# Salivary gland cancer - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Recognition & Referral) ## Complete treatment card ```text SALIVARY GLAND CANCER 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 Review status: REVIEWED against the source listed above (2026-08) 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 Source StatPearls "Malignant Salivary Gland Tumors" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)[1st line] Adult 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 Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. 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. Caution 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. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)