Spectrum of primary salivary gland tumors with special emphasis on their management and outcome at a rural tertiary care centre

Dwaipayan Samaddar, Jaya B. Samaddar, Ahmad M. Aziz


Background: Salivary gland tumors (SGT) are uncommon tumors of diverse histopathology accounting for <2% of all neoplasms. Early diagnosis differentiates between benign and malignant SGT and less extensive surgical procedure can be performed. The objective is to study the spectrum of primary SGT with special emphasis on their distribution, treatment and outcome at a rural tertiary care centre.

Methods: A prospective observational study was conducted on 30 consecutive primary SGT patients attending the Departments of Surgery and Otorhinolaryngology of North Bengal Medical College and Hospital over a period of one and half years. All patients were clinically evaluated, investigated, treated accordingly and followed up during the period of study. Data was collected and compiled in Excel sheet and analysed using GraphPad Software and GraphPad QuickCalcs 2018 (San Diego, CA). A p value <0.05 was considered statistically significant.

Results: Maximum patients (83.3%) were in the age range of 31-60 years. The male to female ratio was 1:4 for benign tumours and 1:1 for malignant tumours. Malignant cases were 66.67%. Involvement of parotid gland was the commonest (43.3%) and mostly presented with swelling (73.3%). Pleomorphic salivary adenoma was the commonest benign tumor (33.3%) and mucoepidermoid carcinoma was the commonest malignant tumor (16.7%). Permanent facial palsy was observed in 2 (9.5%) and recurrence in 4 patients (19%).

Conclusions: SGT are rare and present in various modes. Malignant cases were singularly more in this study.


Mucoepidermoid carcinoma, Pleomorphic salivary adenoma, Salivary gland

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Lingen MW. Head and Neck. In: Kumar V, Abbas AK, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 9th edn. South Asia Edition: Elsevier India; 2015:744.

Gillespie MB, Albergotti WG, Eisele DW. Recurrent salivary gland cancer. Curr Treat Option Oncol. 2012;13(1):58-70.

Hom-Ross PL, Morrow M, Ljung BM. Diet and the risk of salivary gland cancer. Am J Epidemiol. 1997;146(2):171-6.

Horn-Ross PL, Ljung BM, Morrow M. Environmental factors and the risk of salivary gland cancer. Epidemiology. 1997:414-9.

Swanson GM, Burns PB. Cancers of the salivary gland: workplace risks among women and men. Annal Epidemiol. 1997;7(6):369-74.

Dong C, Hemminki K. Second primary neoplasms among 53 159 haematolymphoproliferative malignancy patients in Sweden, 1958-1996: a search for common mechanisms. Bri J Cancer. 2001;85(7):997-1005.

Sun EC, Curtis R, Melbye M, Goedert JJ. Salivary gland cancer in the United States. Cancer Epidemiol Preven Biomark. 1999;8(12):1095-100.

Lee YY, Wong KT, King AD, Ahuja AT. Imaging of salivary gland tumours. Eur J Radiol. 2008;66(3):419-36.

Orell SR. Diagnostic difficulties in the interpretation of fine needle aspirates of salivary gland lesions: the problem revisited. Cytopathology. 1995;6(5):285-300.

Eveson JW, Cawson RA. Salivary gland tumours. A review of 2410 cases with particular reference to histological types, site, age and sex distribution. J Pathol. 1985;146:51‑8.

Barnes L, Eveson JW, Reichart P, Sidransky D. WHO classification of tumours. In: Pathology and Genetics of Head and Neck Tumours. Lyon France: IARC Press; 2005.

Subhashraj K. Salivary gland tumors: a single institution experience in India. Bri J Oral Maxill Surg. 2008;46(8):635-8.

Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M, Licitra L. Major and minor salivary gland tumors. Crit rev oncol/hematol. 2010;74(2):134-48.

Adelstein DJ, Koyfman SA, El-Naggar AK, Hanna EY. Biology and management of salivary gland cancers. Semin Radiat Oncol. 2012;22(3):245-53.

Ferlito A, Shaha AR, Rinaldo A, Mondin V. Management of clinically negative cervical lymph nodes in patients with malignant neoplasms of the parotid gland. ORL: J Oto-Rhino-Laryngol Rela Speci. 2001;63(3):123.

Califano L, Zupi A, Massari PS, Giardino C. Indication for neck dissection in carcinoma of the parotid gland. Our experience on 39 cases. Inter Surg. 1993;78(4):347-9.

Bhattacharyya N, Fried MP. Nodal metastasis in major salivary gland cancer: predictive factors and effects on survival. Arch Otolaryngol Head Neck Surg. 2002;128(8):904-8.

Stennert E, Kisner D, Jungehuelsing M, Guntinas-Lichius O, Schröder U, Eckel HE, et al. High incidence of lymph node metastasis in major salivary gland cancer. Archiv Otolaryngol Head Neck Surg. 2003;129(7):720-3.

