Salivary Gland Cancer

Diagnosis

Diagnosis of salivary gland tumor can be done through the following methods:

• Medical history and physical examination: The patients undergo a comprehensive physical examination to check for the signs associated with salivary gland cancer or other diseases causing symptoms. The patients are also asked about their medical or family health history, which assists in determining the severity of the risk of salivary gland cancer. If the doctor finds anything suspicious, they may recommend the patients to visit the otolaryngologists for a detailed examination of the throat and oral cavity. The patients may expect laryngoscopy and pharyngoscopy during this examination.
• Magnetic resonance imaging: It is recommended to perform MRI for all tumors as there is a high risk of malignancy. It is also the preferred method in cases where the patients have palpable masses with high suspicion of malignancy. MRI provides detailed information about the site and extent of lesions. It also allows examination of the surrounding structures and detects the spread of salivary gland cancer to bone and meninges. Promising results have been obtained with advanced MR imaging techniques, such as proton MR spectroscopy, diffusion-weighted MRI, and dynamic contrast enhancer MRI in differentiating malignant and benign salivary gland tumors.
• Computed tomography: Patients may undergo computed tomography (CT) scan to diagnose salivary gland cancer. Compared to other imaging techniques, a CT scan more accurately evaluates tumor location and spread to the parotid gland. It also allows differentiating between benign and malignant tumors. This method is also implemented in patients more likely to have inflammatory conditions, such as acute inflammation, calculi, abscess, and major salivary duct dilatation, or in patients where the MRI is impossible.
• Positron emission tomography: PET scan provides vital information about the staging, histological grading, and response after treatment. It is a non-invasive procedure that provides information about the anatomy and metabolic processes. Oncologists sometimes combine PET and CT scans (PET-CT) to improve diagnostic accuracy.
• X-rays: It is performed during the advanced stage of the salivary gland tumor to determine if the salivary gland cancer has spread to the lungs. X-rays are also performed in the jaws and teeth to further evaluate swelling or lump near the jaw.
• Ultrasound: Ultrasound may also be performed to determine any swelling in the lymph nodes of the neck. Abnormalities in the lymph nodes may also be detected, indicating the presence of salivary gland cancer. Cancer specialists may also use ultrasound while performing the fine needle biopsy. In some cases, ultrasound provides information about the recurrence of salivary gland cancer.
• Biopsy: Biopsy involves obtaining a sample of the abnormal tissue of the salivary gland or any organ and evaluating them in the laboratory to detect the presence of cancerous cells. Several types of biopsies are used to obtain the sample. A fine needle biopsy involves using a very fine needle, and the sample is obtained under the guidance of imaging techniques, such as ultrasound. A core needle biopsy involves a hollow needle to obtain tissue samples when an adequate sample is not obtained through a fine needle biopsy. If there is a need for a large tissue sample, the patients may undergo an incisional biopsy. The oncosurgeons may completely remove the salivary gland tumor if there is no confirmatory diagnosis of the tumor and it is suspected to be malignant.