Salivary Gland Tumors
Salivary glands are located throughout regions of the head and neck including on the side of the cheek, under the tongue, under the jaw, and throughout the mouth and throat. The parotid gland, located on the side of the cheek, in front of the ear, is the largest of the salivary glands, and is the most common site for tumor development. Interestingly, the parotid gland, has the highest incidence of benign tumors, roughly 80 to 85% of all growths arising in that gland. Alternatively, the smallest salivary glands, the minor salivary glands which are located under the lining of the inside of the mouth and throat, have a much higher ratio of malignant to benign growths.
A variety of malignant tumors in intermediate- and high-grade varieties can affect the salivary glands. The nature of the treatment depends on the grade of the tumor and can include radiation therapy and chemotherapy; however, in most situations, initial treatment involves surgery. The surgical procedure is dictated by the location of the tumor and the structures involved in the process of removing the tumor with clear margins. In select circumstances, radiation is administered as an adjunct to the surgical treatment of the tumor. Depending on the pathology, in some situations, the lymph nodes located in the neck may require treatment as well.
Surgical treatment of salivary gland cancer involves a number of different goals. First and foremost is the removal of the entire tumor with clear margins. Second is the performance of the surgery in a way that minimizes the effects on swallowing and speaking, thereby preserving the general quality of life. In select circumstances, depending on the size and the aggressiveness (grade) of the tumor, the surgery may be quite complex with respect to how nearby vital structures are affected and restored. How those structures are managed during the procedure and how they are restored after the tumor is removed, will greatly impact the outcome of that surgery. Selecting the optimal surgical plan begins with accurate diagnosis of the biopsy, as well as interpretation of the imaging studies which helps to map out the extent of the disease. This preoperative planning is best performed by experts who manage large volumes of salivary malignancies.
Salivary cancers are not common and, as a result, accurate diagnosis relies on an experienced pathologist and a team approach to tumor management so that the treatment selected will produce the best outcome.