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Salivary gland tumours are abnormal, benign, or malignant growths that develop in the salivary glands, which produce saliva in the mouth. Most of these tumours are benign (noncancerous) and occur in major salivary glands (~70%) while some develop in minor salivary glands (~25%). Also, malignant (cancerous) salivary gland tumours comprise 2 to 6% of all head and neck cancers, with 15 to 35% forming in parotid glands, 41 to 45% in submandibular, and 70 to 90% in sublingual glands. It is even possible for benign tumours to turn malignant. By learning about the salivary gland tumour classification and knowing the symptoms, timely and appropriate care can be administered without hampering the patient's quality of life.
Synopsis
What are salivary gland tumours?
Salivary glands make saliva, fluid inside the mouth and throat. The saliva aids in chewing and swallowing, as well as contains enzymes to digest the food. The antibodies present within the saliva fight infections in the mouth and throat.
Salivary gland tumours are abnormal cells growing in the salivary gland or tubes (ducts) that drain the gland. These tumours, whether benign or malignant, can cause changes in the normal functioning of the salivary glands. As a result, they interfere with the gland's ability to secrete saliva adequately, causing issues with chewing, swallowing, and speaking.
Salivary gland tumour classification
Below is the histological classification of salivary gland tumours (WHO 2017)
Benign tumors
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Lymphadenoma
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Sebaceous adenoma
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Ductal papilloma
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Cystadenoma
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Canalicular adenoma
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Oncocytoma
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Pleomorphic adenoma (mixed-type tumors)
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Sailadenoma pappilliferum
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Basal cell adenoma
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Myoepithelioma
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Warthin’s tumor
Malignant tumors
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Salivary duct carcinoma
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Acinic cell carcinoma
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Myoepithelial carcinoma
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Epithelial-myoepithelial carcinoma
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Clear cell carcinoma
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Adenoid cystic carcinoma
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Mucoepidermoid carcinoma
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Polymorphous low-grade adenocarcinoma
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Others: small cell, large cell, squamous cell carcinomas, basal cell adenocarcinomas
Neoplastic epithelial lesions
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Sclerosing polycystic adenosis
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Nodular oncocytic hyperplasia
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Lymphoepithelial sialadenitis
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Intercalated duct hyperplasia
Benign soft tissue lesions
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Haemangioma
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Lipoma/sialolipoma
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Nodular fasciitis
Hematolymphoid tumors
- Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)
Each type of these tumours may present with distinct symptoms and may require specific diagnostic methods and treatment strategies.
Salivary gland tumour symptoms
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Most benign and malignant salivary gland tumours present as a painless mass
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A firm swelling develops in one of the salivary glands (in front of the ears, under the chin, or on the floor of the mouth). The swelling may vary in size and progression depending on the underlying cause. Individuals with benign tumours have slow-developing swelling, while those with malignant tumours have rapidly developing swelling.
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Difficulty swallowing or opening the mouth.
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If malignant tumours invade the nerves, they cause localised or regional pain, numbness, paresthesia, and loss of motor function.
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Persistent bad breath.
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A malignant tumour may also cause facial nerve palsy, a condition where one side of the face is paralysed.
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Changes in taste or difficulty with taste perception.
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Drainage of fluid from the ear.
Causes of salivary gland tumors
The exact cause for developing salivary gland tumours remains elusive. However, salivary gland tumours can develop due to various reasons, such as genetic mutations, radiation exposure, immunosuppression, viral infections (Epstein-Barr Virus or Human Papilloma Virus), ultraviolet light exposure, certain lifestyle habits (smoking), or age-related changes. Sometimes they develop without any apparent cause.
Individuals with a family history of salivary gland tumours inherited genetic syndromes, or those exposed to chemicals (silica dust, nickel industries, or rubber chemicals) at the workplace are at higher risk for developing the tumours.
Diagnosis of salivary gland tumors
Medical professionals perform a series of evaluations that involve a medical history review, physical examination, and imaging tests. The diagnosis is possible with a fine needle aspiration biopsy of the tumour mass, which helps confirm the cell type. A CT or MRI scan is also recommended to determine the location and extent of the mass. Additional tests such as salivary gland ultrasound, sialography, and blood tests may be ordered for accurate diagnosis.
Treatment of salivary gland tumors
Benign salivary gland tumours are treated with surgery and do not require further treatment. If the tumours are incompletely removed, there is a possibility for recurrence. Malignant salivary gland tumours that are resectable are treated with surgery followed by radiation therapy. In some cases, chemotherapy may also be used. The choice of treatment depends on the type and stage of the tumour and individual health factors.
When should I consult a doctor?
Do not ignore any symptoms of salivary gland tumours. Book an appointment if you experience any of these:
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Swelling or lump in the jaws, cheek, or mouth
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Difficulty swallowing food
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Facial pain or numbness that does not go away
Conclusion
Although most salivary gland tumours are benign, some of them can be malignant. Since malignant salivary tumours can severely affect the quality of life and cause morbidity, it is important to diagnose the condition early and initiate prompt treatment. By knowing the salivary gland tumour classification and what symptoms to look for, early and complete care is possible. If you or your loved ones have lumps in the neck or exhibit salivary gland tumour symptoms, book an appointment with expert ENT specialists at Manipal Hospitals Bhubaneswar at the earliest.
FAQ's
Some of the most common tumours are:
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Benign: pleomorphic adenoma, Warthin’s tumour, oncocytoma
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Malignant: mucoepidermoid carcinoma, adenoid cystic carcinoma, adenocarcinoma, acinic cell carcinoma
Patients with salivary gland tumours complain of painless lumps. Some of them also complain of facial weakness, difficulty in opening their mouths, changes in taste perception, and fluid leaking from their ears.
Salivary gland tumours cannot be prevented. However, you can lower the risk with these steps:
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Reduce radiation exposure
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Minimise exposure to chemicals
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If you are working in rubber, nickel, or asbestos industries, take extra care
If a salivary gland tumour turns out to be malignant and is untreated, it can progress into a more advanced stage requiring aggressive therapy. This may lead to facial disfigurement and even poor outcomes.
To schedule an appointment at Manipal Hospitals, contact our ENT Department or visit our website.
Visit: https://www.manipalhospitals.com/bhubaneswar/specialities/ear-nose-throat/
Contact no: 0674 666 6600
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