Salivary Glands’ Tumour Therapy
The three major paired salivary glands – parotid, submandibular, and sublingual along with the hundreds of small minor salivary glands can potentially give rise to a wide range of neoplasms. The most frequently affected site of salivary gland neoplasia is the parotid gland. Parotid neoplasms are mostly benign whereas submandibular gland and minor salivary gland neoplasms have a greater likelihood of being malignant. Overall, the incidence of malignancy in the parotid gland is 25%, in the submandibular gland 50%, and in minor salivary glands 60-75%. Benign tumors of the salivary glands are generally asymptomatic.
The benign mixed tumors, or pleomorphic adenomas, are the most common tumor of major and minor salivary glands. At approximately 85% of the cases, these tumors are found in the parotid gland. Among these, Warthin’s tumor, also termed as adenolymphoma or papillary lymphomatous cystadenoma, is the second most common benign neoplasm accounting for approximately 15% of all parotid epithelial tumours. This tumor has greater prevalence in male patients (4:1 male:female ratio) during the sixth and seventh decades of life. A particular characteristic of the Warthin’s tumor is its tendency to grow bilaterally, unlike the other benign neoplasms of the salivary glands. The most common area (approximately 90%) of the lesions is the superficial lobe of the parotid gland.
The treatment of the benign tumors of parotid glands includes lateral lobectomy or total parotidectomy with preservation of the facial nerve. This nerve can be identified in five different positions that need to be taken into consideration in any type of parotid surgery. Surgical complications may include postoperative bleeding, gustatory sweating (sweating soon after ingesting food) or nerve injury that can occur as a temporary paralysis of myofacial muscles (failure to depress the lower lip, close the eyes or raise the forehead, or puff the cheeks). Malignant transformation is described in only 0.1% of cases. The incidence of recurrence of benign neoplasm after surgical treatment is extremely rare.
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