Understanding Salivary Gland Tumors: Types, Causes, Symptoms, and Treatment
Salivary gland tumours are abnormal growths that develop in the salivary glands, which are responsible for producing saliva. These tumours can be either benign (non-cancerous) or malignant (cancerous). Although salivary gland tumours are relatively rare, they can occur in any of the salivary glands, including the parotid, submandibular, and sublingual glands. This article provides a comprehensive overview of the types, causes, symptoms, and treatment options for salivary gland tumours.
Written by Dr.Sonia Bhatt
Last updated on 3rd Jul, 2025
What Are Salivary Gland Tumors?
Salivary glands are specialised glands located in and around the mouth and throat that produce saliva. Saliva plays a crucial role in maintaining oral health, aiding in digestion, and keeping the mouth moist. There are three pairs of major salivary glands and numerous minor salivary glands scattered throughout the mouth and throat. The main salivary glands include the parotid glands (located in front of and below each ear), the submandibular glands (under the jaw), and the sublingual glands (under the tongue). Salivary gland tumours can form in any of these glands, but they most commonly develop in the parotid glands. These tumours can be either benign (non-cancerous) or malignant (cancerous), with benign tumours being more common. Though they may not always be painful, salivary gland tumours can cause swelling, discomfort, and, in some cases, more serious complications if left untreated.
Types of Salivary Gland Tumors
Salivary gland tumours are classified into two main categories: benign and malignant.
Benign Salivary Gland Tumors:
Pleomorphic Adenoma: The most common benign salivary gland tumour, often found in the parotid gland. It is composed of a mix of epithelial and myoepithelial cells.
Warthin Tumor: Typically occurs in the parotid gland and is more common in older adults, particularly men. It is often bilateral and associated with smoking.
Oncocytoma: A rare benign tumour that arises from oncocytes, which are cells with abundant mitochondria.
Basal Cell Adenoma: A benign tumour that usually occurs in the parotid gland and is composed of basaloid cells.
Canalicular Adenoma: A benign tumour that typically affects the minor salivary glands, particularly in the upper lip.
Malignant Salivary Gland Tumors:
Mucoepidermoid Carcinoma: The most common malignant salivary gland tumour, often found in the parotid gland. It is composed of mucous, intermediate, and epidermoid cells.
Adenoid Cystic Carcinoma: A slow-growing but aggressive cancer that can occur in any salivary gland. It is known for its tendency to invade nerves.
Acinic Cell Carcinoma: A malignant tumour that arises from the acinar cells of the salivary glands. It is more common in the parotid gland.
Polymorphous Low-Grade Adenocarcinoma: A malignant tumour that typically affects the minor salivary glands and has a low potential for metastasis.
Salivary Duct Carcinoma: A rare and aggressive cancer that resembles ductal carcinoma of the breast.
Causes of Salivary Gland Tumors
The exact cause of salivary gland tumours is not well understood, but several factors may contribute to their development:
Genetic Mutations: Changes in the DNA of salivary gland cells can lead to uncontrolled cell growth and tumour formation.
Radiation Exposure: Previous radiation therapy to the head and neck can increase the risk of developing salivary gland tumours.
Viral Infections: Certain viral infections, such as Epstein-Barr virus and human papillomavirus (HPV), have been associated with an increased risk of salivary gland tumours.
Occupational Exposure: Exposure to certain chemicals and substances, such as asbestos, rubber manufacturing, and plumbing, may increase the risk of salivary gland tumours.
Smoking: Smoking has been linked to an increased risk of developing Warthin tumours.
Symptoms of Salivary Gland Tumors
The symptoms of salivary gland tumours can vary depending on the type, location, and size of the tumour. Common symptoms include:
Lump or Swelling: A noticeable lump or swelling on or near the jaw, neck, or mouth.
Pain: Persistent pain in the area of the salivary gland, which may radiate to the ear or neck.
Numbness: Numbness or weakness in part of the face, particularly if the tumour is pressing on a nerve.
Difficulty Swallowing: Trouble swallowing or opening the mouth widely.
Facial Muscle Weakness: Weakness or paralysis of the facial muscles on one side of the face.
Dry Mouth: Reduced saliva production, leading to a dry mouth.
Diagnosis of Salivary Gland Tumors
Diagnosing salivary gland tumours involves a combination of a physical examination, medical history, and diagnostic tests. Common diagnostic tools include:
Imaging Studies: X-rays, CT scans, MRI, and ultrasound can help visualise the extent and location of the tumour.
Fine Needle Aspiration (FNA) Biopsy: A minimally invasive procedure where a thin needle is used to extract a small sample of cells from the tumour for analysis.
Core Needle Biopsy: A procedure where a larger needle is used to obtain a tissue sample from the tumour for histopathological examination.
