Salivary gland tumour

70% are benign
Most are in parotid
Ultrasound – modality of choice for salivary gland
The smaller the gland, the higher risk that the tumor is malignant
Lateral parotidectomy
- Superficial – with large margin
- As early as possible
- Complete
- Complications:
  - Facial nerve injury
  - Gustatory sweating
  - Gustatory hyperlacrimation
Benign tumours
- Clinical features
  - Slow growth
  - Painless
  - Soft or tense
  - Mobile nodule
  - No additional symptoms
- Pleiomorphic adenoma
  - 85% of benign
  - Radiation, occupational exposure
  - Firmer tumour
  - Diagnosis
    - Histology – pleiomorphic cells
  - 5% can turn malignant
  - 5% recur
  - Treatment
    - Superficial parotidectomy
- Warthin tumor
  - Older males
  - 10% of benign
  - Etiology
    - Radiation
    - Smoking
  - Softer tumour
  - Treatment
    - Complete surgical excision while preserving facial n.
Malignant tumours
- Etiology
  - Radiation
- Clinical features
  - Rapid growth
  - Painless, fixed nodule
  - Enlarged lymph nodes
  - Infiltration of facial nerve
- Diagnosis
  - FNAB
  - CT for infiltration
- Types
  - Mucoepidermoid carcinoma
    - Most common in children
    - Most are low-grade
    - Painless swelling -> later becomes painful
  - Acinar cell carcinoma
    - Locally invasive
    - Older women
  - Adenoid cystic carcinoma
    - Locally invasive
    - Poor radiosensitivity
- Treatment
  - As complete as possible removal -> radiation‎