Carcinoma of Salivary Glands

Types

• Mucoepidermoid carcinoma:
  • The most common type.
• Adenoid cystic carcinoma.
• Acinic cell carcinoma.
• Adenocarcinoma.
• Carcinoma ex pleomorphic adenoma.
• Undifferentiated.

Spread

• Direct: to the surroundings.
• Lymphatic: to cervical LNs.
• Blood: rare & late.

Complication

• Ulceration.
• Hemorrhage.
• Infection.
• Nerve palsy.

Symptom

• Swelling: rapidly growing on the side of the face.
• Pain: may radiate to the ear, increase by mastication.

Sign

• Swelling usually warm.
• Mildly tender.
• Hard in consistency.
• Ill-defined edge.
• Nodular surface.
• Rapid rate of growth.
• Infiltration of skin, muscles, vessels & nerves.
• Cervical LNs:
  • Enlarged, stony hard, mobile then fixed.

Investigation

• FNA.
• CT.

Treatment

• According to the site of the tumor:
  • Cancer in parotid gland:
    • Total radical parotidectomy + total block dissection of the neck LNs + postoperative radiotherapy to decrease recurrence.
  • Carcinoma in the submandibular gland:
    • Complete excision and total block dissection of the neck LNs + postoperative radiotherapy to decrease recurrence.