SALIVARY GLAND CANCER - Overview, Facts, Types and Syptoms, etc.

SALIVARY GLAND CANCER

Salivary gland cancer is very few. Salivary glands have two different types, and these are the major salivary glands, which consist of the parotid (located at the preauricular area). Submandibular glands (located underneath the mandible) and the sublingual glands. Minor glands are scattered all over the mouth and serve to lubricate and produce saliva that aids in the digestion and deglutition.

TYPES

Salivary gland tumors are classified into two broad categories, and these are either benign or malignant salivary gland tumors.

Benign tumors

  • Basal and pleomorphic adenoma
  • Whartin’s gland tumor
  • Lymphadenoma
  • Intraductal papilloma
  • Sialoadenoma

Malignant tumors

  • Acinic cell carcinoma
  • Mucoepidermoid and adenoid cystic carcinoma
  • Basal cell carcinoma
  • Salivary duct carcinoma
  • Large cell carcinoma

SYMPTOMS

Salivary gland tumors present with the following:

  • Mass located anywhere near the roof and floor of the mouth
  • Facial nerve paralysis (seen in the later stages of the disease or early stages of large tumors)
  • Pain on the facial area with diminished sensation 
  • Non-movable and knuckle hard mass on the oral area
  • Presence of oral sores or ulcerations in the buccal mucosa

DIAGNOSIS

  • Physical examination- examination of the character of the mass, its location, size and shape of borders
  • Imaging procedures MRI and CT scan- Rules out any metastatic masses on areas contiguous to the primary tumor.
  • Fine needle aspiration biopsy of the mass- this is important to help assess the exact type of salivary gland tumor, which will be the basis of chemotherapeutic options.
  • Direct laryngoscopy- this procedure is done to detect and to visualize possible metastasis of the primary salivary gland tumor.
  • Ultrasonography- used as a guide to detecting the location of the tumor. Classification is then labeled as intrinsic (within the muscle layer) or extrinsic (its margins are found in the outer border of the muscle).
  • Flow cytometry- This test coupled with the histopathologic findings to adequately determine the presence of adenoid cystic adenoma.

TREATMENT

  • Chemotherapy using a combination of Doxorubicin-platinum agents to induce programmed cell death among salivary gland cancer. A newer generation of chemotherapeutic agent 5-fluorouracil has an increased activity for malignant cells but has lesser gastrointestinal upset.
  • Radiotherapy is not the first choice in the management of this type of neoplasm. It is reserved for non-operable tumors. This treatment is also reserved for use in tumors that are left behind by surgical resection.
  • Surgery – Refers to the removal of the entire mass and including the salivary gland of origin. For the parotid gland (superficial parotidectomy, partial), submandibular gland (needs complete removal of the gland to ensure no recurrence of the mass)
  • Removal of the lymph nodes of the neck- Since the lymph nodes are responsible for the removal of toxins from the body, it has a higher chance of malignant potential that can be addressed by prompt removal before they become cancerous.

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