Introduction
Neoplasms of the salivary gland is the next most common neoplasms of the mouth after squamous cell carcinomas [PSI].
Above 70% develop in the parotid gland
Over three-quarters are benign
Women are slightly more frequently affected
Classification
The modified WHO classification (1972) includes:
Epithelial tumours
-
Adenomas:
- Pleomorphic adenoma (‘mixed tumour’)
- Monomorphic adenomas
- Warthin’s tumour, oxyphoitic adenoma
-
Carcinomas:
- Mucoepidermoid carcinoma
- Acinic cell carcinoma
- Adenocarcinoma
- Epidermoid carcinoma
- Undifferentiated carcinoma
- Malignant mixed tumour
Non-epithelial tumours
- Lymphomas
- Sarcomas
Clinical features
- Benign tumours are generally asymptomatic enlargements
- Malignant varieties are painful, irregular, ulcerative and metastatic
Investigations
- Sialography
- Postero-anterior view of the skull
- Oblique lateral view of the jaws
Management
- Benign and malignant lesions: surgical excision
- Malignant lesions: radiotherapy and chemotherapy in addition to excision
- Secondary bacterial infections: treat with antibiotics e.g. ampicillin/cloxacillin 250/250 mg every 6 hours for 5-7days
- Adjust doses as appropriate for children