Bell RB, Dierks EJ, Homer L, Potter BE. Management and outcome of patients with malignant salivary gland tumors. J Oral Maxill Surg. 2005;63(7):917-28.

Armstrong JG, Harrison LB, Spiro RH, Fass DE, Strong EW, Fuks ZY. Malignant tumors of major salivary gland origin: a matched-pair analysis of the role of combined surgery and postoperative radiotherapy. Arch Otolaryngol Head Neck Surg. 1990;116(3):290-3.

Parkin DM, Ferlay J, Curado MP, Bray F, Edwards B, Shin HR, et al. Fifty years of cancer incidence: CI5 I–IX. Inter J Cancer. 2010;127(12):2918-27.

Carvalho AL, Nishimoto IN, Califano JA, Kowalski LP. Trends in incidence and prognosis for head and neck cancer in the United States: a site‐specific analysis of the SEER database. Inter J Cancer. 2005;114(5):806-16.

Nandakumar A. National cancer registry programme. Indian Council of Medical Research, Consolidated report of the population-based cancer registries, New Delhi, India. 1990: 96.

Shanta V, Swaminathan R, Nalini J, Kavitha M. Consolidated Report of Population Base Cancer Registries 2001‑2004. National Cancer Registry Programme Indian Council of Medical Research. Co‑Ordin Unit, Nation Cancer Regi Prog. 2006:1 35‑53.

Ito FA, Ito K, Vargas PA, De Almeida OP, Lopes MA. Salivary gland tumors in a Brazilian population: a retrospective study of 496 cases. Inter J Oral Maxillofacial Surg. 2005;34(5):533-6.

Sando Z, Fokouo JV, Mebada AO, Djomou F, NDjolo A, Oyono JL. Epidemiological and histopathological patterns of salivary gland tumors in Cameroon. Pan Afri Med J. 2016;23(1):66.

Saghravanian N, Ghazi N, Saba M. Clinicopathologic evaluation of salivary gland neoplasms: a 38-year retrospective study in Iran. Annal Diag Pathol. 2013;17(6):522-5.

Kara MI, Göze F, Ezirganli S, Polat S, Muderris S, Elagoz S. Neoplasms of the salivary glands in a Turkish adult population. Med Oral Patol Oral Cir Bucal. 2010;15(6):e880-5.

Wang XD, Meng LJ, Hou TT, Huang SH. Tumours of the salivary glands in northeastern China: a retrospective study of 2508 patients. Bri J Oral Maxill Surg. 2015;53(2):132-7.

Gao M, Hao Y, Huang MX, Ma DQ, Chen Y, Luo HY, et al. Salivary gland tumours in a northern Chinese population: a 50-year retrospective study of 7190 cases. Inter J Oral Maxill Surg. 2017;46(3):343-9.

Taghavi N, Sargolzaei S, Mashhadiabbas F, Akbarzadeh A, Kardouni P. Salivary gland tumors: a 15-year report from Iran. Turkish J Pathol. 2016;32(1):35-9.

Fonseca FP, de Vasconcelos Carvalho M, de Almeida OP, Rangel AL, Takizawa MC, Bueno AG, et al. Clinicopathologic analysis of 493 cases of salivary gland tumors in a Southern Brazilian population. Oral Surg, Oral Med, Oral Pathol Oral Radiol. 2012;114(2):230-9.

Bello IO, Salo T, Dayan D, Tervahauta E, Almangoush A, Schnaiderman-Shapiro A, et al. Epithelial salivary gland tumors in two distant geographical locations, Finland (Helsinki and Oulu) and Israel (Tel Aviv): a 10-year retrospective comparative study of 2,218 cases. Head Neck Pathol. 2012;6(2):224-31.

Taghavi N, Sargolzaei S, Mashhadiabbas F, Akbarzadeh A, Kardouni P. Salivary gland tumors: a 15-year report from Iran. Turkish J Pathol. 2016;32(1):35-9.

Comoglu S, Ozturk E, Celik M, Avci H, Sonmez S, Basaran B, et al. Comprehensive analysis of parotid mass: A retrospective study of 369 cases. Auris Nasus Lary. 2018;45(2):320-7.

Kumaran JV, Daniel MJ, Krishnan M, Selvam S. Salivary gland tumors: An institutional experience. SRM J Res Dental Sci. 2019;10(1):12.

Fomete B, Adebayo ET, Ononiwu CN. Management of salivary gland tumors in a Nigerian tertiary institution. Annal Afri Med. 2015;14(3):148.

Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M, Licitra M. Major and minor salivary gland tumors. Crit Rev Oncol Hematol. 2010;74(2):134-48.

Laccourreye H, Laccourreye O, Cauchois R, Jouffre V, Ménard M, Brasnu D. Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: a 25‐year experience with 229 patients. Laryngoscope. 1994;104(12):1487-94.

Laskawi R, Schott T, Mirzaie-Petri M, Schroeder M. Surgical management of pleomorphic adenomas of the parotid gland: a followup study of three methods. J Oral Maxill Surg. 1996;54(10):1176-9.