Neoplasms of the salivary gland treatment guideline

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