Types and methods of treatment of neoplasms of the parotid salivary glands

Causes of parotid salivary gland tumors

At the current stage of medical development, it is not known for sure why some people develop tumors and others do not. Most likely, it is influenced by a number of factors: from genetic predisposition to environmental deterioration, from harmful dietary habits to stress-induced changes in the work of the endocrine system. In any case, every Ukrainian doctor can note that the number of patients with tumors, including malignant ones, has been increasing in recent years. Therefore, even if the lump under the ear causes purely aesthetic discomfort, it cannot be ignored in any case.

What types of neoplasms are there in the parotid salivary glands?

Neoplasms of the salivary glands are benign and malignant. Types of benign neoplasms:

• a cyst is a soft tissue bag with liquid contents;
• pleomorphic adenoma is the most common neoplasm of the parotid salivary gland in adults, which has a tendency to malignancy (transformation into cancer);

Wharton’s tumor (adenolymphoma of the parotid salivary gland) is a tumor with a glandular structure and a complex anatomical location. It can occur on both paired glands at once.

Malignant neoplasms require treatment by an oncologist, who decides on the extent of the necessary surgery and chemotherapy or radiation. It can be a carcinoma, a cylindroma (aggressive tumor of a cylindrical shape), focal formation of the parotid salivary gland with metastases, and other types of cancer. The surgeon removes the primary focus then and in such a way as the oncologist determines.

Symptoms of a tumor in the salivary gland

The first and obvious symptom is the appearance of a lump in the parotid or submandibular region. At the same time, in the case of adenolymphoma or adenoma, the parotid salivary gland does not necessarily hurt. If it is a cyst, inflammation and suppuration are possible, accompanied by pain, swelling of the parotid salivary gland and increased sensitivity. Sometimes the lump remains the same size and does not cause discomfort, except for aesthetic, but when the tumor grows, it begins to press on the surrounding tissues and the facial nerve. Asymmetry of the face becomes more pronounced, difficulties with opening the mouth are possible. The larger the neoplasm, the more difficult it is for the surgeon to completely remove it without damaging the anatomical structures of the face.

How are neoplasms in the parotid salivary glands diagnosed?

The first thing a doctor should do when seeing a patient with a salivary gland neoplasm is to take a puncture under ultrasound control. After receiving a histological report, the maxillofacial surgeon understands what he is dealing with: if it is a benign tumor, he prepares the patient for surgery, if the neoplasm is malignant, he refers him to an oncologist. When it comes to cancer, additional studies are conducted (computed tomography of the lungs and CT with contrast), because such tumors quickly metastasize to the neck lymph nodes and lungs. Thus, the earlier a person consults a doctor, the less the risk that the tumor will turn into a malignant one. But if this has already happened, with a comprehensive approach to treatment, there is a fairly high chance of defeating the disease.

A CT scan of the head and neck or an MRI of the parotid salivary gland helps determine which benign neoplasm needs to be dealt with, as well as the optimal access and volume of the future operation.

Is it possible to cure a tumor of the salivary glands with medication?

All types of salivary gland tumors are treated exclusively surgically. Massage of the parotid salivary gland and drug treatment will not help get rid of the neoplasm, and fear of surgery and reluctance to consult a maxillofacial surgeon can lead to fatal consequences. Thus, pleomorphic adenoma of the parotid salivary gland eventually becomes malignant, and as a result of constant inflammation of the cyst of the parotid salivary gland, an abscess (formation of a cavity filled with pus) may occur.

How is the removal of neoplasms of the salivary glands?

The technique and tactics of surgery to remove a tumor of the parotid salivary gland largely depend on the result of histological examination. If it is a benign neoplasm (a non-malignant pleomorphic adenoma), it is completely removed, the postoperative period passes easily, and usually the patient does not even need to be hospitalized: he can go home the same day. Wharton’s tumor is a more complicated case because it is surrounded by the ascending branch of the subclavian vein. Moreover, such a tumor can have a multilevel lobular structure that must be removed completely (there was such a case in our practice), so the removal of an adenolymphoma requires considerable skill and endurance from the maxillofacial surgeon. As for the cyst, it is also important to remove not only its liquid contents, but also the sac itself — thus ensuring no recurrence.

In the case of carcinoma of the parotid salivary gland, not only the tumor itself is radically removed, but also healthy tissues nearby with some margin, because the cancer does not have clear boundaries and its protrusions spread around. If necessary, the maxillofacial surgeon removes the affected salivary gland in whole or in part (subtotal resection of the parotid salivary gland), and then its functions are taken over by the other 5 remaining glands. An oncologist prescribes further treatment for a cancer patient.

Recommendations for recovery after removal of a tumor in the salivary gland

Recommendations for recovery after tumor removal also depend on the histological results of the parotid salivary gland. If we are talking about a benign neoplasm, the patient usually does not need to be hospitalized, and recovery lasts about two weeks. At this time, he should refrain from physical exertion, stay in the open sun or in the solarium and visit the sauna, as well as come to check-ups prescribed by the maxillofacial surgeon and follow his recommendations.

Further therapy in the treatment of cancer (radiation or chemical) is prescribed by an oncologist. The removed tumor can be sent for immunohistochemical analysis, which helps to choose the optimal drugs and dosage for chemotherapy.

What complications can a neoplasm in the salivary gland cause?

An innocent-looking lump under the ear can lead to fatal consequences if there is a malignant tumor inside. Even a benign cyst can cause a number of problems, including damage to the facial nerve, if it continues to grow and become inflamed. Therefore, when a neoplasm appears, it is important to consult a maxillofacial surgeon as early as possible, when it is easier to remove the tumor completely without damaging the nerve and other structures. We at the Sirius Dent Medical Center have extensive experience in the treatment of salivary gland neoplasms of all types.