Sialography: A special type of X-ray that uses a contrast dye to visualise the salivary ducts and glands.
Treatment of Salivary Gland Tumors
The treatment of salivary gland tumours depends on several factors, including the type of tumour (benign or malignant), its size, location, and stage, as well as the patient's overall health. Here is a detailed overview of the various treatment options available for salivary gland tumours:
1. Surgery
Surgery is often the primary treatment for both benign and malignant salivary gland tumours. The goal of surgery is to remove the tumour while preserving as much normal tissue and function as possible. The type of surgery performed depends on the tumour's location and size:
Superficial Parotidectomy: This procedure involves removing the tumour along with the superficial lobe of the parotid gland. It is commonly used for tumours located in the superficial part of the parotid gland.
Total Parotidectomy: In cases where the tumour involves both the superficial and deep lobes of the parotid gland, a total parotidectomy may be necessary. This procedure involves removing the entire parotid gland.
Submandibular Gland Excision: For tumours located in the submandibular gland, the entire gland is typically removed.
Sublingual Gland Excision: Tumors in the sublingual gland are treated by removing the entire gland.
Minor Salivary Gland Excision: Tumors in the minor salivary glands, which are located throughout the mouth and throat, are removed along with a margin of surrounding tissue.
2. Radiation Therapy
Radiation therapy uses high-energy beams to target and destroy cancer cells. It is often used in combination with surgery for malignant salivary gland tumours, especially in cases where the tumour is large, has spread to nearby tissues, or cannot be completely removed surgically. Radiation therapy can also be used as a primary treatment for patients who are not candidates for surgery. Types of radiation therapy include:
External Beam Radiation Therapy (EBRT): This is the most common form of radiation therapy, where radiation is delivered from a machine outside the body.
Intensity-Modulated Radiation Therapy (IMRT): A more advanced form of EBRT that allows for precise targeting of the tumour while minimising damage to surrounding healthy tissue.
Brachytherapy: This involves placing radioactive sources directly into or near the tumour. It is less commonly used for salivary gland tumours.
3. Chemotherapy
Chemotherapy uses drugs to kill cancer cells or stop their growth. It is not typically the primary treatment for salivary gland tumours but may be used in certain situations, such as:
Advanced or Metastatic Cancer: Chemotherapy may be used to treat salivary gland tumours that have spread to other parts of the body.
Combination Therapy: Chemotherapy may be combined with radiation therapy (chemoradiation) to enhance the effectiveness of treatment.
Palliative Care: In cases where the cancer cannot be cured, chemotherapy may be used to relieve symptoms and improve quality of life.
Common chemotherapy drugs used for salivary gland tumours include cisplatin, carboplatin, and doxorubicin.
4. Targeted Therapy
Targeted therapy involves using drugs that specifically target cancer cells while sparing normal cells. These drugs work by interfering with specific molecules involved in cancer cell growth and survival. Targeted therapy is often used for certain types of malignant salivary gland tumours, such as:
HER2-Positive Tumors: Tumors that overexpress the HER2 protein may be treated with targeted drugs like trastuzumab (Herceptin).
EGFR-Positive Tumors: Tumors with mutations in the epidermal growth factor receptor (EGFR) gene may respond to targeted drugs like cetuximab (Erbitux).
5. Immunotherapy
Immunotherapy is a type of treatment that harnesses the body's immune system to fight cancer. It is an emerging area of research for salivary gland tumours and may be considered for certain patients, particularly those with advanced or recurrent disease. Types of immunotherapy include:
Immune Checkpoint Inhibitors: These drugs, such as pembrolizumab (Keytruda) and nivolumab (Opdivo), block proteins that prevent the immune system from attacking cancer cells.
Cancer Vaccines: Experimental vaccines that stimulate the immune system to recognise and attack cancer cells are being studied in clinical trials.
6. Rehabilitation and Supportive Care
Rehabilitation and supportive care are essential components of the treatment plan for patients with salivary gland tumours. These measures aim to improve the patient's quality of life and address any functional impairments resulting from the tumour or its treatment. Supportive care may include:
Physical Therapy: To help patients regain strength and mobility, particularly if surgery affects the muscles and nerves of the face and neck.
Speech Therapy: To address any speech or swallowing difficulties resulting from the tumour or its treatment.
Nutritional Support: To ensure patients maintain adequate nutrition, especially if they experience difficulty eating or swallowing.
Pain Management: To control pain and discomfort associated with the tumour or its treatment.
Conclusion
Salivary gland tumours are a rare but significant condition that can affect the salivary glands. Understanding the types, causes, symptoms, and treatment options for salivary gland tumours can help individuals take proactive steps to manage the condition and maintain their overall health. If you experience persistent symptoms or notice a lump in the area of the salivary glands, it is important to consult a healthcare provider for proper diagnosis and treatment.
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