Treatment approaches for benign tumors of major salivary glands

Abstract

Introduction: Salivary gland tumours (SGT) are heterogenous group of neoplasms in the maxillofacial area with complex morphologic appearances and different clinical behaviour. They often present as painless enlarging masses, mostly located in parotid glands and mostly benign. Epidemiology: SGT’s are more common in women than in men which represents 2%-3% of head and neck neoplasms. Pleomorphic adenomas are most common benign SGT’s followed by Warthin tumours. Treatment: Difficulty with salivary gland tumour is they are rare and have long clinical course that requires follow up data for a decade or more. Prospective randomised trails have therefore not been undertaken and hence progress happens slowly. Improved methods of assessment (MRI, CT, Ultrasound, fine needle aspiration biopsy) have had major impact on salivary gland surgery. Most benign tumours are either pleomorphic adenomas (71%) or Warthin’s tumours (22%). Conclusion: Treatment for this include both medical and surgical therapy. Medical therapy is indicated for inflammatory infectious masses (eg: reactive or fungal) and lymphoma. When symptomatic, recurrent chronic gland infection (eg: parotitis) proves refractory to conservative medical or endoscopic (i.e. sialoendoscopy) treatments, salivary gland excision is sometimes indicated. Surgical therapy includes parotidectomy and submandibular gland surgery.