Salivary Gland Tumours

Salivary gland disorders can be divided into infection/inflammation or tumours.

Salivary gland growths make up 6% of all head and neck tumours. They can be benign or malignant. Salivary gland cancers are rare with an incidence of 1 in 100 000 per population per year in Singapore.

Salivary glands are divided into two groups: major and minor salivary glands.

• The major salivary glands are the parotid, submandibular and sublingual glands.
• The minor salivary glands are numerous and they are scattered throughout the upper aerodigestive tract.

Majority of salivary gland tumours grow in the parotid glands, fortunately, most of them are benign. 50% of submandibular gland growths are cancerous while 75% of sublingual and minor salivary gland tumours are cancerous.

How do salivary gland tumours present?

Patients with salivary gland tumours usually complain of a painless slowly enlarging lump. Those with advanced parotid cancers may also suffer from unilateral facial weakness. Rarely in cases of laryngeal minor salivary gland tumours, patients may complain of shortness of breath as a result of airway obstruction from the tumour mass.

How do we investigate a salivary gland tumour?

After a thorough head and neck physical examination, we will perform a fine needle aspiration cytology of the lump and a computed tomography scan or magnetic resonance imaging to determine the size of the growth, its extent and infiltration and possible nodal spread.

What are the main modalities of treatment?

For benign growths, surgery alone will be adequate. However in cancerous growths, patients may need to undergo radiotherapy with or without chemotherapy after surgery is performed.