Benign salivary gland tumors represent a diverse group of neoplasms with varied clinical behaviors. Successful management of these neoplasms relies on accurate clinical and diagnostic assessment, as well as appropriate therapeutic intervention. A strong understanding of the biologic behavior of the various types of lesions allows the development of an appropriate treatment plan tailored to each individual patient affected.
Tumors of the salivary glands account for only 2-4% of head and neck neoplasms. Most (~70%) salivary gland tumors originate in the parotid gland, with the bulk of the remainder arising in the submandibular gland (~8%) and in the minor salivary glands (~22%).
Although 75% of parotid gland tumors are benign, slightly more than 50% of tumors of the submandibular gland and 60-80% of minor salivary gland tumors are found to be malignant.
Benign minor salivary gland tumors thus are relatively uncommon neoplastic entities. Of these, pleomorphic adenoma, cystadenoma, and canalicular adenoma are the most frequently encountered.
The ubiquitous deposition of the minor salivary glands complicates the diagnosis and management of salivary gland tumors. The approach to a suspected tumor of the minor salivary glands begins with a thorough history and a physical examination. Radiographic imaging (computed tomography [CT] with or without magnetic resonance imaging [MRI]) and a histopathologic diagnosis (obtained via fine-needle aspiration [FNA] cytology) often provide useful diagnostic information prior to definitive surgical therapy.
The general consensus is that definitive surgical therapy is indicated for most benign tumors of the minor salivary glands (with some notable exceptions). (See Treatment.) The primary contraindication for surgical treatment of benign salivary gland tumors is the presence of associated medical comorbidities that preclude the use of general anesthesia.