Salivary gland tumours
Neoplastic lesions of the salivary glands are divided into benign or malignant. Malignant lesions are further divided into primary and secondary.
- Adenoid cystic carcinoma
- Squamous cell carcinoma
- Undifferentiated carcinoma
- Carcinoma expleomorphic adenoma
- Mucoepidermoid carcinoma
- Acinic cell carcinoma
- Inspect the mass
- Inspect the rest of the ears, nose, throat, head and neck
- Check the cranial nerves (if facial nerve palsy, probably malignant tumour)
- Fine needle aspiration is 95% sensitive, and is safe
- Imaging with CT or MRI
Malignant tumours of the salivary glands are described using the UICC system.
|T0 No evidence of primary tumour|
|T1 Tumour <2 cm, without parenchymal extension|
|T2 Tumour >2 cm but <4 cm, without parenchymal extension|
|T3 Tumour 4-6cm or with parenchymal extension, but without facial nerve invovlement|
|T4 Tumour >6 cm, or invades skull base, or invades facial nerve|
|T4a No local extension|
|T4b Local extension involving skin, soft tissue, bone or nerve|
|N0 No regional lymph node metastasis|
|N1 Metastasis in single ipsilateral node, <3 cm in greatest diameter|
|N2a Single ispilateral node involvement, 3-6 cm|
|N2b Multiple ipsilateral node involvement, all <6 cm|
|N2c Contrlateral or bilateral node involvement, <6 cm|
|N3 Node involvement >6 cm|
|M0 No distant metastasis|
|M1 Distant metastasis|
Complications of parotid surgery
- Nerve damage: temporary nerve paralysis of the facial nerve occurs in 10% of patients; permenent dysfunction is rare (less than 2%).
- Frey's syndrome - gustatory sweating.
- Salivary fistula
Salivary tumours in children
Salivary tumours are rare in children, and occur mainly in the parotid. Only 3% of parotid neoplasms occur in patients under 16 years old.
Mixed tumours are the most common tumours by far. The peak incidence occurs at 10 years old. The behaviour of the tumours is similar to those in adults. Haemangiomas are the next most common tumour.
These are very rare. Well differentiated / high grade mucoepidermoid carcinoma is the most common malignant parotid tumour in children.