Salivary gland neoplasm
| Salivary gland cancer | |
|---|---|
 |
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| The major salivary glands: the parotid gland (1), where most salivary gland tumors form, the submandibular gland (2), and the sublingual gland (3). | |
| Classification and external resources | |
| Specialty | Oncology |
| ICD-10 | C07-C08, D11 |
| ICD-9-CM | 142, 210.2 |
| MedlinePlus | 001040 |
| MeSH | D012468 |
Salivary gland cancer is a cancer that forms in tissues of a salivary gland. The salivary glands are classified as major and minor. The major salivary glands consist of the parotid, submandibular, and sublingual glands. The minor glands include small mucus-secreting glands located throughout the palate, nasal and oral cavity. Salivary gland cancer is rare, with 6% of head and neck tumors forming in the salivary glands, the majority in the parotid.
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 2004, which classifies salivary neoplasms as primary or secondary, benign or malignant, and also by tissue of origin. This system defines five broad categories of salivary gland neoplasms:
Others, not included in the WHO classification above, include:
Signs include fluid draining from the ear, pain, numbness, weakness, trouble swallowing, and a lump. The most common symptom of major salivary gland cancer is a painless lump in the affected gland, sometimes accompanied by paralysis of the facial nerve.
In most cases, local excision with a margin of normal tissue is the appropriate form of biopsy for a major salivary gland tumor. In the parotid region, this requires identification of the facial nerve. For submandibular tumors, the entire submandibular triangle is cleared. In contrast, minor salivary gland tumors have a higher likelihood of being malignant, and an incisional biopsy is performed initially so that definitive treatment can be planned. In the parotid region, the presence of pain, recent rapid enlargement of a preexisting nodule, skin involvement, or facial nerve paralysis suggests cancer. Enlarged cervical lymph nodes in association with a salivary gland tumor are considered a manifestation of cancer until proved otherwise. Fine-needle aspiration is indicated if accurate diagnosis will allow for better treatment planning.
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