Salivary Gland Cancers
Salivary gland cancers represent a diverse group of neoplasms with varied biological behaviour. The etiological factors behind these cancers range from exposure to radiation (ionizing to non-ionizing), UV rays, diet rich in PUFA, early menarche, multiparty, exposure to EB virus, and various genetic factors.
Majority of the tumours originate in the parotid gland, 80% of which are benign while 20% of them are malignant. Most of these patients (65%-80%) present with an asymptomatic parotid mass. The duration of symptoms before presentation averages 4-8 months. Palpable cervical lymph nodes, facial nerve palsy, deep tumour fixation, and rapid tumour enlargement suggest malignant changes.
Salivary gland cancers are radio-resistant, therefore the mainstay of treatment remains as surgery. Surgical resections of the parotid tumours revolve around the facial nerve. Hence the patients have to be counselled regarding facial nerve paresis and resection if found involved on the operating table. Radiation therapy is beneficial in the adjutant setting. Chemotherapy may be useful for palliation of unresectable / recurrent cases.