Salivary gland tumours: all questions answered

The presence of salivary gland tumours may leave patients feeling concerned, anxious, and questioning if they are cancerous. Leading consultant ENT specialist Mr Ricard Simo addresses the questions and concerns that you may have about these tumours.

What are the symptoms of salivary gland tumours?

The majority of salivary gland tumours, (80%) present as a lump in the salivary gland. In the majority of cases, the majority appear on the parotid gland, which is the flat gland that is in front of the ear.

Only around 20 % of tumours arise from the soma diva gland, and they are just below the jawline. There are other, smaller salivary glands inside the mouth, and the throat, but the development of tumours on these sides is relatively rare.

How are these diagnosed?

The majority of salivary glands will present to a clinician, who will examine the patient, take their health history and palpate the tumour.

Based on that, we normally organise an ultrasound-guided funnel aspiration biopsy, which is performed under ultrasound guidance. We are able to diagnose the tumours very accurately, in around 90% of cases.

The clinician will also often, arrange for patients to have either a CT scan or an MRI scan. These are mainly for surgical planning and obviously for those patients who do have malignancy, that will serve as staging.

How are salivary gland tumours treated?

Most salivary gland tumours are benign, but will still require treatment. Surgery is the treatment of choice, as these tumours will continue to grow and could potentially undergo malignant transformation.    

The risk of this is approximately at a rate of 1% for every year that the tumour continues to grow. For malignant low-grade tumours, surgery may be sufficient, but for high-grade malignant tumours, surgery, as well as adjuvant postoperative radiotherapy will be needed.

For malignant tumours, especially those of low grade, surgery is usually sufficient. However, for high-grade tumours, the most aggressive ones, you will need to have surgery and adjuvant post-operative therapy.

Are most salivary gland tumours malignant?

No, in fact, 80% of salivary gland tumours are benign, while only 20 % of the tumours of the protic gland are malignant. In the submandibular gland, there's only about 50%. The smaller the gland, the more likely that the tumour is malignant. The tumour arises from a specific gland in the minus larvae glands, which are scattered around the lining of the mouth and throat. Up to 80 % of these tumours may be malignant, but the vast majority are benign.

Do benign salivary tumours need to be removed?

Yes, the majority will have to be removed. As previously mentioned, these tumours are all benign but will continue to grow, and then there is a potential risk of malignant transformation, which will require them to be removed.

Surgery is the treatment of choice for the majority of these tumours. However, in patients who may be frail or in certain types of tumours, such as Warthin’s tumours, they may not require surgical treatment. Instead, they can be put into active surveillance as a protocol.

In patients who are very elderly, frail or may not want to have surgery, the tumours can be left alone, but they’ll be just a minority. The vast majority of patients will require surgery for these tumours.

If you are concerned about salivary gland tumours and would like to book a consultation with Mr Simo, simply visit his Top Doctors profile today.