The salivary glands (the glands that secrete saliva) can be divided into two groups, i.e. major salivary glands and minor salivary glands. The major salivary glands include the parotid gland, submandibular gland and the sublingual gland. The minor salivary glands are tiny glands located on the oral mucosa, palate, uvula, floor of the mouth, posterior part of the tongue, retromolar and the peritonsillar areas. Carcinoma may arise from any of the major or the minor salivary glands. The exact cause of salivary gland carcinoma is not fully understood but smoking and exposure to radiotherapy of the head & neck area are considered as the major risk factors.
Carcinoma of the salivary gland usually presents as a slow-growing lump in the cheek along with dull but progressive pain. The tumour is usually fixed to the mandible and the adjacent muscles & the skin leading to restricted movements of the jaw. There may be anaesthesia of the overlying skin or the mucous membrane, resorption of the bone and enlarged lymph nodes in the neck. The parotid gland carcinoma usually presents as a rapidly growing tumour along with progressive facial nerve palsy and neuralgia.
Staging of salivary gland carcinoma is done as follows:
- In stage I of the tumour is less than 4 cm in size.
- In stage II, the tumour is 4 cm to 6 cm in size.
- In stage III, the tumour is more than 6 cm in size; or there is involvement of a single group of lymph nodes on the same side of the neck.
- In stage IV, the tumour is larger than 6 cm in size and invades adjacent tissues; or there is extensive involvement of the lymph nodes, or the tumour metastasises to distant parts of the body.
- Recurrent salivary gland carcinoma is the one that reappears after an apparent recovery in response to the initial treatment.
Procedures used in diagnosis & evaluation of the salivary gland carcinoma include MRI, CT scan and biopsy.
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