eMedicine Specialties > General Surgery > Glands

Salivary Gland Tumors, Minor, Benign: Workup

Author: Fadi Chahin, MD, Aesthetic and Reconstructive Surgery, Private Practice
Coauthor(s): Matthew R Kaufman, MD, Consulting Surgeon, The Plastic Surgery Center
Contributor Information and Disclosures

Updated: Nov 4, 2008

Workup

Laboratory Studies

  • A CBC count with differential may sometimes be elevated in the presence of an inflammatory process. This possibility must be excluded.

Imaging Studies

  • Some controversy exists regarding the routine use of imaging for small lesions of the superficial lobe of the parotid gland, as imaging findings do not usually alter management. However, CT or MRI is useful for suspected tumors of the deep lobe of the parotid gland or parapharyngeal space and of the submandibular, sublingual, and minor salivary glands. These imaging studies are useful for evaluating the local and possible regional extension of such tumors, assessing the possibility of invasion of the surrounding tissues, and aiding in planning the surgical resection.

Diagnostic Procedures

  • The utility of FNAB has been well established by Eneroth et al and others, who have advocated its use and reported accuracy rates of 74-90%.3 Although the procedure is somewhat operator dependent, it is generally regarded as safe, simple to perform, and relatively inexpensive and results in low morbidity.
  • Some controversy exists about whether the procedure is warranted for masses in the superficial lobe of the parotid gland, as it is not likely to change the management. However, if the FNAB results are consistent with lymphoma or sialadenitis, for example, a large resection would be unnecessary, alleviating patient and family anxiety.

Histologic Findings

See Clinical.

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References
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References

  1. Beahrs OH, Adson MA. The surgical anatomy and technic of parotidectomy. Am J Surg. Jun 1958;95(6):885-96. [Medline].

  2. Buxton RW, Maxwell JH, French AJ. Surgical treatment of epithelial tumors of the parotid gland. Surg Gynecol Obstet. Oct 1953;97(4):401-16. [Medline].

  3. Eneroth CM, Franzen S, Zajicek J. Aspiration biopsy of salivary gland tumors. A critical review of 910 biopsies. Acta Cytol. Nov-Dec 1967;11(6):470-2. [Medline].

  4. Conley JJ, et al. Salivary glands and the facial nerve. In: Tumors of the Minor Salivary Glands. 1975:263-267.

  5. Cross DL, Gansler TS, Morris RC. Fine needle aspiration and frozen section of salivary gland lesions. South Med J. Mar 1990;83(3):283-6. [Medline].

  6. Granick MS, Solomon MP, Hanna DC. Management of benign and malignant salivary gland tumors. In: Georgiade GS, Riefkohl R, Levin LS, eds. Georgaide Plastic, Maxillofacial, and Reconstructive Surgery. 3rd ed. Baltimore, Md: Williams & Wilkins; 1997:155-65.

  7. Hanna EY, Suen JY. Neoplasms of the salivary glands. In: Cummings CW, Fredrickson JM, Harker LA, et al, eds. Otolaryngology: Head and Neck Surgery. Vol 2. 3rd ed. 1998:1255-98.

  8. Nythus L, Lloyd M, Baker R, eds. Anatomy of the parotid gland, submandibular triangle, and the floor of the mouth. In: Mastery of Surgery. 3rd ed. Boston, Mass: Little Brown; 1997:293-312.

  9. Saleh HA, Abbarah T. Intraductal papilloma of the minor salivary gland involving the nasal cavity: is it a distinct histopathologic entity?. Otolaryngol Head Neck Surg. Jun 1998;118(6):850-2. [Medline].

  10. Seifert G, Sobin LH. The World Health Organization's Histological Classification of Salivary Gland Tumors. A commentary on the second edition. Cancer. Jul 15 1992;70(2):379-85. [Medline].

  11. Townsend CM, Beauchamp RD, Evers BM, et al. Salivary gland tumors. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 16th ed. Philadelphia, Pa: WB Saunders; 2001:547-52.

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Further Reading

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Keywords

salivary gland tumors, SGT, benign tumors of the minor salivary glands, benign epithelial tumors, pleomorphic adenoma, Warthin tumor, monomorphic adenoma, intraductal papilloma, oncocytoma, sebaceous neoplasms, cystadenoma lymphomatosum, cystic papillary adenoma, adenolymphoma, lymphoepithelial hyperplasia, Mikulicz disease, intraductal papilloma, papillary cystadenoma, oxyphil adenoma, oncocytoma, benign nonepithelial tumors, lipoma, hemangioma, angioma, lymphangioma, cystic hygroma, neural sheath tumors, melanoma, squamous cell carcinoma, salivary gland neoplasm, minor salivary gland resection, parotidectomy, intraoral resection, mandibulotomy, submandibular gland surgery

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Contributor Information and Disclosures

Author

Fadi Chahin, MD, Aesthetic and Reconstructive Surgery, Private Practice
Fadi Chahin, MD is a member of the following medical societies: American College of Surgeons, American Society of Plastic and Reconstructive Surgery, and American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Matthew R Kaufman, MD, Consulting Surgeon, The Plastic Surgery Center
Matthew R Kaufman, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Association of Plastic Surgeons, American Medical Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Sanjiv S Agarwala, MD, Chief of Oncology and Hematology, St Luke's Cancer Center, St Luke's Hospital and Health Network; Associate Professor of Cancer Biology, University of Pennsylvania
Sanjiv S Agarwala, MD is a member of the following medical societies: American Association for Cancer Research, American Society for Head and Neck Surgery, Eastern Cooperative Oncology Group, and European Society for Medical Oncology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David L Morris, MD, PhD, Professor, Department of Surgery, St George Hospital, University of New South Wales, Australia
Disclosure: Nothing to disclose.

CME Editor

Paolo Zamboni, MD, Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy
Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences
Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA, Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital
John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract
Disclosure: AMGEN Royalty Other; AstraZeneca Grant/research funds Other

 
 
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