymphoma Secondary tumours (i.e., a tumour which has metastasized to the salivary gland from a distant location) Others, not included in the WHO classification above, include:
Intraosseous (central) salivary gland tumours Hybrid tumours (i.e., a tumour displaying combined forms of histologic tumour types) Hybrid carcinoma Others Keratocystoma Sialolipoma
Treatment Early-stage lesions may be amenable to surgical treatment. More advanced or unresectable cancers tend to be treated with radiotherapy (RT) alone or chemoradiotherapy (CRT), which hampered the comparison of the efficacy of RT alone with that of surgery combined with adjuvant RT. But some effort had been made to reflect the role of surgery in the management of salivary gland tumours.
Treatment may include the following:
… excerpt ends here. Continue reading the full article.



![Salivary gland tumour: Relative incidence of parotid tumours.[10]](https://upload.wikimedia.org/wikipedia/commons/thumb/b/b1/Relative_incidence_of_parotid_tumors.png/500px-Relative_incidence_of_parotid_tumors.png?utm_source=en.wikipedia.org&utm_campaign=parser&utm_content=thumbnail)
![Salivary gland tumour: Relative incidence of submandibular tumours.[10]](https://upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Relative_incidence_of_submandibular_tumors.png/500px-Relative_incidence_of_submandibular_tumors.png?utm_source=en.wikipedia.org&utm_campaign=parser&utm_content=thumbnail)

