6.4.3: 3. Evaluation of Submandibular Salivary Gland Mass- Key Points
- Page ID
- 18324
\( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \) \( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)\(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\) \(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\)\(\newcommand{\AA}{\unicode[.8,0]{x212B}}\)
- 50% are malignant
- Adenoid cystic carcinoma is the most common malignancy
- Clinical evaluation, cytology and imaging do not conclusively exclude malignancy….hence complete resection of the tumour and histological examination are required, or if surgery is not to be done, a core needle biopsy
- Objectives of preoperative evaluation
- Distinguish between a submandibular lymph node and salivary mass
- Avoid unnecessary surgery
- Do appropriate surgery
- Avoid embarking on surgery that is beyond the scope of a surgeon e.g. tumour requiring neck dissection
- History and examination are important means to identify non-neoplastic causes e.g. sialadenitis, sialolithiasis, and benign and malignant primary tumours, although 2/3 of malignant tumours are clinically benign
- FNAC is helpful in selected cases
- Ultrasound may distinguish a lymph node from a salivary mass, and identify cervical nodal metastases
- Histological classification of primary salivary gland neoplasms is difficult and complex. Cytological and histological diagnoses should always be treated with caution and viewed in a clinical context, especially if not reported from centers of excellence