Dawaa Reference

Clinical reference

Salivary gland cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD28.04 - condition scope only, no dose · Malignant Salivary Gland Tumors - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK563022/ · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • A palpable lump in a salivary gland area, sometimes painful, is the usual presenting complaint [skin nodule]
  • Difficulty swallowing and facial weakness may also feature in the history [difficulty swallowing · facial weakness]
  • Advanced disease can bring pain, palate or parapharyngeal fullness, trismus, skin ulceration, or a fistula [fistula · skin ulcer · trismus]
  • Tumours of the pharynx or larynx can cause painful swallowing, airway obstruction, a hoarse voice, and breathlessness on exertion [breathlessness · hoarseness · painful swallowing]
  • A mass growing rapidly, with pain, facial weakness, or neck node swelling, raises suspicion for malignancy [facial weakness · lymphadenopathy]

Signs — what you find (5)

  • Facial nerve palsy turns up in roughly 12 to 15 percent of parotid cancers, especially with adenoid cystic, mucoepidermoid, or salivary duct carcinoma [cranial nerve palsy]
  • Submandibular cancers tend to feel firm and lobulated and may be fixed to skin or deeper tissue
  • A large, fixed mass in front of the ear can come with metastatic neck nodes
  • Sublingual gland cancer often shows as a painless, non-ulcerated floor-of-mouth mass, though about half of cases are painful and numb
  • Salivary NHL can show one- or two-sided parotid swelling with neck node enlargement, splenomegaly, and skin vasculitis with purpura [parotid swelling · purpura · rash · splenomegaly]

Tests (9)

  • Ultrasound is the first non-invasive study, best for superficial parotid lesions and for guiding a needle biopsy
  • Uneven echo texture, blurred margins, local invasion, and enlarged nodes on ultrasound point to malignancy
  • MRI is favoured for assessing deep-lobe, sublingual, or minor gland tumours, including nerve involvement
  • MRI outperforms CT for detecting perineural spread, particularly with adenoid cystic carcinoma
  • PET cannot separate benign from malignant tumours, since benign ones like pleomorphic adenoma also take up glucose avidly
  • Fine-needle aspiration is preferred over incisional biopsy for parotid lesions and separates benign from malignant with about 80 percent sensitivity and 97 percent specificity
  • FNA can struggle to pin down the exact malignant subtype and tumour grade
  • Core needle biopsy carries more pain and a higher risk of facial nerve injury and haematoma than FNA
  • An intraoperative frozen section tells benign from malignant with about 90 percent sensitivity and 99 percent specificity

If not this — what else fits (6)

  • A range of benign salivary tumours, such as pleomorphic adenoma or Warthin tumour, top the differential
  • Benign cysts, sialadenitis, and sialoliths are also considered
  • Reactive node swelling from infection or inflammation is on the list, including tuberculosis and mononucleosis
  • Chronic sclerosing sialadenitis, or Kuttner tumour, is more often seen in the submandibular gland
  • First branchial cleft cysts and lymphoepithelial cysts are considered, the latter especially in HIV-positive patients
  • Metastases from cancers elsewhere in the body can also mimic a primary salivary tumour

SourceStatPearls "Malignant Salivary Gland Tumors" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line
Adult dose and duration

A firm, growing, or fixed salivary gland mass (usually parotid) is suspicious for malignancy and needs urgent ENT/head-and-neck surgical referral for biopsy and staging; there is no primary-care drug treatment. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A firm, growing, or fixed salivary gland mass (usually parotid) is suspicious for malignancy and needs urgent ENT/head-and-neck surgical referral for biopsy and staging; there is no primary-care drug treatment.

Cautions
  • Rare in Egyptian primary care.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Concerning signs of malignancy beyond a firm, growing or immobile mass are rapid growth, pain, facial nerve paresis, and cervical lymphadenopathy.
  • RED FLAG - Fixation to skin or deep tissue, hard cervical lymphadenopathy, or pain, which is uncommon in benign salivary tumours.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.