II. Epidemiology
- Incidence: 2-8 per 100,000 people in U.S.
- Represent 6% of all head and neck tumors
- Rare compared to other Oral Growths
- Malignant Salivary Gland Tumors
- Adult: Only 16% of Salivary Gland Tumors are malignant
- Child: >50% of solid Salivary Gland Tumors are malignant
- Malignancies typically form in Submandibular Gland, Sublingual Gland or minor Salivary Glands
- Parotid Gland tumors are most often benign
III. Types
- Benign
- Benign Salivary tumors in children are typically pleomorphic adenoma, Hemangioma or lymphatic malformation
- Mixed Tumor (Pleomorphic adenoma)
- Most Common benign Salivary Gland Tumor (accounts for >50% of cases)
- May affect major Salivary Glands (Parotid Gland is most often affected)
- May also affect minor Salivary Glands (esp. Palate)
- Slow growing, nonulcerated painless tumor
- Occurs most commonly in women aged 30 to 60 years
- Risk of malignant transformation (excision recommended)
- Monomorphic Adenoma
- Warthin's Tumor
- More common in older men
- Associated with Tobacco Abuse
- Malignant
- Mucoepidermoid carcinoma (ages 20 to 50 years)
- Presents as low grade tumor in most cases
- Excellent prognosis with early treatment
- Adenoid cystic carcinoma (age over 50 years)
- Predisposition for nerve infiltration (often presents with facial weakness)
- Recurrence may occur years after excision
- Mucoepidermoid carcinoma (ages 20 to 50 years)
- Metastatic
- Cutaneous Squamous Cell Carcinoma
- Regional spread from the face or scalp
- Cutaneous Squamous Cell Carcinoma
IV. Signs: Findings suggestive of malignancy
- Salivary Gland pain
- Facial paresis
- Non-mobile mass (fixed to surrounding tissue)
- Neck Lymphadenopathy
V. Locations: May affect any of Salivary Glands
- Parotid Gland (typically benign)
- Sublingual Gland
- Submandibular Gland
- Minor Salivary Glands
- Especially on posterolateral Hard Palate
- Buccal mucosa and lips may also be affected
VI. Symptoms
- Slow growing, painless Salivary Gland mass
VII. Signs
- Palpation reveals Salivary Gland Enlargement
VIII. Diagnosis
- Fine Needle Aspirate of Salivary Gland Tumor
IX. Imaging
- Ultrasound
- Computed Tomography (CT)
- MRI
X. Management
- Benign Salivary Gland Tumors are typically excised due to risk of recurrence or malignant transformation (esp. if radioresistant)
XI. Prognosis: Malignant Salivary Gland Tumors
- Mucoepidermoid carcinoma
- Excellent prognosis with early treatment
- Five year survival dependent on grading: 50-90%
- Adenoid cystic carcinoma
- Five year survival: 65%
- Twenty year survival: 15%