SALIVARY GLAND TUMORS

Question 1

Salivary glands consist of 3 large, paired major glands. Name them.

Answer 1

• Parotid gland
• Submandibular gland
• Sublingual gland

Question 2

What is the function of the salivary glands?

Answer 2

• Role in digestion by secreting saliva

- Tooth protection by saliva

Question 3

Which of the salivary glands is the largest?

Answer 3

-Parotid gland

Question 4

Where is the parotid gland located?

Answer 4

Superfically, partly behind the ramus of the mandible, covering the masseter muscle.
2.5 inf and 2.5 ant of EAM (external auditory meatus)

Question 5

What is the epidemiology of parotid gland cancer?

Answer 5

• 3 - 4% of all H & N cancers
• Female patients with a history of salivary gland carcinoma have an 8 times increased incidence for breast cancer
• More likely to be malignant in children compared to adults

Question 6

What is the percentage of malignant salivary gland tumors among all H&N cancers?

Answer 6

• 7% of all H&N cancers in North America each year.

Question 7

What is the site of the highest incidence of salivary glands?

Answer 7

-Parotid gland (80-90%)
Among these tumors 66% are benign.
15-33% are malignant tumors

Question 8

What is the etiology of salivary gland tumors?

Answer 8

• Unknown
• low-dose ionizing radiation in childhood used to treat benign conditions such as acne
• risk factor: dental radiographs
• bomb atomic survivor

Question 9

What are the 5 year survival for salivary gland tumors?

Answer 9

T1 - 100%
T2 - 83%
T3 - 80%
T4 - 43%

Question 10

What is the most common clinical presentation for salivary gland tumors?

Answer 10

• Asymptomatic parotid mass (lasting 4-8 months)
• localized swelling
• pain
• facial palsy (partly paralysis of face due to facial nerve non-functioning)
• rapid growth

Question 11

What is the most common histopathology for salivary gland tumors?

Answer 11

• origin: adenocarcinoma

- Pathology: adenoid cystic or mucoepidermoid

Question 12

What is the lymphatic drainage of salivary gland tumors?

Answer 12

• Retroauricular nodes

- which drain into upper cervical nodes

Question 13

What is the treatment of choice for salivary gland tumors?

Answer 13

-Surgery
-if surgical margins are positive, Radiation Therapy is prescribed
(2 cm margin including surgical bed)

Question 14

What are the side effects of RT on salivary gland tumors?

Answer 14

• Acute side effects:
• DAY 1 Sialendinitis (infection viral or bacterial of salivary gland) starting
• WEEK 2-3 Xerostomia, mucosal erythema, thick saliva, loss of taste
• WEEK 3-4 Patchy mucositis, Dry desquamation
• WEEK 5-6 Moist desquamation, sore throat, dysphasia (difficulty of speech)

Question 15

What are the common acute side effects for H&N cancers?

Answer 15

• Nasal cavity: mucositis, secretions
• Taste: loss of taste, taste alterations
• Salivary gland: xerostomia
• Skin: erythema, tanning
• Ear: serous otitis media
• Cataract, laryngeal edema
• Trismus (difficulty opening mouth, lockjaw)
• Alopecia