Neoplasms of the salivary gland

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Introduction

The next most common neoplasms of the mouth after squamous cell carcinomas [PSI].

Above 70% develop in the parotid gland and over three-quarters are benign.

Women are slightly more frequently affected.

Classification

  • The modified WHO classification (1972) includes:

    • Epithelial tumours
      • Adenomas:
      • Pleomorphic adenoma ('mixed tumour')
      • Monomorphic adenomas
      • Warthin's tumour, oxyphoitic adenoma
      • Carcinomas:
      • Mucoepidermoid carcinoma
      • Acinic cell carcinoma
      • Adenocarcinoma
      • Epidermoid carcinoma
      • Undifferentiated carcinoma
      • Malignant mixed tumour
    • Non-epithelial tumours
      • Lymphomas
      • Sarcomas

Clinical features

  • Benign tumours are generally asymptomatic enlargements.
  • Malignant varieties are painful, irregular, ulcerative and metastatic.

Investigation 

  • Sialography
    • Postero-anterior view of the skull
    • Oblique lateral view of the jaws

Treatment

  • Benign and malignant lesions: surgical excision
  • Malignant lesions: radiotherapy and chemotherapy in addition to excision
  • Secondary bacterial infections: treat with antibiotics g. ciprofloxacin 500 mg orally every 12 hours for 5-7 days.
  • Adjust doses as appropriate for children.