• Paired major salivary glands include parotid, submandibular, and sublingual glands
• Minor salivary glands are distributed in the mucosa of the lips, cheeks, hard and soft palate, uvula, floor of mouth, tongue, and peritonsillar region
• Few salivary glands in the nasopharynx, paranasal sinuses, larynx, trachea, bronchi, and lacrimal glands
• About 5% of head and neck tumors are in the salivary glands
• 5 times more prevalent in major than minor salivary glands (70% in parotids)
• Malignancy rates by gland:
• 70% of parotid tumors are pleomorphic adenomas (50% of all salivary gland tumors)
• Mixed tumors are more common in women, with peak incidence in fifth decade
• Warthin tumor accounts for 5% of parotid tumors
• Monomorphic tumors are rare and seen most commonly in the minor salivary glands of the lip
• Mucoepidermoid carcinoma is the most common parotid cancer
• Acinic cell carcinomas are found almost exclusively in the parotid
• Descending frequency of minor salivary gland carcinomas: Adenoid cystic, adenocarcinoma, mucoepidermoid
• 70% of minor salivary gland carcinomas occur in the oral cavity, principally hard palate
• Nodule in the parapharyngeal space
• Enlarged cervical lymph nodes
• Weakness in the muscles of facial expression
• Cranial nerve palsies
• Majority of tumors derived from intercalated and excretory duct cells; rarely, myoepithelial cells
• Benign neoplasms of the salivary gland:
• Malignant neoplasm of the salivary gland:
• In parotid region, presence of pain, rapid enlargement of preexisting nodule, skin involvement or facial nerve paralysis suggests cancer
• Enlarged cervical lymph nodes in association with salivary gland tumors are considered manifestations of cancer until proven otherwise
• Complete history and physical exam
• For minor salivary gland, often perform incisional biopsy to plan for definitive treatment (as these are more often malignant)
• Benign tumors are removed with margin of normal tissue
• For low-grade salivary gland cancers, complete excision is sufficient
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