Salivary Gland Tumors

Located between the ear and jaw, salivary glands are responsible for the secretion of saliva in the mouth. They also support oral health and help with digestion. While considered a rare occurrence, tumors can develop in any of the salivary glands in the mouth, throat, or neck.

• Abnormal growths primarily affect the parotid, sublingual and submandibular glands, although minor salivary glands may also be affected.
• The majority of salivary tumors occur in parotid glands on either side of the mouth and in front of both ears.

Affecting women more than men, salivary tumors may develop due to DNA mutations in cells. However, it’s not known what precisely causes these tumors. Often found within the parotid gland, pleomorphic adenomas, basal cell adenoma, and Warthin’s tumor are the most common benign salivary tumors. Mucoepidermoid carcinomas are the most common cancerous tumors that affect salivary glands, followed by adenoid cystic carcinoma and low-grade acinic cell carcinoma.

Growths affecting salivary glands are sometimes painless, while others may cause facial weakness or an imbalance with facial nerves. Some patients might notice fluid drainage in one or both ears, trouble fully opening the mouth, or difficulty swallowing. Symptoms experienced may also include:

• Swelling or a visible lump in the mouth, jaw, or neck
• Numbness in the face
• Recurring or persistent pain around areas where salivary glands are located

Following an initial physical examination, assessment of a salivary tumor usually involves fine needle aspiration, also called an aspiration biopsy. During the procedure, a small needle is inserted into tissues to remove cells for laboratory testing. Diagnosis may also involve the use of an endoscope inserted through the mouth to view the voice box (larynx) and other parts of the throat. If the growth is cancerous, image tests are typically done to determine if the cancer has spread to nearby areas in the neck, throat, or jaw.

If a salivary tumor is non-cancerous and not causing any difficulties, treatment may only involve monitoring of the growth. For tumors that are cancerous or affecting nerves, surgery may be recommended to remove part or all of the affected salivary gland. With tumors that extend into other areas, some facial nerves, bones, or skin may also need to be removed. A neck dissection may be performed to remove lymph nodes if the cancer has spread to this area.

Following surgery for tumors, patients sometimes need reconstructive surgery to restore the ability to properly breathe, speak, chew, and swallow. With radiation therapy, high-powered beams are used to kill cancer cells in glands and nearby tissues. Chemotherapy is not currently a standard treatment recommendation for salivary cancer.

Most salivary tumors are non-cancerous (benign), meaning they will not spread to nearby tissues. Risk factors for cancer in this area include age-related changes to tissues and cells and exposure to radiation and certain workplace hazards. If throat and ear irritations occur with greater frequency or early signs of a problem are spotted during a dental exam, patients may be referred to an ear, nose, and throat specialist for further evaluation and treatment.