SALIVARY GLAND TUMORS
Salivary Gland Tumors are growths in the Salivary Glands. There are many different types of tumors which can develop in these glands, some non-cancerous (benign) and others cancerous. All Salivary Glands can develop tumors; however some are more prone than others. For example the majority of tumors are seen in the Parotid Gland. In addition, some glands tend to develop benign tumors while others are more likely to develop a cancerous tumor. For example, 80% of Parotid Gland Tumors are benign, while 50% of Submandibular Tumors and only 35% of Sublingual Gland Tumors are benign.
CAUSES:
Although the causes of Salivary Gland Cancer are not clear, certain risk factors have been associated with increased chance of developing Salivary Gland Cancer. These risk factors include:
- Age Salivary Gland Cancer can occur in people of all ages; however, it is more likely to occur in older adults.
- Radiation exposure Sources of such radiation include medical treatments of the head and neck and radiation fallout from power plant accidents or nuclear weapons.
- Chemical exposure Constant exposure to certain industrial chemicals, pesticides or sawdust has been associated with an increased risk of developing various types of Salivary Gland Cancer.
SYMPTOMS
The most common symptom is a painless mass. Often, Salivary Gland Tumors may not cause any symptoms. They are frequently found during a physical examination or incidentally noted on an imaging study done for another reason. Symptoms that may present include:
- A painless growth in the area of the ear, cheek, jaw, lip, or inside the mouth.
- Difficulty swallowing or opening the mouth widely.
- Weakness or numbness in the face.
- Facial or oral pain that does not go away.
TYPES OF SALIVARY GLAND CANCER:
The majority of Salivary Gland Tumors are non-cancerous (benign). These growths do not spread to other parts of the body and are rarely life-threatening. There are several types of benign Salivary Gland Tumors and they include Pleomorphic Adenoma, Warthin tumors and Oncocytomas.
There are many types of Salivary Gland Cancers. Salivary Glands are made up of many different kinds of cells and Salivary Gland Cancer can arise from any of these cell types. The rate that the cancer grows and spreads depends on the type of cancer. These cancers include Mucoepidermoid, Acinic Cell, Carcinoma Ex-Pleomorphic, Adenoid Cystic and Squamous Cell cancer.
DIAGNOSTIC TESTING
Imaging of the neck with an MRI or CT scan helps identify the extent of growth and involvement of surrounding structures.
Fine needle aspiration biopsy is often used to determine whether the salivary growth is cancerous. The biopsy samples the cells in the area of concern which are then sent to a pathologist for analysis. During the procedure, a thin needle is inserted through the skin into the salivary mass to collect a sample of cells. Multiple samples are usually taken to ensure an accurate analysis. Ultrasound technology can be used to visualize masses which are difficult to find and to guide the placement of the needle. Fine needle aspiration biopsy is carried out in the office by Dr. Zadeh. The samples of cells are then sent to a pathologist for evaluation.
TREATMENT
The type of treatment varies based on the patient, location of the tumor and type of tumor. Treatment options include observation, surgical removal, radiation therapy and chemotherapy.
Surgical excision of the tumor with the involved Salivary Gland is a common treatment for Salivary Gland Tumors (see below). Because the glands are numerous, removal of one of the salivary glands does not typically cause any noticeable decrease in saliva production. The nerves that control the motion of the facial muscles lie in close proximity or are within the salivary glands. Dr. Zadeh uses facial nerve monitoring equipment and delicate and meticulous dissection techniques to minimize the risk of any trauma to these important nerves during the procedure. Dr. Zadeh also uses cosmetic surgery principles to disguise the incision scar.
Laryngeal nerve monitor