Overview

The salivary glands produce enzymes to digest food and antibodies to prevent mouth and throat infections. Tumors are either malignant (cancerous) or benign (non-cancerous). They grow in both groups of salivary glands, known as major and minor.

Major salivary glands include:

  • Parotid - These are the largest glands and are found near the bottom of each ear. Approximately two-thirds of salivary gland tumors develop there.
  • Sublingual - These two glands are located under the tongue.
  • Submandibular - This pair of glands sits below the jawbone.

There also hundreds of tiny, minor salivary glands scattered throughout the mouth, nose and throat. While tumors are less likely to develop there, there is a greater chance they will be malignant, rather than benign. Minor salivary gland cancer is usually found on the roof of the mouth. 

There are two broad categories of salivary gland tumors:

  • Lymphomas
  • Carcinomas (Mucoepidermoid Carcinoma, Adenoid Cystic Carcinoma, Adenocarcinomas)

Given the range of possible tumor locations and potentially microscopic gland size, it’s important to see a medical team with extensive diagnostic experience.

Salivary Gland Stones, Infections and Benign Tumors

Nearly three-quarters of salivary gland tumors are benign. But these non-cancerous growths still require surgical removal in many cases, with procedures similar to those for malignant tumors. 

Other, tumor-like growths may just require steroidal medication. Additional salivary gland problems can include:

  • Sialolithiasis (stones) - calcium buildups that can stop saliva flow
  • Sialadenitis - bacterial infections
  • Viral infections
  • Cysts 
  • Sjögren's Syndrome - a chronic condition in which white blood cells attack the salivary gland
  • Sialadenosis - enlargement of one of the salivary glands, usually the parotid

These conditions are not cancerous but could still require medical treatment.

Our approach

Salivary gland cancer is hard to diagnose without the right expertise. There are several sets of larger glands but also hundreds of tiny ones to examine. It’s important to distinguish between cancerous and benign tumors — both need treatment, but may require separate, refined approaches.

Special expertise and techniques are required to diagnose salivary gland cancer. Many of the glands are tiny and spread throughout the mouth, nose and throat. Doctors also need to draw the crucial distinction between malignant (cancerous) and benign tumors.

The doctors at Center for Head and Neck Oncology use the latest tests, scans and other diagnostic tools to quickly and accurately make those decisions. That allows them to move on to the next step: talking to the patient about the best way to treat their salivary gland, with a personal approach the ultimate goal.

From pathologists to ear, nose and throat specialists, the team members have the experience and specialized training to successfully treat salivary gland cancer. Physicians around the world consult the doctors at the Center for Head and Neck Oncology because of their expertise. They take special precautions to protect the delicate facial nerve, a key consideration in many salivary gland cases.

Caring for Salivary Gland Tumors with a Team Approach

An ear, nose and throat specialist (otolaryngologist or ENT) will work directly with each patient throughout their salivary gland treatment. But the multidisciplinary team also includes specialists from across the North Shore-LIJ Health System and the Center for Head and Neck Oncology. They meet weekly to discuss cases, ensuring that patients receive the most useful, appropriate and up-to-date treatments. 

Risk factors

While the cause of salivary gland cancer is unknown, researchers have identified a few risk factors that could increase the chances of getting the disease:

  • Older age
  • Previous head and neck radiation treatment
  • Exposure to certain metals (like nickel alloy dust) or minerals (like silica dust) at work

Symptoms

Most symptoms of salivary cancer are caused by tumors expanding a gland. Symptoms can include:  

  • A lump (usually painless) inside the mouth or in the ear, cheek, jaw or lip
  • Fluid draining from the ear
  • Trouble swallowing or opening the mouth all the way
  • Facial numbness or weakness
  • Facial pain that won’t go away

Just because someone has these symptoms doesn’t necessarily mean they have salivary gland cancer. See a doctor to determine what the cause of symptoms. 

Diagnosis

Specialists use many diagnostic tools to identify salivary gland cancer, including:

  • Physical exam - Looking at the head, neck, mouth and throat for lumps or other disease signs
  • Endoscopy - Inserting a thin tube and camera into the mouth to look at the mouth, throat and larynx (voice box)
  • CT (CAT) scan - Overlapping X-rays from different angles, with dye sometimes injected into veins or swallowed to allow doctors to see delicate, tiny structures
  • PET (Positron Emission Tomography) scan - Injecting glucose (sugar) into the veins and using a rotating scanner to look for malignant cells throughout the body, not just at the origin site of the cancer (where it first started to grow)
  • MRI (Magnetic Resonance Imaging) - Using a magnet, radio waves and a computer to take detailed pictures of the inside of the body
  • Biopsy - Removing cells or tissue and examining them with a microscope
  • Surgery - Removing the whole growth to check for cancer